N.J. Admin. Code § 8:39-1.2

Current through Register Vol. 56, No. 9, May 6, 2024
Section 8:39-1.2 - Definitions

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

"Actual hours worked" means the hours that a staff member is scheduled to work on the particular shift for which information is being reported.

"Advance directive" means a written statement of a resident's instructions and directions for health care in the event of future decision making incapacity, in accordance with the New Jersey Advance Directives for Health Care Act, N.J.S.A. 26:2H-53 et seq., P.L. 1991, c.201. An advance directive may include a proxy directive, an instruction directive, or both.

"Advanced practice nurse" means a person certified by the New Jersey Board of Nursing in accordance with Section 8 or 9 of P.L. 1991, c.377; amended by P.L. 199, c. 85, §6.

"Adverse drug reaction" means any unexpected, unintended, undesired or excessive response to a drug such that it:

1. Requires discontinuing the drug (therapeutic or diagnostic);
2. Requires changing the drug therapy;
3. Requires modifying the dose;
4. Negatively affects prognosis; or
5. Results in temporary or permanent harm or disability, or death.

"Available" means ready for immediate use (pertaining to equipment) or capable of being reached (pertaining to personnel), unless otherwise defined in these rules.

"Bed" or "licensed bed" means one of the total number of beds for which each licensed long-term care facility is approved for resident care by the Commissioner of the New Jersey State Department of Health and Senior Services.

"Certified nurse aide" means an individual who has satisfied the requirements of N.J.A.C. 8:39-43.1(a).

"Cleaning" means the removal by scrubbing and washing, as with hot water, soap or detergent, or vacuuming, of infectious agents and of organic matter from surfaces on which and in which infectious agents may find conditions for surviving or multiplying.

"Cohorting" means the practice of grouping patients who are or are not colonized or infected with the same organism to confine their care to one area and prevent contact with other patients.

"Commissioner" means the Commissioner of the New Jersey Department of Health and Senior Services, or his or her designee.

"Communicable disease" means an illness due to a specific infectious agent or its toxic products which occurs through transmission of that agent or its products from a reservoir to a susceptible host.

"Conspicuously posted" means placed at a location within the facility accessible to and seen by residents and the public.

"Contamination" means the presence of an infectious or toxic agent in the air, on a body surface, or on or in clothes, bedding, instruments, dressings, or other inanimate articles or substances, including water, milk, and food.

"Controlled Dangerous Substances Acts" means the Controlled Substances Act of 1970 (Title II, Public Law 91-513) and the New Jersey Controlled Dangerous Substances Act of 1971, N.J.S.A. 24:21-1 et seq.

"Current" means up-to-date, extending to the present time.

"Defibrillator" means a medical device heart monitor and defibrillator that has received approval of its pre-market notification filed pursuant to 21 U.S.C. § 360(k) from the United States Food and Drug Administration, is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, is capable of determining, without intervention by an operator, whether defibrillation should be performed, and upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual's heart.

"Department" means the New Jersey Department of Health and Senior Services.

"Dietitian" means a person who possesses a bachelor's degree from an accredited college or university with a major area of concentration in a nutrition-related field of study, and one year of full-time professional experience or graduate-level training in nutrition.

"Direct resident care" means clinical care services provided directly to residents by a registered professional nurse, licensed practical nurse and/or a certified nurse aide and the supervision of those providing clinical care services to residents.

"Disinfection" means the killing of infectious agents outside the body, or organisms transmitting such agents, by chemical and/or physical means, directly applied.

"Documented" means written, signed, and dated. If an identifier such as a master sign-in sheet is used, initials may be used for signing documentation, in accordance with applicable professional standards of practice.

"Drug administration" means a procedure in which a prescribed drug or biological is given to a resident by an authorized person in accordance with all laws and regulations governing such procedures. The complete procedure of administration includes:

1. Removing an individual dose from a previously dispensed, properly labeled container (including a unit dose container);
2. Verifying it with the prescriber's orders;
3. Giving the individual dose to the resident;
4. Seeing that the resident takes it (if oral); and
5. Recording the required information, including the method of administration.

"Drug dispensing" means a procedure entailing the interpretation of the original or direct copy of the prescriber's order for a drug or a biological and, pursuant to that order, the proper selection, measuring, labeling, packaging, and issuance of the drug or biological to a resident or a service unit of the facility, in conformance with all applicable Federal, State, and local rules and regulations.

"Drug regimen review" means an individual resident record review conducted by the consultant pharmacist, including, but not limited to, laboratory tests, dietary requirements, physician's or advanced practice nurse's and nurse's clinical notes, physician's or advance practice nurse's orders and progress notes, in order to monitor for potentially significant adverse drug reactions, drug-to-drug and drug-food interactions, allergies, contraindications, rationality of therapy, drug use evaluation, and laboratory test results.

"Epidemic" means the occurrence or outbreak in a facility of one or more cases of an illness in excess of normal expectancy for that illness, derived from a common or propagated source.

"Facility" means a facility or distinct part of a facility licensed by the New Jersey State Department of Health and Senior Services as a long-term care facility.

"Full-time" means relating to a time period established by the facility as a full working week, as defined and specified in the facility's policies and procedures.

"Guardian" means a person appointed by a court of competent jurisdiction to handle the affairs and protect the rights of any resident of the facility.

"Health care facility" means a facility so defined in N.J.S.A. 26:2H-1 et seq., and amendments thereto.

"Licensed nursing personnel" (licensed nurse) means registered professional nurses or practical (vocational) nurses licensed by the New Jersey State Board of Nursing.

"Licensed practical nurse" means an individual licensed by the New Jersey Board of Nursing pursuant to N.J.S.A. 45:11-27.

"Medication error" means a discrepancy between what the prescriber ordered and what the resident receives. The error may or may not be seen by the (pharmacist) surveyor during an observation of a resident receiving medication. If a medication error is seen by the surveyor during a medication observation pass, it shall be included in determining the medication error rate.

"Medication error rate" is calculated by the following equation: (number of errors observed divided by the opportunities for errors) x 100.

"Monitor" means to observe, watch, or check.

"Number of staff" means the number of registered professional nurses, licensed practical nurses and certified nurse aides who are scheduled to provide and be responsible for direct resident care on a particular shift, which is calculated by dividing the total actual hours worked by each category of staff member by the number of hours in the shift.

1. Actual hours worked includes the hours for each category of staff members included in this definition for which they will be providing direct resident care during any portion of the shift.

"Pharmacist" means an individual so licensed by the New Jersey State Board of Pharmacy, pursuant to N.J.A.C. 13:39-3.

"Physician" means a person licensed to practice medicine by the New Jersey State Board of Medical Examiners, pursuant to N.J.S.A. 45:9-1 et seq.

"Reasonable hour" means any time between the hours of 8:00 A.M. and 8:00 P.M. daily.

"Registered professional nurse" means an individual licensed by the New Jersey Board of Nursing pursuant to N.J.S.A. 45:11-26.

"Religious and recreational activities" includes any religious, social, or recreational activity that is consistent with the resident's preferences and choosing, regardless of whether the activity is coordinated, offered, provided, or sponsored by facility staff or by an outside activities provider.

"Resident" means a person who resides in the facility and is in need of 24-hour continuous nursing supervision.

"Self administration" means a procedure in which any medication is taken orally, injected, inserted, or topically or otherwise administered by a resident to himself or herself. The complete procedure of self-administration includes:

1. Removing an individual dose from a previously dispensed (in accordance with the New Jersey State Board of Pharmacy Rules, N.J.A.C. 13:39), labeled container (including a unit dose container);
2. Verifying it with the directions on the label; and
3. Taking orally, injecting, inserting, or topically or otherwise administering the medication.

"Shift" means a standardized reporting period, which shall consist of, based on the facility's choice, either three eight-hour periods (day, evening and night) or two 12-hour periods (day and night).

"Signature" means at least the first initial and full surname and title (for example, R.N., L.P.N., D.D.S., M.D., D.O.) of a person, legibly written with his or her own hand. A controlled electronic signature system may be used.

"Social isolation" means a state of isolation wherein a resident of a long-term care facility is unable to engage in social interactions and religious and recreational activities with other facility residents or with family members, friends, and external support systems.

"Staff-to-resident ratio" means a ratio calculated with the numerator being the number of staff for each category of direct resident care staff scheduled to work on a particular shift and the denominator being the number of residents in the facility during that particular shift.

"Supervision" means authoritative procedural guidance by a qualified person for the accomplishment of a function or activity within his or her sphere of competence, with initial direction and periodic on-site inspection of the actual act of accomplishing the function or activity. "Direct supervision" means supervision on the premises within view of the supervisor.

"Unit-of-use" means a system in which drugs are delivered to the resident areas either in single unit packaging, bingo or punch cards, blister or strip packs, or other system where each drug is physically separate.

N.J. Admin. Code § 8:39-1.2

Amended by R.2005 d.400, effective 11/21/2005.
See: 37 N.J.R. 1932(a), 37 N.J.R. 4437(a).
Added definition "Defibrillator".
Amended by R.2010 d.019, effective 1/19/2010.
See: 41 N.J.R. 42(a), 42 N.J.R. 468(b).
Added definitions "Actual hours worked", "Certified nurse aid", "Direct resident care", "Licensed practical nurse", "Number of staff", "Registered professional nurse", "Shift" and "Staff-to-resident ratio"; in definition "Commissioner", inserted "Commissioner of the" and ", or his or her designee" and substituted "Department" for "State Commissioner"; and in definition "Department", deleted "State" following "New Jersey".
Notice of readoption with technical change, effective 12/20/2021.
See: 53 N.J.R. 2199(a).
Amended by 55 N.J.R. 2271(a), effective 11/6/2023