N.J. Admin. Code § 10:53-2.3

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:53-2.3 - Facility setting

(a) In addition to the requirements at N.J.A.C. 8:36, assisted living residences and comprehensive personal care homes must meet the following criteria for HCBS Medicaid/NJ Family Care reimbursement:

1. The unit or dwelling must be a specific physical place that can be rented or occupied pursuant to a legally enforceable lease agreement by the beneficiary that, at a minimum, must provide protections that address eviction processes and appeals comparable to those provided pursuant to applicable landlord/tenant law. If a residential lease is not utilized, the facility must enter into a residency agreement or other written agreement with the beneficiary and such agreement must have the same responsibilities and protections from eviction that tenants have pursuant to State, county, and municipal landlord/tenant laws.

2. The beneficiary must have privacy in his or her sleeping or living unit.

i. The unit must have entrance door(s) lockable by the beneficiary, with only appropriate staff having keys to doors;

ii. Beneficiaries sharing units must have a choice of roommates in that residence;

iii. The beneficiary must have the freedom to furnish and decorate his or her sleeping or living unit within the lease or other agreement;

3. The beneficiary must have the freedom and support to control his or her own schedules and activities;

4. The beneficiary must have access to food at any time;

5. The beneficiary must be able to have visitors of his or her choosing at any time;

6. The residence must be physically accessible to the beneficiary; and

7. The residential setting must not have the qualities of an institution and must have the qualities of a home and community-based setting.

(b) If any of the above requirements cannot be met, any limitations must be approved through a person-centered planning process and documented in the beneficiary's person-centered plan.

N.J. Admin. Code § 10:53-2.3

Adopted by 54 N.J.R. 2389(a), effective 12/19/2022