New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 164 - ADULT DAY HEALTH SERVICES › Subchapter 1 - GENERAL PROVISIONS › Section 10:164-1.2 - 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:
"ACCAP" means the AIDS Community Care Alternative Program
				  created pursuant to the Omnibus Budget Reconciliation Act of 1981.
"ADHS" means adult day health services.
"ADL" means an activity of daily living, from among the
				  following list of six separate activities of daily living:
1. Bathing/dressing;
2. Toilet use;
3. Transfer;
4. Locomotion;
5. Bed mobility; and
6. Eating.
"Adult day health services beneficiary" or "beneficiary"
				  means an individual who is a Medicaid beneficiary, pursuant to N.J.A.C. 10:49,
				  an HCEP participant, or a JACC participant, who is eligible for adult day
				  health services pursuant to
				  N.J.A.C.
				  10:164-1.5. An adult beneficiary is at least
				  18 years of age.
"Adult day health services facility" means an identifiable
				  part of a nursing facility, or a hospital-affiliated facility, or a
				  freestanding ambulatory care facility or such other facility that is licensed
				  by the Department in accordance with its Standards for Licensure of Adult Day
				  Health Services Facilities, N.J.A.C. 8:43F, and that possesses a valid and
				  current provider agreement from the Department.
"Advanced practice nurse" means an individual so certified by
				  the New Jersey State Board of Nursing in accordance with
				  N.J.S.A.
				  45:11-23 et seq.
"AFC" means the Adult Family Care program created pursuant to
				  the Omnibus Reconciliation Act of 1981.
"CAP" means the Caregiver Assistance Program, a Medicaid Home
				  and Community Based Program under the Enhanced Community Options Waiver,
				  pursuant to
				  N.J.A.C.
				  10:60-10.2.
"Department" means the State of New Jersey Department of
				  Human Services.
"HCEP" means the Home Care Expansion Program established
				  pursuant to
				  N.J.S.A.
				  30:4E-5 et seq.
"HIV adult day health services facility" means an adult day
				  health services facility that provides additional services to individuals with
				  HIV infection in an identifiable and separate setting and that is licensed
				  pursuant to N.J.A.C. 8:43A.
"JACC" means the Jersey Assistance for Community Caregiving
				  Program, an ElderCare Initiative pursuant to the State of New Jersey
				  Appropriations Act.
"Legally authorized representative" means a person or entity
				  empowered by law, judicial order, power of attorney, or otherwise to make
				  decisions on behalf of the beneficiary and includes a beneficiary's spouse,
				  domestic partner, civil union partner, or immediate next-of-kin.
"Licensed practical nurse (LPN)" means an individual who is
				  so licensed by the New Jersey State Board of Nursing, pursuant to
				  N.J.S.A.
				  45:11-27.
"Limited assistance" means physical help in maneuvering of
				  limbs or other non-weight-bearing assistance at least three times during the
				  past three days.
"Medicaid" means medical assistance and health services
				  provided under a State plan approved under Title XIX of the Social Security Act
				  and administered in New Jersey pursuant to
				  N.J.S.A.
				  30:4D-1 et seq. and N.J.A.C. 10:49.
"Medicaid beneficiary" means an individual who participates
				  in the program for medical assistance, including Medicaid Waiver programs,
				  authorized under Title XIX or Title XXI of the Social Security Act and
				  administered jointly by the New Jersey Department of Health and Senior Services
				  and the New Jersey Department of Human Services.
"Medical appointment" means a scheduled day and time for an
				  individual to be evaluated or treated by a physician or other licensed health
				  care professional.
"Medical nutrition therapy" means the assessment of
				  nutritional status and treatment, use of diet therapy, counseling and
				  specialized nutritional supplements.
"Medication administration" means a procedure in which a
				  prescribed medication is given to a beneficiary by an authorized person in
				  accordance with all laws and rules governing such procedures. The complete
				  procedure of administration includes removing an individual dose from a
				  previously dispensed, properly labeled container (including a unit dose
				  container), verifying it with the prescriber's orders, giving the individual
				  dose to the beneficiary, seeing that the beneficiary takes it, and recording
				  the required information, including the method of administration. After the
				  prescribed medication has been given the RN shall: assess the beneficiary for
				  the development of side effects or interactions and/or for a change in the
				  beneficiary's ability to maintain the medication regimen (which may include an
				  assessment of the beneficiary's compliance with the medication regimen, the
				  beneficiary's knowledge about the dose and medication taken and the side
				  effects and interactions, and swallowing difficulties or short-term memory
				  deficits).
"Physician assistant" means an individual so licensed by the
				  New Jersey State Board of Medical Examiners pursuant to
				  N.J.S.A.
				  45:9-27.10 et seq.
"Registered professional nurse" or "RN" means an individual
				  who is so licensed by the New Jersey State Board of Nursing, pursuant to
				  N.J.S.A.
				  45:11-26.
"Rehabilitation service" means physical therapy, occupational
				  therapy, and/or speech-language pathology.
"Skilled service" means a needed skilled service provided by
				  an RN or a licensed practical nurse, including, but not limited to:
1. Oxygen need;
2. Ostomy care;
3. Nurse monitoring (for example, medication
				administration, pacemaker checks, or the monitoring of urinary output, unstable
				blood glucose or unstable blood pressure that requires physician and/or
				advanced practice nurse intervention);
4. Wound treatment;
5. Stasis ulcer treatment;
6. Intravenous or intramuscular
				injection;
7. Nasogastric or
				gastrostomy tube feeding; and
8.
				Medical nutrition therapy.
"Supervision/cueing" means oversight, encouragement, or
				  cueing provided at least three times during the past three days, or supervision
				  provided one or more times plus physical assistance provided no more than two
				  times for a total of at least three episodes of assistance or
				  supervision.
"Wound" means an ulcer, a burn, a Stage II, III or IV
				  pressure sore, an open surgical sites, a fistula, a tube site, or a tumor
				  erosion site.