New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 44C - STANDARDS FOR COMMUNITY RESIDENCES FOR PERSONS WITH HEAD INJURIES › Subchapter 1 - GENERAL PROVISIONS › Section 10:44C-1.3 - 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 wrongfully inflicting or allowing to be
				  inflicted, physical abuse, sexual abuse, or verbal or psychological abuse or
				  mistreatment by a caregiver upon a person served.
"Adaptive behavior" means behavior that in a cultural or
				  functional context indicates the ability of a person served to adjust to
				  environmental demands in a fashion that benefits the person served while
				  respecting the rights of those with whom he or she comes in contact.
"Advanced practice nurse," also known as a nurse practitioner
				  (see N.J.S.A. 45:11-46c), is defined at N.J.S.A. 45:11-23 and may, in addition
				  to those tasks lawfully performed by a registered professional nurse, manage
				  specific common deviations from wellness and stabilized long-term care
				  illnesses by initiating laboratory and other diagnostic tests and prescribing
				  or ordering certain medications, treatments, and devices (see N.J.S.A.
				  45:11-49).
"Advocacy" means one or more of the following
				  services:
1. Personal advocacy:
				one-to-one advocacy to secure the rights of people with head injuries and their
				families;
2. Systems advocacy:
				seeking to change a policy or practice that affects people with head
				injuries;
3. Legislative advocacy
				as permitted by law: seeking legislative enactments that would enhance the
				rights and/or opportunities for people with disabilities or persons with head
				injuries;
4. Legal advocacy: using
				the judicial and quasi-judicial systems to protect the rights of persons with
				head injuries;
5. Self-advocacy:
				advocacy of a person served on his or her own behalf.
"Affirming rights" means respecting rights and providing the
				  assistance persons served need to exercise those rights and to engage in
				  self-advocacy.
"Affiliation" means a relationship, usually signified by a
				  written agreement, between two organizations, under the terms of which one
				  organization agrees to provide specified services and personnel to meet the
				  needs of the other organization, usually on a scheduled basis.
"Agency" means the licensee and his or her staff responsible
				  for the care and safety of the persons served in each community residence for
				  persons with head injuries licensed under this chapter.
"Approved" means approved by the Office of Licensing.
"Assessment" means the process of identifying the strengths
				  and needs of a person served, and the conditions that impede or promote
				  development. There are two levels of assessment: screening and
				  evaluation.
"Assistive device" means any implement or mechanism that
				  enables a person with head injuries to increase, maintain, and/or improve his
				  or her functioning capabilities.
"Assistive technology" means the use of commercial or
				  custom-designed devices, modifications, and/or related technical services to
				  increase, maintain, and/or improve the functional capabilities of persons with
				  head injuries who have resulting disabilities.
"Audiology" means services provided by an audiologist who
				  meets applicable legal requirements for the provision of audiology services and
				  who meets the academic and work experience standards established by the
				  American Speech-Language and Hearing Association for the Certificate of
				  Clinical Competence in Audiology.
"Authorization to operate" means official correspondence
				  issued by the Office of Licensing to permit a licensee to operate beyond the
				  license expiration date, because of a delay in completing a licensing
				  inspection.
"Behavior Support Plan" means a written, approved plan that
				  employs techniques to decrease maladaptive behavior and increase adaptive
				  behavior.
"Business manager" means the staff member charged with the
				  responsibility of providing oversight of business practices, including budgets,
				  purchasing, accounting and personnel practices.
"Capacity" means the maximum number of persons with head
				  injuries who may reside in the licensed residence.
"Case manager" means the person responsible for the
				  development, coordination, and overall management of the individual treatment
				  plan for each person served, and who is employed by the licensee. There may
				  also be an external case manager, such as one acting on behalf of an insurance
				  company, managed care organization, or other payor source.
"Commensurate wage" means a wage that is proportionate to the
				  prevailing wage paid to similarly experienced workers in the geographic
				  vicinity of the person's place of employment for essentially the same type of
				  work based on a comparison of the quantity of work produced by the worker with
				  a head injury and a resulting disability with those of work produced by
				  similarly experienced workers. This wage is to be determined by time studies as
				  approved by the New Jersey Department of Labor.
"Community agency" means an agency licensed by the Department
				  to provide services to persons with head injuries.
"Community agency head" means the person responsible for the
				  overall operation of the agency under contract with or licensed by the
				  Department. This may be the licensee, owner, or executive director.
"Community residence for persons with head injuries" means a
				  community residential facility licensed pursuant to N.J.S.A. 30:11B-1 et seq.,
				  providing food, shelter, personal guidance, and integration with the community,
				  under such supervision as required, to not more than 15 persons with head
				  injuries, who require assistance, temporarily or permanently, in order to live
				  in the community, and shall include, but not be limited to: group homes,
				  halfway houses, supervised apartment living arrangements, and hostels. Such
				  residences shall not be located on the grounds or immediately adjacent to
				  public institutions serving a similar population. Such a residence shall not be
				  considered a health care facility within the meaning of the "Health Care
				  Facilities Planning Act," P.L. 1971, c. 136 (N.J.S.A.
				  26:2H-1 et seq.).
"Commissioner" means the Commissioner, Department of Human
				  Services.
"Critical information" means information that must be
				  communicated from shift to shift in order to ensure the health, safety, and
				  welfare of the persons served, and includes, but is not limited to: unexpected
				  behavioral outbursts, unexpected or unexplained mood swings on the part of
				  persons served, the administration of PRN medication, problems with
				  transportation, unexpected visits to the doctor or hospital, routine visits to
				  the doctor requiring follow up for a reportable communicable disease, and
				  missed medical appointments.
"Deficiency" means that an applicant or licensee has not
				  complied with a rule contained in this chapter.
"Department" means the Department of Human Services.
"Dignity of risk" means:
1. Providing a person served with new and
				untried experiences;
2. Assisting
				the person served when he/she chooses among possible courses of action in
				trying new experiences;
3.
				Assisting the person served in determining the risks and
				consequences;
4. Assessing the
				risks and consequences on behalf of the person served;
5. Assuring that the person served and the
				legal guardian (if any) understand such risks and consequences; and
6. Defining, documenting and providing the
				means of support necessary to establish the allowable limits of the risk,
				assuring thereby that the person served is as safe as possible at all times.
"Direct support professional" means any licensee and any full
				  time, part time, temporary employment services, or contract employee at a
				  community residence for persons with head injuries present in the living or
				  program area who work directly with the person served. For the purpose of this
				  definition, this term does not include housekeepers, food service workers,
				  maintenance workers, clerical staff, or volunteers.
"Division" means the Division of Developmental
				  Disabilities.
"Evaluation" means an assessment process performed by
				  qualified professionals according to procedures that incorporate the use, when
				  possible, of standardized tests and measures.
"Eviction" means the legal process of officially removing a
				  tenant from the premises.
"Executive leadership" means the person or persons to whom
				  the licensee may delegate administrative authority over the licensee's
				  community based programs regulated or under contract with the Department. A
				  person who functions as executive leadership may also be referred to as an
				  executive director.
"Exploitation" means the act or process of a caregiver using
				  a person served or his or her resources for another person's profit or
				  advantage. (See
				  N.J.S.A.
				  30:6D-73 et seq. and N.J.A.C. 10:44D)
"Falsification" means intentionally making a record or a
				  document false, giving a false appearance to a record or a document, tampering
				  with a record or a document.
"Fiduciary capacity" means that the licensee acts with a high
				  degree of good faith when handling money entrusted to the licensee by persons
				  served.
"Fire official" means a person certified by the Commissioner
				  of the Department of Community Affairs, and appointed or designated by the
				  appointing authority of a local enforcing agency to direct the enforcement of
				  the Uniform Fire Safety Act, and any certified fire inspector working under the
				  direction of the fire official.
"Full license" means the authorization to operate based upon
				  substantial compliance with this chapter. A full license shall be effective for
				  up to one year.
"Functional literacy" means the ability to read, comprehend,
				  and assimilate the oral and written language and numerical information required
				  to function in a specific work or community environment, with or without
				  accommodation strategies. Accommodation strategies may include, but are not
				  limited to, picture instructions or calculators, computers and/or audiovisual
				  tapes.
"Group homes" means living arrangements operated in
				  residences leased or owned by the licensee, which provide the opportunity for
				  persons served to live together in a home, sharing in chores and the overall
				  management of the residence. Staff in a group home provide supervision,
				  training, and/or assistance in a variety of forms and intensity as required to
				  assist the persons served as they move toward independence and integration with
				  the community.
"Guardian" means a person or agency appointed by a court of
				  competent jurisdiction who is otherwise legally authorized and responsible to
				  act on behalf of a minor or incompetent adult to assure provision for the
				  health, safety, and welfare of the person and to protect his or her
				  rights.
"Head injury" means, for the purposes of this chapter,
				  traumatic brain injury.
"Human Rights Committee" means a group comprised of
				  professionals, individuals served, advocates, and/or interested persons from
				  the community at large who function as an advisory group to the CEO or
				  executive director on issues directly or indirectly affecting the rights of
				  individuals served.
"Imminent danger" means a situation that could be expected to
				  cause a serious risk to the health, safety or welfare of a person
				  served.
"Individual treatment plan" (ITP) means a written plan of
				  intervention and action developed by the transdisciplinary team in a
				  person-centered planning process. It describes the methodologies, strategies,
				  and programs that will be employed and monitored to provide habilitation or
				  rehabilitation to enable persons served to acquire or restore functional skills
				  to the highest possible level of performance, within a reasonable time period.
				  The ITP shall also document barriers to implementation and goal achievement.
				  The ITP shall be reviewed and modified on a regular and as-needed basis, but no
				  less than annually. For a person who makes only specific services requests, the
				  ITP is a service plan that addresses only those specific requests. The ITP may
				  be appealed in accordance with licensee procedure.
"Informed consent" means a formal expression, oral or
				  written, of agreement with a proposed course of action by someone who has the
				  capacity, the information and the ability to render voluntary agreement.
"Integration" means participation in the mainstream of
				  community life, that persons served maintain social relationships with family
				  members, peers, and others in the community who do not have head injuries. In
				  addition, integration means that persons served have equal access to and full
				  participation in community resources and activities available to the general
				  public.
"Interferon Gamma Release Assay" (IGRA) means a blood test
				  to identify or rule out infection with
M. tuberculosis
. Only
				  FDA-approved IGRAs, such as QuantiFERON-TB Gold or T-Spot.TB are
				  acceptable.
"License" means the authorization issued by the Department
				  of Human Services to operate a community residence providing services to
				  persons with head injuries.
"Licensee" means the person, partnership, or corporation
				  responsible for providing services associated with the operation of a community
				  residence(s).
"Maladaptive behavior" means behavior that is injurious or
				  destructive to self, others, or the environment, that demonstrates a reduction
				  in or lack of ability that is necessary to adjust to environmental
				  demands.
"Mental health program" means a service designed to develop,
				  support, and maximize the quality of life and functional abilities of persons
				  served with severe and/or persistent and diagnosed psychiatric disabilities, as
				  a result of, or in addition to the head injury.
"Mini-team review" means a modified version of a complete
				  transdisciplinary team, the composition of which shall always include the
				  person served, and/or his or her guardian, and/or personal representative; the
				  case manager; and the individual in the discipline(s) knowledgeable in the
				  issues for review.
"Negative licensing action" means an action, which imposes a
				  restriction on a licensee and may include suspension of admissions, issuance of
				  a provisional license, a reduction in the licensed capacity, a denial of the
				  license, a non-renewal of the license, a suspension of the license, or a
				  revocation of the license.
"Neglect" means any of the following acts by a caregiver on
				  a person served: willfully failing to provide proper and sufficient food,
				  clothing, maintenance, medical care, or a clean and proper home; or failure to
				  do, or permit to be done, any act necessary for the well-being of a person
				  served. (See
				  N.J.S.A.
				  30:6D-73 et seq. and N.J.A.C. 10:44D)
"Non-ambulatory person" means a person served not capable of
				  independent ambulation.
"Occupant" means any person lawfully occupying or sharing
				  occupancy of a unit of dwelling space on a regular basis or for more than 30
				  consecutive days.
"Office of Investigations (OI)" means that component of the
				  Department responsible to investigate serious unusual incidents in community
				  programs licensed, contracted, or regulated by the Department.
"Office of Licensing" means the licensing agency, that
				  component of the Department responsible to inspect and license programs under
				  this chapter.
"Owner" means the person, corporation or association who must
				  comply with
				  30:11B-1 et seq. and this chapter.
				  The owner may be responsible for day-to-day operations or may employ an
				  executive leadership, if so desired or if required by the qualifications
				  associated with the executive leadership title.
"Payment authority" means a person, a private corporation
				  (usually an insurance company) or public agency (local, State or Federal
				  government) that provides funding of the residential placement and related
				  services for care of the person served.
"Person served" means a person with head injury receiving
				  services in a community residence for persons with head injuries.
"Person with head injury" means a person with traumatic brain
				  injury.
"Personal advocate" means a person selected by a person
				  served to provide assistance or act on his or her behalf in non-legal
				  matters.
"Personal care" means services and supports including, but
				  not limited to:
1. Bathing, hair care,
				skin care, shaving, nail care, and oral hygiene;
2. Alimentary procedures to assist one with
				eating and bowel and bladder management;
3. Positioning;
4. Care of adaptive personal care devices;
				and
5. Feminine hygiene.
"Personal guidance" means the assistance provided to a person
				  with head injury in activities of daily living and/or personal care because he
				  or she routinely requires help completing such activities of daily living
				  and/or cannot direct someone to complete such activities when physical
				  disabilities prevent self-completion; or there is a documented health or mental
				  health problem requiring supervision of the person for the protection of the
				  person or others.
"Placing agency" means the person or payment authority that
				  is responsible for selecting and/or funding a program.
"Plan of correction" means a written response outlining
				  actions taken or to be taken to address deficiencies cited in a licensing
				  inspection report.
"Power of attorney (POA)" means a written document that
				  grants a person (other than the individual granting the permission), the
				  authority to act as an agent for the grantor, within the parameters of duties
				  and powers specified in the document.
"Process" means activities that are systematically and
				  intentionally linked in order to produce a service.
"Program description" means a document submitted to obtain a
				  license from the Department. A program description includes a detailed
				  description of services provided to persons with head injuries and staff
				  coverage, and is reviewed as part of the licensing inspection process. The
				  program description shall be amended to reflect major changes in the provision
				  of services.
"Protecting rights" means ensuring that the rights of a
				  person served are not ignored or infringed upon. This affirmation and
				  protection is reflected in all aspects of the service process, from service
				  initiation to discharge and follow up.
"Provisional license" is a negative licensing action issued
				  to prompt corrective actions in existing community residences. A provisional
				  license shall be effective for less than one year.
"Rehabilitation/habilitation" means the process of providing
				  those comprehensive services deemed appropriate to the needs of a person with a
				  head injury in a coordinated manner in a program designed to achieve objectives
				  of improved health, welfare, and the realization of the person's maximum
				  physical, cognitive, social, psychological and vocational potential.
1. Rehabilitation services are necessary when
				the person with a head injury is in need of assistance in order to reacquire
				skills and it is beyond the person's personal capacities and resources to
				achieve his or her maximum potential for personal, cognitive, social, and
				economic adjustment and beyond the services available in the person's usual
				daily experience.
2. Habilitation
				is closely related to and is conceptually and programmatically a part of
				rehabilitation. The range of functional goals is the same as the range of
				services that shall be provided for the person to attain the goals. The chief
				difference is the condition or nature of the person served. Habilitation refers
				to the process that involves persons served who need to acquire particular
				skills and/or functional abilities they did not possess previously, such as
				independent living skills or vocational skills, while rehabilitation refers to
				the process that involves persons served who need to re-acquire or maximize
				lost skills and/or functional abilities.
"Rehabilitation nurse" means a person who meets legal
				  requirements as a registered nurse and who has training and experience in
				  dealing with the unique needs of those persons served who need rehabilitation.
				  Rehabilitation nursing is a specialty practice within the profession.
				  Rehabilitation nurses diagnose and treat the human responses of persons and
				  groups to actual or potential disabilities that interrupt or alter their
				  functioning and life satisfaction. The goal of rehabilitation nursing is to
				  assist the person or group in the restoration and maintenance of maximal health
				  and improve the person's quality of life. One mechanism of ascertaining the
				  knowledge of rehabilitation nursing is through certification as a certified
				  rehabilitation nurse (C.R.R.N.).
"Rehabilitative treatment environment" means a rehabilitation
				  setting that provides for:
1. The
				provision of a range of choices, with personal preference, self-determination
				and dignity of risk receiving full respect and consideration;
2. A variety of social interactions that
				promote community integration;
3.
				An environment of peer support and mentorship;
4. Professional team involvement and
				competence; and
5. A physical
				environment conducive to enhancing the functional abilities of the persons
				served.
"Relocate" means providing accommodations which enable a
				  person to evacuate the premises within three minutes, if prior accommodations
				  could not be evacuated by the person within three minutes.
"Residence" means a community residence for persons with head
				  injuries.
"Roommate" means the person with whom one shares a
				  bedroom.
"Self-advocacy group" means a group of persons with head
				  injuries who meet on a regular basis (such as at house meetings) to discuss
				  common goals, issues, needs, and wishes. With the assistance of a facilitator,
				  if needed, a self-advocacy group can serve as a united voice for persons with
				  head injuries.
"Substantial non-compliance" means:
1. The violation by an owner, applicant,
				licensee, or executive leadership of the laws of the State of New Jersey
				pertaining to or governing community residences for persons with head
				injuries;
2. One or more licensing
				requirements have been left unmet and the unmet licensing requirements directly
				endanger the health, safety, or well-being of a person served;
3. The owner, applicant, licensee or
				executive leadership refuses to cooperate with Department personnel in gaining
				admission to a residence or in conducting an investigation or
				inspection;
4. The owner,
				applicant, licensee or executive leadership has failed to adhere to the
				approved program description;
5.
				The owner, applicant, licensee or executive leadership has falsified any
				information in order to obtain a license;
6. The owner, applicant, licensee or
				executive leadership has refused to furnish the Department with files, reports,
				or records as required by this chapter; or
7. The owner, applicant, licensee or
				executive leadership has failed to act in a fiduciary capacity in order to
				protect the funds of persons served.
"Supervised apartments" means apartments that are occupied by
				  persons served and leased or owned by the licensee. Staff provide supervision,
				  guidance, and training, as needed, in activities of daily living as defined by
				  the needs and targeted future goals of the person served, in accordance with
				  the requirements of this chapter. Up to four persons served may reside in a
				  single apartment.
"Support" means activities, materials, equipment or other
				  services designed and implemented to assist the person served. Examples
				  include, but are not limited to, instruction, training, assistive technology,
				  and/or removal of architectural barriers. Support also includes positive
				  interactions between the person served and person(s) significant to the person
				  served.
"Transdisciplinary Team" (TDT) means a group that shall be
				  comprised of the person served and all personnel directly involved in the
				  person-centered planning process of defining the person's capabilities and
				  needs, in refining and meeting all of the person's goals and objectives, and in
				  the provision of care or supervision. The team shall also include, as needed,
				  other significant persons such as employers and those disciplines and persons
				  involved in the provision of care or supervision. Team membership shall
				  represent a variety of disciplines, to the extent possible. The team members
				  shall share their knowledge and expertise in order to facilitate the
				  assessment, planning, and implementation of the person's program. There shall
				  be interaction and integration among the team members to ensure that the
				  achievement of the individual's goals is facilitated. Family members, peers,
				  and advocates shall participate at the discretion of the person served or his
				  or her legal guardian.
"Traumatic brain injury" means an acquired injury to the
				  brain. Such term does not include brain dysfunction caused by congenital or
				  degenerative disorders, nor birth trauma, but may include brain injuries caused
				  by anoxia due to trauma.
"Uniform Construction Code" means
				  52:27D-119 et seq. and N.J.A.C.
				  5:23.
"Uniform Fire Safety Act" means
				  52:27D-192 et seq., and the
				  related codes adopted pursuant thereto.
"Unusual incident" means an event involving a person served
				  or employee involving indications or allegations of criminal actions, injury,
				  negligence, exploitation, abuse, clinical mismanagement or medical malpractice,
				  a major unforeseen event, for example, serious fire, explosion, power failure
				  that presents a significant danger to the safety or well being of persons
				  served, and/or employees; or a newsworthy incident.
"Variance" means written recognition by the Department that
				  the licensee has complied with the intent of a standard in a
				  Department-approved alternative manner, in accordance with
				  10:44C-1.10.
"Volunteer" means an unpaid person who supports and
				  supplements programs and services. A volunteer may be an individual, or a
				  member of an organized group.
"Waiver" means the temporary suspension of a standard that
				  is granted in writing by the Office of Licensing.
"Willful non-compliance" means that action or non-action of
				  an applicant or licensee who has knowledge of the violations of licensing rules
				  and/or terms of the license, has been advised of the consequences of not
				  achieving compliance and has not achieved compliance after being given an
				  adequate opportunity to do so.