New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 49A - NURSING FACILITY PATIENT CARE RATIO REQUIREMENTS
Subchapter 1 - GENERAL INFORMATION
Section 10:49A-1.2 - Definitions
The following words and terms, as used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Department" means the New Jersey Department of Human Services.
"Facility" means a Class I (private), Class II (county), or Class III (special care) nursing facility identified by both a unique Medicaid/NJ FamilyCare provider number and a unique daily payment rate. A facility may be a specific unit co-located with other services (for example, a special care nursing facility floor sharing space with a nursing facility shall be considered a separate facility, if it has a separate Medicaid/NJ FamilyCare provider number and daily rate).
"GAAP" means the U.S. Generally Accepted Accounting Principles, a common set of accounting principles, standards, and procedures issued by the national Financial Accounting Standards Board (FASB). GAAP aims to improve the clarity, consistency, and comparability of the communication of financial information. Any financial concept, measure, metric, or other financial reference used in this chapter, or to meet the requirements of this chapter, must follow U.S. Generally Accepted Accounting Principles.
"Patient care ratio" (PCR) means the percentage of a facility's Medicaid revenue expended on resident care, services, and support that is calculated.
"Patient care ratio (PCR) reporting year" means a calendar year from January 1 through December 31, during which Medicaid/NJ FamilyCare-covered services are provided by a facility.
"Related party" means a person or entity that is related to the reporting facility. A related party relationship includes, but is not limited to, relationships between:
(1) divisions of an organization;
(2) organizations under common control through common officers, directors, or members;
(3) an organization and its director, trustee, officer, or key employee, or an immediate family member of those individuals, any of whom holds a controlling interest in the organization either directly or through corporations, trusts, or similar arrangements; and
(4) any parties that enable one to control or substantially influence the actions of the other.
"Resident" means an individual who resides at the facility for at least one night at any time during a PCR reporting year.
"Revenue" means all recognized income received from, or on behalf of, a resident as a condition of receiving services from the facility, including any fees or other contributions the facility may require as part of a resident reserving, securing, or receiving services.
"State audit entity" means the Department, the New Jersey Department of Law and Public Safety, the New Jersey Office of the State Comptroller, or any authorized agents of those entities.
