N.J. Admin. Code § 8:33C-1.2

Current through Register Vol. 56, No. 9, May 6, 2024
Section 8:33C-1.2 - Definitions

The following words and terms, when used in this chapter, shall have the following meanings:

"Advanced practice nurse" means a licensed registered professional nurse with certification in a specialty requiring expertise in maternal and child health who has been certified by the New Jersey Board of Nursing, in accordance with N.J.A.C. 13:37-7, Certification of Nurse Practitioners/Clinical Nurse Specialists.

"Back transport" means the act of returning patients to the facility to which they were originally admitted or to their local hospital for further care when the problems that required transport to a higher level facility have been resolved and the patient no longer requires such higher level of care.

"Central service facility" means a health care facility, regulated by the Department, providing essential administrative and clerical support services to two or more direct providers of health care services in a region, which may also include some direct provision of health care services.

"Certified nurse midwife" means a registered professional nurse, licensed as such by the New Jersey State Board of Nursing, who is also a graduate of an accredited school certified by the American College of Nurse Midwives, and licensed as such by the New Jersey Board of Medical Examiners as required through N.J.A.C. 13:35-2A.

"Co-managed" means for two or more providers to temporarily share responsibility for a patient's health care.

"Commissioner" means the New Jersey State Commissioner of Health.

"Community Perinatal Center" means a Department-designated Community Perinatal Center-Basic, Community Perinatal Center-Birth Center, Community Perinatal Center-Intensive and Community Perinatal Center-Intermediate collectively.

"Community Perinatal Center-Basic" means a general acute care hospital licensed by the Department in accordance with N.J.A.C. 8:43G, and authorized to provide services to neonates and uncomplicated, low risk maternity patients expected to deliver neonates at least 36 weeks in gestational age and weighing greater than 2,499 grams as well as supportive services to infants returned from Regional or Community Perinatal Center-Intensive facilities, as such services are specified within a formal letter of agreement between the facility and a Regional Perinatal Center.

"Community Perinatal Center-Birth Center" means an ambulatory care facility, or a distinct part of a health care facility separately licensed as an ambulatory care facility, authorized to provide routine prenatal and intrapartal care to low risk maternity patients who are expected to deliver neonates at least 37 weeks of gestational age, weighing greater than 2,499 grams, and requiring less than a 24-hour stay following birth.

"Community Perinatal Center-Intensive" means a general acute care hospital, licensed by the Department in accordance with N.J.A.C. 8:43G, and authorized to provide services to neonates and complicated maternity patients who are expected to deliver neonates at least 28 weeks of gestational age and weighing greater than 999 grams, as such services are specified within a formal letter of agreement between the facility and a Regional Perinatal Center.

"Community Perinatal Center-Intermediate" means a general acute care hospital, licensed by the Department in accordance with N.J.A.C. 8:43G, and authorized to provide services to neonates and complicated maternity patients expected to deliver neonates at least 32 weeks of gestational age and weighing greater than 1,499 grams, as such services are specified within a formal letter of agreement between the facility and a Regional Perinatal Center.

"Consultation" means information or guidance provided by a person recognized as a specialist in a particular medical field. This information may be provided via the telephone or through co-management of the high risk maternal-fetal or neonatal patient.

"Consumer/consumer advocacy organization" means an individual who may receive health care services in a specific health care service region, who is not a health care provider and has no fiduciary interest in a health care service; or an agency or organization which is not a health care provider and advocates for consumers.

"Department" means the New Jersey State Department of Health.

"General member" means any individual, facility or organization with an interest in maternal and child health who has joined a Maternal and Child Health Consortium.

"High risk" or "patient who is at risk" means any patient identified with a medical/obstetrical condition requiring more than routine medical or surgical intervention.

"High risk infant follow-up" means a system of screening and tracking infants with potentially serious health problems or at risk for development delays following discharge from the hospital.

"Hospital" means a New Jersey licensed general acute care hospital.

"Hospital provider" means an individual who is a direct provider of a health care service or has administrative responsibility for a New Jersey licensed general acute care hospital or an individual who is employed by a hospital.

"Hospital service area" means those municipalities in an area determined through the most recent patient origin/market share data collected by the Department to meet one or more of the following criteria:

1. The hospital derives five percent or more of total admissions from the municipality;

2. Greater than 20 percent of residents of the municipality who are hospitalized utilize the subject hospital; or

3. The hospital is located within the municipality.

"Infant" means a child from birth to one year of age.

"In-hospital coverage" means a system whereby a licensed practitioner is physically present in the hospital as required by N.J.A.C. 8:43G-19.

"Intensive care" means a hospital unit in which special equipment and skilled personnel are concentrated to provide immediate and continuous attention to patients who, because of surgery, shock, trauma, serious injury or life threatening conditions, require intensified comprehensive observation and care.

"Intermediate care" means a hospital unit in which special equipment and personnel are available to care for stable, though ill, patients.

"Intermediate birth weight" means a weight of between 1,500 and 2,500 grams at birth.

"Intrapartum" means the period occurring during childbirth or delivery.

"Labor-delivery-recovery-postpartum (LDRP) bed" means a licensed obstetric bed, the primary function of which is to accommodate an obstetrical patient during the entire course of labor, delivery, recovery, and postpartum periods.

"Letter of agreement" means a document between licensed perinatal and pediatric health care providers and an MCHC, or a document between a Regional Perinatal Center and a Community Perinatal Center, developed in cooperation with the MCHC, which defines the relationship between the parties, specifies all tasks to be provided by each party, and is signed by a representative of each party to the agreement who is authorized to bind the party to such an agreement.

"Low birth weight" means a weight of less than 2,500 grams at birth.

"Maternal and Child Health Consortium (MCHC)" means a voluntary formed nonprofit organization which is licensed as a central service facility by the Department as specified in these rules, and incorporated under Section 501(c)(3) of the United States Internal Revenue Code.

"Maternal and child health service region" means a MCHC's designated geographically contiguous perinatal and pediatric service delivery area.

"Maternal-fetal transport" means transport of a high risk pregnant patient (that is, a patient diagnosed with a fetal condition which will require stabilization or resuscitation of the infant during the neonatal period, a patient with a severe maternal illness, and other cases in which care by a perinatologist is required) from one facility to another facility able to provide the appropriate level of care.

"Member in good standing" means a MCHC member that has made timely payment of its financial assessment (based on a budget approved by the Department), in accordance with the MCHC's by-laws.

"Mid-level practitioner" means a certified nurse midwife or advanced practice nurse as set forth in N.J.A.C. 13:35-2A, or a physician assistant as set forth in N.J.A.C. 13:35-2B.

"Neonatal" means the period up to 28 days after birth.

"Neonatal intensive care" means a hospital intensive care unit staffed with specially trained nursing personnel and containing specialized support equipment for treatment of newborn infants who require intensified, comprehensive observation and care exceeding that provided in pediatric acute or newborn nursing units.

"Neonatal transport" means a situation where a team is deployed from one facility to evaluate and stabilize the condition of a neonate at another facility, with the intent of transferring the neonate to the team's facility for a higher level of care, as medically appropriate.

"Neonate" or "newborn" means a child from the moment of birth up to 28 days thereafter.

"Neonatologist" means a physician who is board certified in pediatrics with a certification in neonatology from the American Board of Pediatrics, Sub-Board of Neonatal/Perinatal Medicine or the American Osteopathic Board of Pediatrics, Sub-Board of Neonatology.

"Non-hospital provider" means an individual who is a health care provider or has administrative responsibility for a health care facility but is not employed by a hospital.

"Obstetrician" means a physician who is certified, or eligible for certification by the American Board of Obstetrics and Gynecology, Inc., or the American Osteopathic Board of Obstetrics and Gynecology.

"On-call coverage" means a system whereby a licensed practitioner is readily available to be at the facility within 30 minutes of initial contact as described in N.J.A.C. 8:43G-19.

"Pediatrician" means a physician who is certified or eligible for certification by the American Board of Pediatrics or the American Osteopathic Board of Pediatrics.

"Perinatal" means the period from the 20th week of gestation through the neonatal period.

"Perinatologist" means a physician who is board certified in obstetrics/gynecology with additional certification in maternal-fetal medicine from the American Board of Obstetrics and Gynecology, Inc., Division of Maternal-Fetal Medicine or the American Osteopathic Board of Obstetrics, Sub-Board of Maternal-Fetal Medicine.

"Postpartum" means the period up to, and including, six weeks following birth.

"Preconceptional care" means assessing an individual for risk factors and counseling the individual prior to pregnancy.

"Prenatal (antepartal)" means the period of fetal development prior to birth.

"Provider" means an individual who is a provider of health care either directly through the provision or administration of health services or indirectly by having a fiduciary interest in such services.

"Referral" means a situation where the attending physician transfers the responsibility of the patient's care to a physician specializing in either neonatal or maternal-fetal medicine at the Regional Perinatal Center. Such a transfer of responsibility can consist of consultation only with the attending physician retaining care responsibility or continued management by the Regional Perinatal Center through delivery.

"Regional Perinatal Center" means a general acute care hospital which is designated and licensed to provide care to high risk mothers and neonates. Such a facility provides consultation, referral, transport and follow-up to other members of its Maternal and Child Health Consortium.

"Regional perinatal and pediatric plan" means the five-year plan developed and updated annually by the existing or proposed MCHC, which describes how prenatal, intrapartum, newborn and infant follow-up services and pediatric services are delivered in the maternal and child health service region, as well as strategies for improving services.

"Regional transport system" means a system developed by the MCHC which includes written policies and procedures for the triage of mothers and/or infants to the most appropriate level of care in accordance with formal letters of agreement.

"Regionalized services" means services which are planned and delivered within a specific geographic zone for the best use of financial and medical resources such as staffing, equipment, facilities, education and expertise to coordinate appropriate quality health care to a specific population.

"Risk reduction services" means specific perinatal addiction prevention and intervention services which may be provided individually or on a regional basis.

"Risk reduction specialist" means a registered professional nurse, a licensed or certified social worker, or other professional in a maternal and child health addiction-related field who has specialized training and experience in perinatal addiction.

"Total quality improvement program" means an ongoing and systematic process designed to review, measure and evaluate quality of care and perinatal and pediatric outcomes.

"Transfer" means a temporary or permanent shift in responsibility for a patient's health care management from one provider to another.

"Transport" means the process whereby the attending physician or certified nurse midwife at the Birth Center or Community Perinatal Center determines that the status of the patient has become acutely high risk and arranges for the transfer of the patient to a higher level facility, and includes maternal-fetal and/or neonatal transport.

"Ventilatory support" means the application of positive pressure ventilation and oxygen through mechanical devices, including continuous positive airway pressure (CPAP).

"Very low birth weight" means a weight of less than 1,500 grams at birth.

N.J. Admin. Code § 8:33C-1.2

Amended by R.2007 d.293, effective 9/17/2007.
See: 39 N.J.R. 829(a), 39 N.J.R. 3915(a).
In definition "Regional perinatal and pediatric plan", substituted "five-year plan" for "three-year plan".
Notice of readoption with technical change, effective 12/20/2021.
See: 53 N.J.R. 2198(a).