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. 18, September 16, 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:
"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.
