N.J. Admin. Code § 8:97-1.2

Current through Register Vol. 56, No. 11, June 3, 2024
Section 8:97-1.2 - Definitions

The following words and terms, as used in this chapter, apply to both for-profit and nonprofit nursing homes and have the following meanings, unless the context clearly indicates otherwise. Financial terms should be interpreted consistently with Generally Accepted Accounting Principles (GAAP).

"Audited" means the same as described in the instructions to Internal Revenue Services (IRS) Form 990, as amended and supplemented. Consistent with the instructions to IRS Form 990, the term means a formal examination of an organization's financial records and practices by an independent, certified public accountant with the objective of issuing a report on the organization's financial statements as to whether those statements are fairly stated in all material respects according to generally accepted accounting principles (or other recognized comprehensive basis of accounting).

"Centers for Medicare and Medicaid Services" or "CMS" means the Federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and, among other responsibilities, also oversees quality standards in nursing homes.

"Cost report" means the most recent annual report that a nursing home files pursuant to 42 CFR 413.20(b), as a condition of being a Medicare-certified provider or facility, files with CMS to provide, using the applicable Federal form, information regarding, among other things, the nursing home's characteristics, utilization data, costs and charges by cost center, Medicare settlement data, and financial data (42 U.S.C. § 1395g (section 1815(a) of the Social Security Act)).

"Data dashboard" means the website that the Department maintains at http://www.nj.gov/health/ltc/nursing-homes pursuant to N.J.S.A. 26:2H-46.3, which provides a separate page or listing for each nursing home and links to the sites at which information and data relevant to each nursing home may be found, and a description of the data and information that is accessible through each link.

"Department" means the New Jersey Department of Health.

"Generally accepted accounting principles" or "GAAP" means the accounting principles that a reporting entity determines to be applicable, and that are generally accepted in the United States as authoritative by:

1. The Financial Accounting Standards Board (FASB) with respect to nongovernmental entities, as articulated in the Financial Accounting Standards Board Accounting Standards Codification (R) (2009), incorporated herein by reference, as amended and supplemented, available at www.fasb.org, and from the FASB at 401 Merritt 7, PO Box 5116, Norwalk, CT 06856; or
2. The Governmental Accounting Standards Board (GASB) with respect to State and local governmental entities, as articulated in the GASB Codification of Governmental Accounting and Financial Reporting Standards (2021), incorporated herein by reference, as amended and supplemented, available at www.gasb.org, and from the GASB at 401 Merritt 7, PO Box 5116, Norwalk, CT 06856.

"Generally accepted auditing standards" or "GAAS" means the auditing standards that are generally accepted in the United States as authoritative, as specified in the AICPA Professional Standards (2021), incorporated herein by reference, as amended and supplemented.

"Health care organization" means any organization or entity engaged in providing, financing, improving, supervising, evaluating, or other activity related to health care. Examples include, but are not limited to, physician practices, hospitals, and skilled nursing facilities.

"Health care system" means any combination of a nursing home with one or more other health care organizations or related parties that share any amount of common ownership or control with an entity responsible for providing centralized management and administrative services to the entities pursuant to its common ownership or control.

"IRS Form 990" means Internal Revenue Service Form 990 and relevant related schedules, instructions, and glossary thereto, contained in the information collection of the Internal Revenue Service of the United States Department of the Treasury, bearing Office of Management and Budget Control Number OMB No. 1545-0047 (last Information Collection Review concluded January 23, 2023), incorporated herein by reference, as amended and supplemented, available at: http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202212-1545-014, and includes the instructions and glossary thereto.

"Medicare-certified" means, that a facility has been approved or certified by Medicare and has met all necessary Federal requirements (including certain specific Federal health and safety requirements, among other things) to receive Medicare payments.

"Nursing home" means a nursing home as defined at N.J.S.A. 26:2H-29, which includes:

1. Both freestanding and "hospital-based" facilities; and
2. Hospital-based subacute care units, commonly referred to as "transitional care units" or "TCUs," as defined at N.J.A.C. 8:39-47.2.

"Reven"Owner" means any person, partnership, corporation, company, trust, or any other organization that owns, directly or indirectly (including ownership by any family members), more than five percent of the voting rights, profit or beneficial interest in an organization, regardless of whether that interest is evidenced by shares, certificates, stocks, contract, agreement or any other form used to represent a voting, profit or beneficial interest, including any person whose combined ownership, individually and/or through a controlling interest in any other organizations, and owns more than five percent voting, profit, or beneficial interest in the organization.

"Owner-certified financial statement" means a financial statement that is prepared using the accrual basis and includes, at a minimum, a balance sheet, statement of operations or income, statement of changes in net assets, and statement of cash flows, and is prepared in accordance with GAAP, and is then subsequently audited by an independent certified public accountant in accordance with GAAS.

ue center" means a distinct operating unit within a health care organization that generates revenue.

"System nursing home" means a nursing home that is part of a network or system of nursing homes or other health care facilities that are commonly referred to as a "health care system."

N.J. Admin. Code § 8:97-1.2

Adopted by 56 N.J.R. 433(a), effective 3/18/2024