reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 16 - PATIENT RIGHTS › Section 8:43A-16.3 - Notice

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The administrator shall provide all patients
				and/or their families , upon request, the name, addresses, and telephone numbers of
				the following offices with which complaints may be lodged: the Division of Health
				Facility Survey and Field Operations and the State Long-Term Care Ombudsman
				.
(b) The administrator shall also
				provide all patients and/or their families upon request with the names, addresses,
				and telephone numbers of offices where information concerning Medicare and Medicaid
				coverage may be obtained.
(c) Addresses
				and telephone numbers contained in (a) and (b) above shall be conspicuously posted
				throughout the facility, including, but not limited to, the admissions waiting area
				or room, the patient service area of the business office, and other public
				areas.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 17 - HOUSEKEEPING, SANITATION AND SAFETY › Section 8:43A-17.1 - Housekeeping policies and procedures

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The housekeeping
				service shall have written policies and procedures that are reviewed every three
				years or as needed, revised as needed, and implemented. They shall include, at
				least, scope of responsibility, assignment by designated unit, and responsibility
				for all cleaning tasks.
(b) The
				housekeeping service shall have a written schedule that determines the frequency of
				cleaning and maintaining cleanliness for all equipment, structures, areas, and
				systems within its scope of responsibility.
(c) There shall be a list available at all times
				of all cleaning and disinfecting agents used in the facility together with their
				Materials Safety Data Sheets (MSDS).
(d)
				Records of all pesticides and herbicides used at the facility shall be maintained
				on-site, together with their Materials Safety Data Sheets (MSDS).
(e) All cleaning and disinfecting agents shall be
				correctly labeled with the name of the product and its use, as specified by the
				manufacturer, including agents that have been repackaged from a bulk
				source.
(f) All pesticides shall be
				applied in accordance with State Pesticide Control Code, N.J.A.C. 7:30.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 17 - HOUSEKEEPING, SANITATION AND SAFETY › Section 8:43A-17.2 - Housekeeping staff

Current through Register Vol. 56, No. 14, July 15, 2024
(a) There shall be an
				individual responsible for the housekeeping or environmental services. This
				individual may be a contracted provider.
(b) Housekeeping personnel shall be trained upon
				hire and on an annual basis or more frequently as necessary. Training should focus
				on cleaning procedures, including the selection and use of appropriate chemicals in
				the cleaning and care of equipment and surfaces.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 17 - HOUSEKEEPING, SANITATION AND SAFETY › Section 8:43A-17.3 - Housekeeping patient services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All areas, including
				areas with limited access such as cabinet drawers, locked medication rooms, and
				storage areas, shall be kept clean to sight and touch and free of condensation, mold
				growth and noxious odors.
(b) All
				equipment and materials necessary for cleaning, disinfecting, and sterilizing (if
				applicable) shall be provided.
(c) All
				household and cleaning products in the facility shall be identified, labeled, and
				securely stored in a cabinet, closet, or room which is inaccessible to
				patients.
(d) Housekeeping and cleaning
				supplies shall be selected and approved by the Infection Control Committee. They
				shall be measured and used correctly according to the manufacturers' written
				instructions.
(e) All toilets and
				bathrooms shall be kept clean to sight and touch, in good repair, and free of odors
				that reflect poor housekeeping practices.
(f) Toilet tissue, soap, and disposable towels or
				air driers shall be provided in each bathroom at all times. Soap and disposable
				towels or air driers shall be provided at each handwashing sink at all
				times.
(g) Reusable hand-cleanser
				dispensers shall be clean inside and out. Disposable dispensers shall be discarded
				and not refilled.
(h) Carpeting shall be
				kept clean and odor-free and shall not be frayed, worn, torn, or buckled.
(i) Window and partitioning curtains and drapes
				shall be kept clean to sight and touch and odor-free.
(j) Walls, ceilings, and vents shall be kept clean
				to sight and touch and odor-free.
(k)
				Windows and screens shall be kept clean to sight and touch and in good
				repair.
(l) Effective and safe controls
				shall be used to minimize and eliminate the presence of rodents, flies, roaches and
				other vermin in the facility. The premises shall be kept in such condition as to
				prevent the breeding, harborage, or feeding of vermin. All openings to the outer air
				shall be effectively protected against the entrance of insects.
(m) Nonskid wax shall be used on all waxed
				floors.
(n) All communal toys shall be
				washed after each use. No stuffed animals shall be allowed except for personal
				use.
(o) Plants and flowers shall not be
				allowed in patient treatment areas (such as operating rooms and procedure rooms) or
				sterile processing areas.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 17 - HOUSEKEEPING, SANITATION AND SAFETY › Section 8:43A-17.5 - Regulated medical waste and solid waste management

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Policies and
				procedures for solid waste and recyclables shall be established and enforced to
				ensure appropriate collection, storage and disposal and to maintain them clean and
				odor-free and to prevent the breeding of insects or vermin.
1. Plastic bags shall be used for solid waste
				removal from patient care units and support departments. Bags shall be of sufficient
				strength to safely contain waste from point of origin to point of disposal and shall
				be effectively closed prior to disposal.
2. Outside storage containers for solid waste
				shall be kept covered, except those used for corrugated cardboard, recyclables, or
				construction materials.
3. Garbage
				compactors shall be located on an impervious pad that is graded to a drain. The
				drain shall be kept clean and shall be connected to the sanitary sewage disposal
				system.
4. All solid waste that is not
				regulated medical waste shall still be disposed of in a manner approved by the New
				Jersey Department of Environmental Protection. Disposal shall be as frequent as
				necessary to avoid creating a nuisance.
5. Indoor storage containers for solid waste shall
				be fireproof and kept covered when necessary to control odors or other
				nuisances.
6. Solid waste shall be
				stored within the containers provided for it in an area that is kept clean. Waste
				shall be collected from the storage area regularly to prevent nuisances such as
				odors, flies, other vermin, or rodents, and so that waste does not overflow or
				accumulate beyond the capacity of the storage containers.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 18 - QUALITY ASSURANCE PROGRAM › Section 8:43A-18.1 - Quality assurance plan

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The facility shall
				establish and implement a written plan for a quality assurance program for patient
				care. The quality assurance plan shall be reviewed at least annually and revised as
				necessary. The plan shall specify a timetable and the individual responsible for
				coordinating the quality assurance program and shall provide for ongoing monitoring
				of staff and patient care services.
(b)
				There shall be a multidisciplinary committee responsible for the direction of the
				quality assurance program. The committee shall include at least representation from
				the medical staff, nursing staff and administration. The committee shall establish a
				mechanism to include participation of all disciplines in the identification of areas
				for review that affect patient care throughout the facility.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 18 - QUALITY ASSURANCE PROGRAM › Section 8:43A-18.2 - Quality assurance activities

Current through Register Vol. 56, No. 14, July 15, 2024
(a) There shall be an
				ongoing process for monitoring and evaluating patient care services, staffing,
				infection prevention and control, housekeeping, sanitation, safety, maintenance of
				physical plant and equipment, patient care statistics, and discharge planning
				services.
(b) Evaluation of patient care
				throughout the facility shall be criteria-based, so that certain review actions are
				taken or triggered when specific quantified, predetermined levels of outcomes or
				potential problems are identified.
(c)
				The quality assurance process shall incorporate periodic review of patient medical
				records.
(d) The quality assurance
				process shall include evaluation by patients of care and services provided by the
				facility. If the families of patients are routinely involved in the care and
				services provided by the facility, the quality assurance process shall include a
				means for obtaining input from families of patients.
(e) The administrator shall follow up on the
				findings of the quality assurance program to ensure that effective corrective
				actions have been taken, including at least policy revisions, procedural changes,
				educational activities, and follow-up on recommendations, or that additional actions
				are no longer indicated or needed.
(f)
				The quality assurance program shall identify and establish indicators of quality
				care specific to the facility, which shall be monitored and evaluated.
(g) The results of the quality assurance program
				shall be submitted to the governing authority at least annually and shall include at
				least deficiencies found and recommendations for corrections or improvements.
				Deficiencies which jeopardize patient safety shall be reported to the governing
				authority immediately.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.1 - Physical plant general compliance for new construction or alteration

Current through Register Vol. 56, No. 14, July 15, 2024
(a) New buildings and
				alterations and additions to existing buildings for freestanding ambulatory care
				facilities shall conform with the New Jersey Uniform Construction Code, N.J.A.C.
				5:23, and the construction guidelines.
(b) New buildings and alterations and additions to
				existing buildings for ambulatory care facilities that are part of an acute care
				hospital shall conform with the New Jersey Uniform Construction Code, N.J.A.C. 5:23,
				and the construction guidelines.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.2 - Physical plant general compliance for construction or alteration completed prior to the effective date of this chapter

Current through Register Vol. 56, No. 14, July 15, 2024
Existing buildings constructed or altered prior to the effective
				  date of this chapter shall be in conformance with Federal, State, and local
				  standards in effect at the time of construction, alteration, or approval of plans by
				  the Department.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.3 - Plan submission; payment of review fees

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Prior to any
				construction, plans shall be submitted for review and approval, in accordance with
				the provisions of this chapter, to the Health Care Plan Review Unit.
(b) Review fees shall be paid, pursuant to
				N.J.A.C. 8:31-1.1.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.4 - Alterations and repairs

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If alterations or
				repairs costing in excess of 50 percent of the physical value of the structure are
				made within any period of 12 months, requirements for new structures shall apply to
				the entire structure, including those portions not altered or repaired.
(b) If alterations or repairs costing between 25
				percent and 50 percent of the physical value of the structure are made within any
				period of 12 months, only the altered or repaired portions need to conform to the
				requirements for new structures.
(c) If
				alterations or repairs costing under 25 percent of the physical value of the
				structure are made within any period of 12 months, the construction official and
				appropriate subcode officials shall determine to what degree the portions so altered
				or repaired shall be made to conform to the requirements for new structures.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.5 - Provision for the handicapped

Current through Register Vol. 56, No. 14, July 15, 2024
Facilities shall be available and accessible to the physically
				  handicapped pursuant to the Barrier-Free Subcode of the New Jersey Uniform
				  Construction Code, N.J.A.C. 5:23-7.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.6 - Common elements for ambulatory health care facilities

Current through Register Vol. 56, No. 14, July 15, 2024
All new ambulatory health care facilities, except small
				  facilities addressed at
				  8:43A-19.7, shall comply with Chapter
				  3.1 (Outpatient Facilities) of the construction guidelines.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.7 - Small ambulatory care facilities

Current through Register Vol. 56, No. 14, July 15, 2024
(a) For purposes of this
				section, "small ambulatory care facility" means a facility that provides ambulatory
				care services at which four or fewer workers use the space and equipment at any one
				time.
(b) Chapter 3.3 (Small Primary
				(Neighborhood) Outpatient Facilities) of the construction guidelines applies to new
				small ambulatory care facilities.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 19 - PHYSICAL PLANT AND FUNCTIONAL REQUIREMENTS › Section 8:43A-19.8 - Construction and renovation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Whenever
				construction and renovation projects are planned in and around a health care
				facility, a risk assessment shall be conducted to determine the impact of the
				project on patient areas, personnel, and mechanical systems.
1. The infection control program shall review
				areas of potential risk and populations at risk. The infection control program shall
				approve control measures, if necessary.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 20 - FAMILY PRACTICE SERVICES › Section 8:43A-20.1 - Additional requirements

Current through Register Vol. 56, No. 14, July 15, 2024
An ambulatory care facility which provides family practice
				  services shall comply with N.J.A.C. 8:43A-1 through 11 and 13 through 19, and this
				  subchapter.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 20 - FAMILY PRACTICE SERVICES › Section 8:43A-20.2 - Medical staff to be provided

Current through Register Vol. 56, No. 14, July 15, 2024
If an ambulatory care facility provides family practice services,
				  the medical director shall be a family practice physician or the facility shall have
				  a family practice physician on the medical staff. The family practice physician
				  shall be available during the facility's hours of operation. ("Available" means
				  capable of being reached.)
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 21 - FAMILY PLANNING, PRENATAL, POSTPARTUM, AND GYNECOLOGICAL SERVICES › Section 8:43A-21.1 - Additional requirements and exceptions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An ambulatory care
				facility which provides family planning, prenatal, postpartum, and/or gynecological
				services shall comply with N.J.A.C. 8:43A-1 through 11 and 13 through 19, and this
				subchapter. If the facility also provides surgical or anesthesia services, then the
				facility shall also comply with N.J.A.C. 8:43A-12.
1. The facility shall be a formal member of a
				Maternal and Child Health Consortium, in accordance with N.J.A.C. 8:33C.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 21 - FAMILY PLANNING, PRENATAL, POSTPARTUM, AND GYNECOLOGICAL SERVICES › Section 8:43A-21.2 - Medical staff to be provided

Current through Register Vol. 56, No. 14, July 15, 2024
If an ambulatory care facility provides prenatal, postpartum,
				  gynecological, and/or family planning services, the medical director shall be an
				  obstetrician-gynecologist or the facility shall have an obstetrician-gynecologist on
				  the medical staff. The obstetrician-gynecologist shall be available during the
				  facility's hours of operation. ("Available" means capable of being reached.)
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 21 - FAMILY PLANNING, PRENATAL, POSTPARTUM, AND GYNECOLOGICAL SERVICES › Section 8:43A-21.3 - Medical history

Current through Register Vol. 56, No. 14, July 15, 2024
In addition to complying with
				  8:43A-6.4(a), the
				  facility shall obtain the patient's obstetrical and gynecological history, if
				  appropriate, including a history of psychological and social problems.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 21 - FAMILY PLANNING, PRENATAL, POSTPARTUM, AND GYNECOLOGICAL SERVICES › Section 8:43A-21.4 - Medical records

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The complete medical
				record for prenatal patients shall include, but not be limited to, documentation of
				assessment of uterine growth, fetal heart tones, estimated delivery date, urine
				tests for protein, blood pressure, weight gain, and an updated assessment of
				obstetrical risk, and shall be in conformance with
				8:33C-4.3.
(b) The facility shall establish and implement
				written policies and procedures regarding the transfer of patient information when
				the patient is transferred to another health care facility, or if the patient has
				been an inpatient and becomes an outpatient at the same facility, to ensure
				continuity of care. In the case of a prenatal patient, a copy or summary of the
				patient's prenatal medical record shall be transferred, no later than 34 weeks
				gestation, from the facility to the inpatient facility where delivery is to take
				place. The facility shall also request a copy or summary of the patient's labor,
				delivery and postpartum record from the inpatient facility prior to any scheduled
				postpartum visits.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 22 - PEDIATRIC SERVICES › Section 8:43A-22.1 - Additional requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An ambulatory care
				facility which provides pediatric services shall comply with N.J.A.C. 8:43A-1
				through 11 and 13 through 19, and this subchapter.
1. The facility shall be a formal member of a
				Maternal and Child Health Consortium, in accordance with N.J.A.C. 8:33C.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 22 - PEDIATRIC SERVICES › Section 8:43A-22.2 - Medical staff to be provided

Current through Register Vol. 56, No. 14, July 15, 2024
A facility which provides pediatric services shall have a
				  pediatrician or family practice physician on the medical staff and available during
				  the facility's hours of operation. ("Available" means capable of being reached.)
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 22 - PEDIATRIC SERVICES › Section 8:43A-22.3 - Medical records

Current through Register Vol. 56, No. 14, July 15, 2024
The complete medical record for pediatric patients shall include,
				  but not be limited to, documentation of assessment of growth, including at least a
				  record of weight and length or height, documentation of a basic developmental
				  assessment, including sensory screenings, and a record of immunization.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 23 - PRIMARY CARE › Section 8:43A-23.1 - Additional requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An ambulatory care
				facility which provides primary care services, as defined at
				8:43A-1.3, shall comply with N.J.A.C.
				8:43A-1 through 11 and 13 through 19, and this subchapter. If the facility provides
				family practice services, then the facility shall also comply with the rules in
				N.J.A.C. 8:43A-20. If the facility provides primary care to a pediatric population,
				then the facility shall also comply with the rules in N.J.A.C. 8:43A-22.
1. If a facility provides primary care services
				only, the requirement at
				8:43A-8.2 for a registered professional
				nurse to be on the premises during the hours of operation may be satisfied by a
				physician, if permitted by the policies and procedures of the facility.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 23 - PRIMARY CARE › Section 8:43A-23.2 - Infection prevention and control

Current through Register Vol. 56, No. 14, July 15, 2024
The administrator shall designate a person with training or
				  experience in surveillance, prevention, and control of nosocomial infection who
				  shall be responsible for the direction, provision, and quality of infection
				  prevention and control services.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 23 - PRIMARY CARE › Section 8:43A-23.3 - Mobile vans

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If a facility wishes to provide services
				through use of one or more mobile vans, the facility shall obtain the prior
				authorization of the Certificate of Need and Healthcare Facility Licensing Program.
				Such authorization may be contingent upon an on-site inspection by representatives
				of the Department.
(b) Policies and
				procedures for the use of mobile vans in the provision of primary care services
				shall address at least patient care, control of drugs, medical records, and
				infection prevention and control.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 23 - PRIMARY CARE › Section 8:43A-23.4 - Primary care outpatient facilities

Current through Register Vol. 56, No. 14, July 15, 2024
New facilities that provide primary care services, except small
				  facilities addressed at
				  8:43A-23.5, shall comply with Chapter
				  3.2 of the construction guidelines.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 23 - PRIMARY CARE › Section 8:43A-23.5 - Small primary care outpatient facilities

Current through Register Vol. 56, No. 14, July 15, 2024
(a) For purposes of this
				section, "small primary care outpatient facility" means a facility that provides
				primary care services at which four or fewer workers use the space and equipment at
				any one time.
(b) Small primary care
				outpatient facilities may be located within existing commercial, residential,
				licensed child care, educational, or other types of buildings or may be small,
				freestanding, new or converted structures.
(c) New small primary care outpatient facilities
				shall comply with Chapter 3.2 of the construction guidelines.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.1 - Scope of renal dialysis standards

Current through Register Vol. 56, No. 14, July 15, 2024
The standards within this subchapter shall apply to both
				  hemodialysis and peritoneal dialysis units within ambulatory care facilities
				  providing renal dialysis services. Ambulatory care facilities that provide chronic
				  dialysis services shall comply with N.J.A.C. 8:43A-1 through 11 and 13 through 19,
				  and this subchapter. Hospital facilities that provide renal dialysis services within
				  the hospital shall comply with N.J.A.C. 8:43G-30 and with the requirements of this
				  subchapter, except as specifically modified by N.J.A.C. 8:43G-30.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following terms, when used in this subchapter, shall have the
				  following meanings, unless the context clearly indicates otherwise:
"Ambulatory dialysis" means maintenance dialysis therapy provided
				  to an individual on an outpatient basis.
"Patient care technician" means unlicensed dialysis facility staff
				  who has been specifically trained and demonstrates competency to provide direct
				  patient care, under the direct supervision of a registered professional nurse, to
				  individuals receiving dialysis services.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.3 - Minimum and maximum program size and transfer agreements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A facility providing
				ambulatory dialysis services shall have at least six stations. In the case of new
				construction or renovation involving at least 25 percent of the existing physical
				plant, an open treatment area shall contain no more than 21 stations.
(b) A facility providing ambulatory dialysis
				services shall have a written transfer agreement with at least one hospital with a
				New Jersey license to provide inpatient dialysis and with at least one hospital
				having a Medicare-certified and Department-licensed renal transplantation program.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.4 - Renal dialysis policies and procedures

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The renal dialysis
				service shall have written policies and procedures that are reviewed every three
				years, revised as needed, and implemented. They shall include at least:
1. Admission criteria for the ambulatory dialysis
				service that includes acceptance of patients who have communicable or transmittable
				diseases;
2. Criteria for handling the
				abusive or disruptive patient;
3.
				Orientation of new patients to the unit;
4. Specific facility response to medical and
				non-medical emergencies including, for example, equipment failure and water supply
				problems; and
5. Prohibition against
				patients bringing food into the unit, except for beverages which may be allowed at
				the discretion of the facility director.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.5 - Qualification of the medical director

Current through Register Vol. 56, No. 14, July 15, 2024
The medical director of a facility that provides ambulatory
				  dialysis services shall be a nephrologist. A medical director designated prior to
				  July 1, 1993, shall have the qualifications of a nephrologist as specified at
				  8:43A-1.15. A medical director
				  designated on or after July 1, 1993, shall be certified in the subspecialty of
				  nephrology by either the American Board of Internal Medicine of the American Board
				  of Medical Specialties or by the American Osteopathic Board of Internal Medicine,
				  Bureau of Osteopathic Specialists of the American Osteopathic Association.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.6 - Renal dialysis staff qualifications and policies and procedures

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Renal dialysis
				services shall be under the administrative supervision of an individual with at
				least one of the following qualifications:
1. A
				baccalaureate degree from an accredited college or university and the equivalent of
				at least one year experience in supervising renal dialysis services; or
2. Five years full-time experience in the
				provision of renal dialysis services and documentation of supervisory experience for
				at least one year.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.7 - Dialysis staffing

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The qualified
				individual who serves as the director of nursing services, as defined in
				8:43A-8.2, shall have that
				responsibility at only one facility.
(b)
				The director of nursing services may also function as facility administrator or
				alternate facility administrator.
1. However, if
				the director of nursing is functioning in an administrative capacity, this
				individual shall not assume patient care and/or charge nurse
				responsibilities.
2. In addition, under
				no circumstances shall any direct care personnel, including the charge nurse,
				perform any administrative responsibilities not directly related to the clinical
				care they are providing or directly supervising for the facility.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.8 - Infection prevention and control

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The administrator
				shall designate a person with training or experience in surveillance, prevention,
				and control of nosocomial infection who shall be responsible for the direction,
				provision, and quality of infection prevention and control services.
(b) The facility shall have written infection
				control policies and procedures specific to the dialysis service, which shall
				include standard precautions in accordance with
				8:43A-24.4(b).
(c) Transducer filters shall be replaced if
				wetted.
(d) The facility shall maintain
				dialysis infection control standards as recommended in the current guidelines from:
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.9 - Reuse of dialyzers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If dialyzers are reused, reuse shall conform
				with the guidelines in the Association for the Advancement of Medical
				Instrumentation (AAMI) publications, "Hemodialyzers," 2<nd> Edition and
				Amendment, RD16:1996 and A1:2002, "Hemodialyzer blood tubing," 2<nd> Edition
				and Amendment, RD17:1994 and A1:2002, and "Reuse of hemodialyzers," 3<rd>
				Edition and Amendment, RD47:2002 and A1:2003, incorporated herein by reference , as
				amended and supplemented.
1. AAMI publication s
				can be obtained from;
Association for the Advancement of Medical Instrumentation
901 N. Glebe Road, Suite 300
Arlington, VA 22203
or at the AAMI website at
http://www.aami.org
.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.11 - Supplies and equipment

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every facility shall
				have at least one operational back-up machine for the first six machines. For each
				additional 10 machines, an additional operational back-up machine is
				required.
(b) All equipment that is
				present in the facility shall be functional and maintained in operational condition
				and in sufficient numbers to adequately service all patients.
(c) The facility shall follow all procedures and
				processes as required or recommended by the manufacturer of the dialysis equipment
				being used in the treatment of patients.
(d) Patients shall be dialyzed in chairs that can
				be adjusted so that the patient's head is lower than his or her feet, except when
				the patient is dialyzed in a hospital bed or stretcher.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.12 - Renal dialysis staff education and training

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each facility shall
				develop, revise as necessary, and implement a written plan of staff education. The
				plan shall address the educational needs, relevant to the renal dialysis service, of
				different categories of staff on all work shifts. The plan shall include education
				programs conducted at least annually.
(b) The staff education plan shall include
				education programs that address at least the following:
1. Orientation of all staff to the facility or
				service in which the individual will be employed including a review of the service's
				equipment, policies, and procedures and identification of individual employee duties
				for receiving and evacuating patients in the event of a disaster;
2. Use of new clinical procedures, new equipment,
				and new technologies, including where applicable, computers;
3. Individual staff requests for education
				programs;
4. Educational needs based on
				assessment of staff performance and competency;
5. Facilities shall establish a process for
				evaluation of staff competencies, which shall be performed and documented at least
				annually;
6. Areas identified by the
				facility quality assurance program as needing additional educational programs;
				and
7. Rights and responsibilities of
				staff under the New Jersey Advance Directives for Health Care Act (26:2H-53 ) and the Federal Patient Self
				Determination Act (
				42 U.S.C.
				§
											1395cc(f) ) and internal
				facility policies and procedures to implement these laws.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.13 - Patient care plan

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The referring or
				transferring facility shall provide the receiving facility the most recent patient
				care plan, copies of summaries of the patient's treatments, records, medical
				progress, a description of dietary care, a summary of the patient's current needs
				and results of laboratory tests prior to transfer.
(b) Within one calendar month of initiation of
				dialysis treatment at the facility, a written plan of care shall be developed for
				each ambulatory dialysis patient by a multidisciplinary team consisting of at least,
				a nephrologist, a transplant surgeon or designee, a registered professional nurse, a
				dietitian, and a licensed social worker. The plan of care shall specify observable
				and measurable goals and expected patient outcomes. The multidisciplinary team shall
				analyze patient outcomes on a regular basis to assess the patient's progress and
				evaluate current and future treatment modalities and modify the plan as
				necessary.
(c) Every six months at
				minimum, the multidisciplinary team shall discuss and review the written patient
				care plan with each ambulatory dialysis patient and/or family, and shall revise as
				needed.
(d) Each member of the
				multidisciplinary team shall enter progress notes into the chronic dialysis
				patient's medical record. Progress notes by the physician, registered professional
				nurse and dietitian shall be entered in the patient's medical record at least
				monthly and by the social worker at least quarterly.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.14 - Medical records

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In addition to
				compliance with the requirements of N.J.A.C. 8:43A-13, the facility shall assure the
				following:
1. An area for medical records storage,
				which is separate from all patient treatment areas, shall be provided. The medical
				records area shall have adequate space for reviewing, dictating, sorting, or
				recording records. If electronic imaging devices are employed (that is, microfilm or
				optical disc), the medical records area shall have adequate space for transcribing
				records in electronic format. The facility shall store the active medical record of
				each patient currently treated by the facility on site.
2. Signature stamps are not used to authenticate
				medical record entries.
3. Each medical
				record shall include:
i. A problem list, including
				access surgeries for dialysis and prior hospitalizations;
ii. A transfusion record;
iii. A record of creation and revision of access
				for dialysis; and
iv. Evidence of
				patient education.
4. A
				patient's medical history and physical examination shall be completed within 30 days
				before or two weeks after initial treatment at the facility. For physical
				examinations performed prior to admission to the renal facility, the admitting
				physician, nurse practitioner, or physician assistant shall review the physical
				examination findings prior to the patient's first treatment at the renal dialysis
				facility and shall indicate on the physical exam form any significant changes in the
				patient's medical condition that occurred since the physical examination was
				performed.
i. Prior to the first treatment in the
				facility, the physician shall inform the nurse functioning in the charge role of at
				least the patient's diagnoses, medications, hepatitis status, allergies, and
				dialysis prescription. The clinical record shall include this data. No dialysis
				shall be initiated until this requirement is met.
5. Prior to providing dialysis treatment of a
				transient patient, a facility shall obtain and include, at a minimum:
i. Orders for treatment in the facility;
ii. A list of the patient's current medications
				and any known patient allergies;
iii.
				Laboratory reports performed no later than one month prior to treatment at the
				facility, including screening for hepatitis B status;
iv. The most current patient care plan;
				and
v. The most current treatment
				records from the referring facility.
6. At the completion of treatment at the transient
				facility, records of care and treatment are provided to the referring facility.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.15 - Physical plant requirements for all ambulatory dialysis facilities

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each station in the
				ambulatory dialysis service shall have a curtain for privacy. One handwashing sink
				shall be available for every four stations. These handwashing sinks shall be
				distributed throughout the treatment area so as to ensure immediate accessibility to
				staff at all times.
(b) The minimum
				dimensional requirements for each dialysis station shall be:
1. There shall be a minimum width of 10 feet along
				the service wall.
2. The floor area
				within the cubicle curtain of each dialysis station shall be at least 80 square feet
				and shall not include the area of the service wall.
3. There shall be 30 inches of clear space around
				each machine and lounge, except that one side of the machine may be installed flush
				against the wall.
4. There shall be a
				minimum of four feet between beds and/or lounges.
5. The dimensional requirements listed in (b)1
				through 4 above shall apply to those facilities initially licensed March 6, 2006 or
				later.
6. In the case of new
				construction or renovation involving at least 25 percent of the physical plant,
				ambulatory renal dialysis units shall be required to conform to the standards
				provided in (b)1 through 4 above.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.16 - Emergency generator and water supply

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An emergency
				generator shall be provided in a room which shall have a one-hour fire rating with
				an approved fresh air intake and an explosion release. All machines shall be
				connected to the emergency generator so that all machines will operate for at least
				four hours following a power shutdown or outage.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.17 - Requirements for pediatric dialysis services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The physical plant
				requirements for pediatric dialysis services shall be established as follows:
1. If pediatric dialysis services are provided,
				they shall be located in a treatment area separate from the services provided to
				adults except if peritoneal dialysis is the service in which case, training and
				back-up care may be integrated into an adult unit. Pediatric patients are defined as
				patients who are less than 14 years of age.
2. The area housing the pediatric dialysis unit
				shall be enclosed with fixed partitions that extend from finished floor to ceiling.
				Vision panels in partitions are required.
3. The pediatric dialysis unit shall have
				handwashing facilities that are separate from the adult unit.
4. If pediatric patients are treated, the facility
				shall use equipment, supplies, and emergency devices to include blood pressure
				cuffs, dialyzers, and bloodlines approved for use on pediatric patients.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.18 - Renal dialysis quality assurance plan

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In addition to the
				requirements set forth in N.J.A.C. 8:43A-18, the facility shall develop a quality
				assurance plan that includes all areas of service, management and operations, which
				shall be monitored by the governing body.
(b) The governing body is responsible for the
				following:
1. Establishment of program goals and
				objectives;
2. Oversight of program
				implementation, revision and effectiveness;
3. Allocation of sufficient time and resources to
				accomplish objectives and attain goals;
4. Inclusion of all attending physicians and other
				categorical key personnel in program operation; and
5. Quality assurance activities shall demonstrate
				that facility staff evaluate the provision of dialysis care and patient services,
				set treatment goals, identify opportunities for improvement, develop and implement
				improvement plans, and evaluate implementation until resolution is
				achieved.
New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 24 - RENAL DIALYSIS › Section 8:43A-24.19 - Consultant pharmacist

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The facility shall
				retain a consultant pharmacist who has no affiliation with the pharmacy that
				provides services to the facility, the facility in which services are provided, or
				any of their affiliates. The consultant pharmacists' responsibilities shall include,
				but not be limited to:
1. Development and/or
				review of all facility policies and procedures regarding pharmaceutical services.
				Policies and procedures shall include the development and maintenance of written
				objectives, an organizational plan and continuous quality improvement regarding the
				administration, storage, control and disposition of medications at the
				facility;
2. Offering educational
				programs in pharmacology to facility staff at the request of the facility
				administrator, director of nursing, or as required by the use of new medication
				systems, pharmacological innovations or advances in technology;
3. Conducting individual drug regimen reviews and
				providing pertinent information related, but not limited to, potential adverse
				reactions, drug interactions, medication dosage, pharmacokinetics, pharmacodynamics,
				pharmacoeconomics, at the request of the facility administrator;
4. At a minimum, conducting quarterly reviews of
				medical records and all areas in the facility in which medications are dispensed,
				administered, stored, or destroyed, document any problems, and propose solutions to
				problems; and
5. Submitting written
				reports, at least quarterly, to the administrator and the medical director.