N.J. Admin. Code § 17:41-1.2

Current through Register Vol. 56, No. 16, August 19, 2024
Section 17:41-1.2 - Definitions

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

"Abuse" means the willful infliction of physical pain, injury, or mental anguish; unreasonable confinement; or the willful deprivation of services that are necessary to maintain a resident's physical and mental health. "Abuse" shall also mean imposing treatment upon a resident who has the capacity to make healthcare decisions, after the resident has made a voluntary and informed choice regarding such treatment. "Abuse" shall also mean providing to a resident treatment that is not medically indicated. However, no resident shall be deemed to be abused for the sole reason that he or she is being furnished non-medical remedial treatment by spiritual means through prayer alone, in accordance with a recognized religious method of healing, in lieu of medical treatment, if it is shown through the Office's review that the resident subscribes to such religious method of healing. "Abuse" also shall not mean the withholding or withdrawal of life-sustaining treatment in accordance with the provisions of N.J.A.C. 17:41-2.

An "act" of any facility, government agency, or managed care organization shall be deemed to include any failure or refusal to act by such facility or government agency.

"Administrator" means any person who is charged with the general administration or supervision of a facility, whether or not such person has an ownership interest in such facility, and whether or not such person's functions and duties are shared with one or more other persons.

"Caregiver" or "caretaker" means a person employed or contracted to provide care or services to an elderly person, and includes, but is not limited to, family, friends, the staff of a facility, managed care organization representative, and managed care organization care managers.

"Exploitation" means the act or process of using a person or his or her resources for another person's profit or advantage without legal entitlement to do so.

"Facility" means any facility or program, health care institution, or institution, whether public or private, offering health or health-related services for the institutionalized elderly, and which is subject to licensing, regulation, visitation, inspection, supervision, or funding by any government agency. Facilities include, but are not limited to, nursing homes, intermediate care facilities, assisted living facilities, residences, and programs, residential healthcare facilities, comprehensive personal care homes, special hospitals, comprehensive rehabilitation hospitals and separately licensed comprehensive rehabilitation units within general acute care hospitals, long-term acute care hospitals, veterans' hospitals, psychiatric hospitals, social day care centers for the elderly, adult medical day care centers, adult family care homes, developmental centers, the independent living section of continuing care retirement communities, and class "C" and "D" boarding homes. "Facility" shall not mean a correctional facility or an acute care medical center.

"Government agency" means any department, division, office, bureau, board, commission, authority, or any other agency or instrumentality created by the State or to which the State is a party, or by any county or municipality, which is responsible for the licensing, regulation, visitation, inspection, or supervision of facilities, or which provides services to patients, residents, or clients of facilities.

"Institutionalized elderly," "elderly," or "elderly person" means any person 60 years of age or older, who is a patient, resident, or client of any facility or program.

"Managed care organization" means an entity that has, or is seeking to qualify for, a comprehensive risk contract, and that is:

1. A Federally qualified HMO that meets the advance directives requirements of 42 CFR Part 489 Subpart I; or

2. Any public or private entity that meets the advance directives requirements and is determined to also meet the following conditions:

i. Makes the services it provides to its Medicaid enrollees as accessible (in terms of timeliness, amount, duration, and scope) as those services are to other Medicaid recipients within the area served by the entity; and

ii. Meets the solvency standards of 42 CFR 438.116.

"Neglect" means failure to perform one's duties according to an accepted professional standard.

"Office" means the Office of the Ombudsperson for the Institutionalized Elderly.

"Office Program" refers to statutory or other activities operating under the auspices and with the approval of the Ombudsperson. Office Programs shall include, but are not limited to: Investigation and Advocacy in response to Complaints Program; The Volunteer Advocate Program; Oversight of the Regional Long-Term Care Ethics Program; The I Choose Home NJ/Money Follows the Person Program; and Outreach/Education Program.

"Resident" means any elderly person who is receiving treatment or care in any facility in all its aspects, including, but not limited to, admission, retention, confinement, commitment, period of residence, transfer, discharge, and any instances directly related to such status. For purposes of this chapter, the term "resident" shall also include an elderly patient or client who is receiving treatment or care in any facility or program.

"State Program Coordinator" means an individual qualified to administer and supervise the Volunteer Advocate Program throughout the entire State of New Jersey, and who is capable and willing to promote the Program's philosophy throughout the community being served.

"Volunteer Advocate" means an individual trained and certified by the Office to make regular weekly visits to assigned long-term care facilities. Volunteer Advocates receive training and are subject to criminal background checks. A Volunteer Advocate may exercise, but need not be limited to, such functions as visitation, consultation, problem solving, eliciting complaints, and generally serving as an advocate on behalf of the institutionalized elderly.

"Volunteer Advocate Program" is the means by which the Ombudsperson promotes and ensures community contact with residents of long-term care facilities, expands the outreach of the Office, enhances the Office's ability to protect residents' rights, and ensures quality of care.

N.J. Admin. Code § 17:41-1.2

Recodified from 17:39-1.2 and amended by 47 N.J.R. 1023(a), effective 5/18/2015.