ASSISTED LIVING PROGRAMS

 

8:36-23.1       Tenant/resident eligibility

 

  • Participation in the services of an assisted living program shall be voluntary on the part of any tenant of any publicly subsidized

 

  • A tenant voluntarily receiving the services of an assisted living program shall be assessed according to the provisions of J.A.C. 8:36-7.1(a) through (g).

 

  • Neither the legal rights and responsibilities enjoyed by a tenant under law nor the legal requirements pertaining to publicly subsidized housing shall be abridged, diminished or abrogated by a resident’s participation in the assisted living program.

 

8:36-23.2       Service provider requirements

 

  • Assisted living programs shall provide their services exclusively in a licensed assisted living residence, comprehensive personal care home, and/or within publicly subsidized housing units. Housing units which are not publicly subsidized are eligible to apply for a certificate of need for an assisted living residence and, if approved, a

 

  • Assisted living program providers which provide staffing, management or other services to licensed assisted living residences or comprehensive personal care homes shall do so in accordance with the licensing standards which are applicable to the particular facility. In such cases, the licensing standards for assisted living residences and comprehensive personal care homes shall take precedence over the standards for assisted living programs. The assisted living residence and/or the comprehensive personal care home shall establish and maintain written contracts detailing all policies, procedures, and services to be provided by the licensed facility and the licensed

 

  • Assisted living program providers shall establish and maintain a written contract with each publicly subsidized housing unit to be

 

  1. The contract shall stipulate that a tenant shall not be prohibited from participation in the assisted living program due to the location or physical characteristics of the unit in which the tenant

 

  1. The contract shall stipulate that tenants shall not be involuntarily moved from one unit to another within the building for the purpose of receiving the services of the assisted living

 

  1. The contract shall include a written acknowledgement by the publicly subsidized housing building manager and owner that each has reviewed the provisions of this chapter and will permit the assisted living program’s operation in accordance with such

 

  1. The contract shall state that there are policies and procedures for the publicly subsidized housing staff to notify the assisted living program of any substantial change in a resident’s condition noticed by housing

 

  1. The contract shall state that there are policies and procedures which ensure the on-premises presence of at least one publicly subsidized housing staff or assisted living program provider staff 24 hours per day. This staff shall be responsible for contacting appropriate authorities, including the assisted living program, in the event of an emergency situation involving a resident or the building as a

 

  1. The assisted living program provider shall submit written documentation to the Department that each building for which it is contracting to provide services is a publicly subsidized housing

 

  • The assisted living program provider shall submit to the Department a copy of the resident agreement/contract it shall utilize at each site at which it shall provide services. The agreement/contract shall include at least the following:

 

  1. The services that will be provided;

 

  1. The charges for services;

 

  1. The circumstances under which services and charges will be revised, with at least 30 days prior written notice;

 

  1. The circumstances and processes under which a resident will be discharged from the program in accordance with the provisions of N.J.A.C. 8:36- 5.1(d) and (e); and

 

  1. Resident rights and

 

8:36-23.3       Services provided to residents

 

  • Each assisted living program shall comply with the applicable provisions in N.J.A.C. 8:36-1 through 11, 13, 15 and

 

  • Each assisted living program provider shall be capable of providing or arranging for the provision of assistance with personal care, and of nursing, pharmaceutical, dietary and social work services to meet the individual needs of each resident.

 

  • The assisted living program provider shall be capable of providing or arranging for the provision of nursing services to maintain residents, including residents who require long-term care. However, a resident may be, but is not required to be, removed from program participation if it is documented in the resident record that a higher level of care is required as demonstrated by one or more of the characteristics identified in N.J.A.C. 8:36-5.1(d).

 

  1. d) The assisted living program’s service agreement with each resident shall clearly specify if the program will or will not continue to provide, or arrange for the provision of, services to residents with the characteristics described in

N.J.A.C. 8:36-5.1(d)1 through 8, to what extent and, if applicable, at what additional cost.

 

(e) In the event that the assisted living program removes a resident from program participation as permitted by (c) above, it shall provide the resident with information to assist in obtaining the level of care required.

 

8:36-23.4       Policy and procedure manual

 

A policy and procedure manual(s) for the organization and operation of the assisted living program shall be developed, implemented and reviewed in accordance with the provisions of N.J.A.C. 8:36-5.7. The manual(s) shall be available in all assisted living program sites, the assisted living program provider main office, and to representatives of the Department.

 

8:36-23.5       Resident transportation

 

  • The assisted living program provider shall have written policies and procedures for arranging resident transportation to and from health care services provided outside of the program site, and shall provide reasonable plans for security and accountability for the resident and his or her personal

 

  • The assisted living program provider shall develop a mechanism for the transfer of appropriate resident information to and from the providers of service, as required by individual residents and as specified in their service plans.

 

8:36-23.6       Notices

 

(a) The assisted living program provider and each program site shall conspicuously post a notice that the following information is available to residents and the public at the program site and at the assisted living program provider’s main office during normal business hours:

 

  1. All waivers from the provisions of this chapter granted by the Department;

 

  1. A copy of the last annual licensure inspection survey report and the list of deficiencies from any valid complaint investigation during the past 12 months;

 

  1. Policies and procedures regarding resident rights and responsibilities;

 

  1. Business hours and telephone number of the assisted living program provider main office;

 

  1. The toll-free hot line number of the Department; telephone numbers of county agencies dealing with senior service issues; and the telephone number of the State of New Jersey Office of the Ombudsman for the Institutionalized Elderly; and

 

  1. The names of, and a means to formally contact, the administration of the assisted living program provider.

 

8:36-23.7       Maintenance of records

 

  • The assisted living program shall maintain an annual listing of residents admitted and discharged, including the destination of residents who are discharged to a health care

 

  • Statistical data, such as resident census and program characteristics shall be forwarded on request, in a format provided by the

 

8:36-23.8       Notification requirements

 

  • When known, and with the resident’s consent, the resident’s family, guardian, and/or designated responsible person or designated agency shall be notified promptly in the event of the following:

 

  1. The resident acquires an acute illness requiring medical care;

 

  1. Any serious accident, criminal act or incident occurs which involves the resident and results in serious harm or injury or results in the resident’s arrest or detention. The Department’s Long-Term Care Licensing and Certification Program shall also be notified in writing of these events;

 

  1. The resident is discharged from the program; or

 

  1. The resident The assisted living program shall have a written procedure established with the program site to ensure that dual notifications of death do not occur.

 

  • Notification of any occurrence noted in (a) above shall be documented in the resident’s record. The documentation with regard to an occurrence noted in (a)4 above shall include confirmation and written documentation of that notification.

 

8:36-23.9       Administration and staffing

 

  • The administrator of an assisted living program shall:

 

  1. Hold a current New Jersey license as a nursing home administrator; or

 

  1. Have successfully completed an assisted living training course which covers the concepts and rules of assisted living as outlined in this chapter, given by a person(s) qualified to train assisted living administrators, in accordance with

N.J.A.C. 8:36-3.2(a)4; and

 

  1. Have successfully completed a Department competency examination, which covers the concepts and rules delineated in this chapter; and

 

  1. Comply with the requirements at N.J.A.C. 8:36-3.2(a)1 and

 

  • The assisted living program provider shall ensure that all personnel providing health care services are assigned duties based on their education, training, competencies, and pursuant to all laws, rules, and regulations applicable to State professional licensing and certification boards and

 

  • Adequate staffing shall be provided based on all assessed needs of residents.

 

8:36-23.10     Financial arrangements

 

  • If the assisted living program offers financial management services, it shall develop written policies and procedures for such services, including any charges for such

 

  • The assisted living program shall:

 

  1. Inform residents, in writing, of any and all fees for services and charges for supplies routinely provided by the program. Residents and/or their family, guardian or responsible person shall be given at least 30 days prior written notice of any change in fees for services or charges for supplies routinely provided. At the resident’s request, this information shall be provided to the resident’s family, guardian, or responsible person;

 

  1. Maintain a written record of all financial arrangements with the resident and/or his or her family, guardian or responsible person, with copies furnished to the resident; and

 

  1. Provide the resident with information regarding financial assistance available from third party payors and/or other payors and referral systems for resident financial

 

8:36-23.11     Resident assessments, service plans, health care plans and health care services

 

(a) Each resident living in publicly subsidized housing who elects to participate in an assisted living program shall receive an initial assessment pursuant to N.J.A.C. 8:36-7.1(a) and the applicable sections of N.J.A.C. 8:36-7.2 through 7.5.

 

8:36-23.12     Dining services and meal preparation assistance

 

  • The assisted living program shall make available dining services and/or meal preparation assistance to meet the daily nutritional needs of residents.

 

  • The assisted living program shall have a mechanism to assist residents with shopping and/or preparation of meals in accordance with their needs and plans of

 

  • The assisted living program shall comply with N.J.A.C. 8:36-10.4(a)1 and 2, 10.5(c)10 and 12, and 6.

 

  • The assisted living program shall review documentation that congregate kitchens in buildings in which meals are prepared for assisted living program residents comply with the provisions of N.J.A.C. 8:24, Retail Food Establishments and Food and Beverages Vending Machines Chapter XII of the New Jersey Sanitary

 

  • The assisted living program shall ensure that a current diet manual shall be available in each building in which the assisted living program provides services.

 

  • The assisted living program shall ensure that meals are planned, prepared and served in accordance with, but not limited to, the following:

 

  1. The nutritional needs of residents;

 

  1. In congregate kitchens in buildings where meals are prepared for assisted living program residents, written dated menus shall be planned in advance. The same menu shall not be used more than once in any continuous seven-day period. Menus shall be posted in a conspicuous place and a copy of the menu shall be provided to each resident. Menus, with changes or substitutes, shall be kept on file for at least 30 days;

 

  1. Diets served shall be consistent with the diet manual, the dietitian’s instructions, if applicable, and, if necessary for special diets, shall be served in accordance with physicians’

 

  1. Where indicated in the health care plan nutrients and calories shall be provided for each resident, based upon current recommended dining allowances of the Food and Nutrition Board of the National Academy of Sciences, National Research Council, adjusted for age, sex, weight, physical activity, and therapeutic needs of the

 

8:36-23.13     Pharmaceutical services

 

  • The assisted living program shall assist residents to obtain pharmaceutical services in accordance with physician’s orders and with each resident’s health service or general service

 

  • The assisted living program shall comply with N.J.A.C. 8:36-11.3(a)1 and 2, 11.4(a) and (b), 11.5(a) and (b)2 through 4, (e) and (f).

 

  • Assisted living program staff shall report drug errors and adverse drug reactions immediately to the assisted living program registered professional nurse who shall comply with the reporting and documenting requirements of

N.J.A.C. 8:36-11.5(e).

 

  • For those residents who do not self-administer medications, the assisted living program shall provide an appropriate and safe medication storage area, either in a common area or in the resident’s housing unit, for the storage of medication.

 

  1. The common storage area shall be kept locked when not in

 

  1. The common storage area shall be used only for the storage of medications and medical

 

  1. The key to the common storage area shall be kept on the person of the assisted living program employee on

 

  1. Each resident’s medications shall be kept separated within the common storage area, with the exception of large volume medications which shall be labeled but may be stored together in the common storage

 

  1. Medications shall be stored in accordance with manufacturer’s instructions, and/or extemporaneously applied pharmacy labels and/or directions, and/or USP DI Volume I: Drug Information for the Health Care Professional, 2005, incorporated herein by reference, as amended and supplemented and USP DI Volume II: Advice for the Patient, incorporated herein by reference, as amended and supplemented. USP DI Volume I: Drug Information for the Health Care Professional and USP DI Volume II: Advice for the Patient can be obtained by contacting Thomson-Micromedex, 6200 S. Syracuse Way, Suite 300, Greenwood Village, CO 80111, (303) 486-6400.

 

  1. All medications shall be kept in their original containers and shall be properly labeled and

 

8:36-23.14     Resident activities

 

  • A planned, diversified program of activities shall be posted and offered daily for residents, including individual and/or group activities, on-site or off-site to meet the service needs of

 

  • The assisted living program shall provide assistance in obtaining transportation services for residents in accordance with N.J.A.C. 8:36-5.8(b).

 

8:36-23.15     Resident records

 

  • The assisted living program shall comply with N.J.A.C. 8:36-15.1 through 6.

 

  • Whenever a resident dies, the assisted living program administrator or his or her designee shall document the date, cause of death, and location, if obtainable, in the resident’s record and shall notify the resident’s

 

8:36-23.16     Resident rights and responsibilities

 

To assure the highest quality of services, each assisted living program shall distribute and implement a statement of resident rights and responsibilities consistent with the provisions of N.J.A.C. 8:36-4.1.

 

8:36-23.17     Reportable events

 

  • The assisted living program’s contract or agreement with a publicly subsidized housing program site, or with an assisted living residence or comprehensive personal care home for which it provides services, shall include procedures for the site to notify the assisted living program of all building and physical plant emergencies such as, but not limited to, interruption for three or more hours of basic services such as heat, light, power, water, telephone and site staff.

 

  • The assisted living program shall notify the Department of Health and Senior Services immediately by telephone at (609) 633-9034 or (609) 392-2020 after business hours, followed within 72 hours by written confirmation, of the following:

 

  1. Any interruption of basic building services, as noted in (a) above;

 

  1. Any actual or expected interruption or cessation in assisted living program operations and services;

 

  1. Termination of employment of the assisted living program administrator and the name and qualifications of his or her replacement;

 

  1. Occurrence of all reportable infections and disease as specified in Chapter II of the State Sanitary Code Communicable Diseases at J.A.C. 8:57-

1.1 through 1.12, among residents and, where known, at the program site;

 

  1. Any deaths or accidents related to the program’s services or activities and all residents who are determined to be missing, and all deaths among residents resulting from accidents in the publicly subsidized housing building or in

 

assisted living residences or comprehensive personal care homes for which services are provided, or related to other building services. Written confirmation of this shall contain information about injuries to residents and/or program personnel, disruption of program and/or building services and extent of damages;

 

  1. Where known all alleged or suspected crimes committed by or against residents, which have also been reported at the time of occurrence to the local police department; and

 

  1. All suspected cases of abuse, neglect or exploitation of residents which have been reported to the State of New Jersey Office of the Ombudsman for the Institutionalized Elderly.

 

8:36-23.18     Other requirements

 

  • The assisted living program shall have a mechanism to provide information and referrals to other levels of care, as required by a resident. All necessary resident information shall also be transferred in accordance with the program’s confidentiality requirements and with all applicable State and Federal laws and

 

  • Records and information regarding the individual resident shall be considered confidential and the resident shall have the opportunity to examine such records, in accordance with facility or program policies. The written consent of the resident shall be obtained for release of his or her records to any individual outside the facility or program, except in the case of the resident’s transfer to another health care facility, or as required by law, third-party payor, or authorized government agencies.

 

  • The assisted living program and each publicly subsidized housing unit in which it provides services shall develop written policies and procedures to assure substantial compliance with N.J.A.C. 8:36-14, 17 and