New Jersey Administrative Code
Title 8 - HEALTH
Chapter 33H - CERTIFICATE OF NEED: POLICY MANUAL FOR LONG TERM CARE SERVICES
Subchapter 1 - GENERAL PROVISIONS
Section 8:33H-1.2 - Definitions
The following words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise:
"Aging in place" means a process whereby individuals remain in their living environment despite the physical and/or mental decline and growing needs for supportive services that may occur in the course of aging. For aging in place to occur, services are added, increased, or adjusted to compensate for the person's physical and/or mental decline.
"Applicant" means an individual, a partnership, a limited liability partnership, a corporation (including associations and joint-stock companies, a limited liability corporation, a State, or a political subdivision (including a municipal corporation) of a State that will be the licensed operator of the proposed service, facility or equipment, which will have overall responsibility for the health care service to be provided.
"Assisted living" means a coordinated array of supportive personal and health services, available 24 hours per day, to residents who have been assessed to need these services, including residents who require formal long-term care. Assisted living promotes resident self-direction and participation in decisions that emphasize independence, individuality, privacy, dignity, and homelike surroundings.
"Assisted living program" means the provision of or arrangement for meals and assisted living services, when needed, to the tenants (also known as residents) of publicly subsidized housing which because of any Federal, State, or local housing laws, regulations or requirements cannot become licensed as an assisted living residence. An assisted living program may also provide staff resources and other services to a licensed assisted living residence and a licensed comprehensive personal care home.
"Assisted living program provider" means an organization licensed by the New Jersey Department of Health , in accordance with N.J.A.C. 8:36, to provide all services required of an assisted living program.
"Assisted living residence" means a facility which is licensed by the Department, in accordance with N.J.A.C. 8:36, to provide apartment-style housing and congregate dining and to assure that assisted living services are available when needed, to four or more adult persons unrelated to the proprietor. Apartment units offer, at a minimum, one unfurnished room, a private bathroom, a kitchenette, and a lockable door on the unit entrance.
"Commissioner" means the State Commissioner of Health .
"Comprehensive personal care home" means a facility which is licensed by the Department, in accordance with N.J.A.C. 8:36, to provide room and board and to assure that assisted living services are available when needed, to four or more adults unrelated to the proprietor. Residential units in comprehensive personal care homes house no more than two residents and have a lockable door on the unit entrance.
"Continuing care retirement community" means the provision of lodging and nursing, medical, or other related services at the same or another location to an individual pursuant to an agreement effective for the life of the individual or for a period greater than one year, including mutually terminable contracts, and in consideration of the payment of an entrance fee with or without other periodic charges. A fee which is less than the sum of the regular periodic charges for one year of residency is not considered an entrance fee. For Certificate of Need exemption purposes, a new or proposed community which will have fewer than four independent living units per nursing facility bed, or an existing community which proposes to construct additional nursing facility beds which will be utilized by persons who have not paid the entrance fee, is not a continuing care retirement community. The required four to one ratio shall be maintained at all times. Beds licensed as assisted living residence, comprehensive personal care home or residential health care may be counted in the numerator of this ratio, at the discretion of the applicant.
"Deficiency" means a finding or findings by the Department that a facility is not in compliance with applicable State licensure requirements and/or Federal requirements for a health care facility. A deficiency remains valid unless overruled by the Commissioner of Health or a judicial appeal process.
"Department" means the New Jersey State Department of Health .
"Direct admission Medicaid patient" or "resident" means an individual who is admitted to a long-term care bed as a Medicaid eligible patient, or a private paying patient who will spend down to Medicaid eligibility within 180 days of placement in the long-term care bed.
"Financially feasible" means revenues exceed expenses during or before the third year subsequent to implementation of a certificate of need-approved project.
"General long-term care bed" means a long-term care bed for which there is no restriction imposed by statute (for example, subacute long-term care), certificate of need approval requirements (for example, pediatric long-term care, specialized long-term ventilator care, specialized long-term care of residents with severe behavior management problems) or stipulations and/or licensure standards that would limit the type of nursing home resident who may occupy the bed or the type of nursing home care which may be provided to the occupant of the bed.
"Hospice" means a program, which is licensed by the New Jersey State Department of Health to provide palliative services to terminally ill persons in the person's home or place of residence, including medical, nursing, social work, volunteer, and counseling services.
"Hospital-based subacute long term care unit" means a unit located within an acute care general hospital which utilizes licensed long-term care beds to provide subacute care for patients.
"Long-term care" means a wide range of personal care, psycho-social, nursing, and other supportive services for people with functional limitations due to chronic--and frequently degenerative--physical or cognitive disorders. Long-term care services range from in-home assistance provided by family members or a home care agency to nursing home care.
"Medicaid-eligible patient" means, for the purpose of this chapter, a person who has received a determination of medical and financial eligibility for Medicaid coverage, or a person who qualifies medically and financially for Medicaid but who does not apply for Medicaid coverage, or a person whose care is paid for through General Assistance funds.
"Nursing home" or "nursing facility" means a facility that is licensed by the Department to provide health care under medical supervision and continuous nursing care for 24 or more consecutive hours to two or more patients who do not require the degree of care and treatment which a hospital provides and who, because of their physical or mental condition, require continuous nursing care and services above the level of room and board.
"Nursing home-level care" means care provided to individuals who have chronic medical condition(s) resulting in moderate to severe impairments in physical, behavioral, cognitive, and/or psychosocial functioning. The need for nursing home-level care and services is determined by a registered nurse and identified in a plan of care, in accordance with 8:36-7.1 "Nursing home-level care" includes, but is not limited to, partial or total assistance with activities of daily living (for example, bathing, dressing, eating, toileting, mobility), assistance with self-administering or administration of medications, and provision of treatments and periodic reassessments as directed by the plan of care. It may also include the provision of physiotherapy, occupational therapy, therapeutic counseling, and other rehabilitative services as indicated by the individual's medical condition.
"Pediatric long-term care" means a facility, distinct nursing unit, or program which is dedicated for occupancy by patients under age 20.
"Planning regions for pediatric and specialized long term care beds/services," unless otherwise specifically defined in the certificate of need call published in the New Jersey Register, means the counties in the following three regions:
1. Region 1: Morris, Sussex, Passaic, Hunterdon, Mercer, Middlesex, Somerset and Warren Counties;
2. Region 2: Bergen, Essex, Union and Hudson Counties;
3. Region 3: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Monmouth, Ocean and Salem Counties.
"Project" means the construction, renovation, and/or related activities which are required in order to implement a certificate of need.
"Respite care" means a service that provides a brief period of relief from caregiving responsibilities for the family members and friends of individuals who require long-term care. It may be offered either on an outpatient basis, for example, in the form of adult day health care, or an inpatient basis, for example, in the form of residential health care.
"Specialized long-term care" means a program of care provided in licensed long-term care beds for residents who require technically complex treatment with life supporting equipment or who have serious problems accessing appropriate nursing home care due to the specialized treatment required by their medical diagnoses and level of functional limitation.
"Statewide restricted admissions facility" means a non-profit nursing home owned and operated by a religious or fraternal organization that serves only members of that organization and their immediate families.
