Quality improvement | NJ

QUALITY IMPROVEMENT

 

8:36-21.1       Quality improvement program

 

  • The facility shall establish and implement a written plan for a quality improvement program for resident care. The plan shall specify a timetable and the person(s) responsible for the quality improvement program and shall provide for ongoing monitoring of staff and resident care

 

  • Quality improvement activities shall include, but not be limited to, the following:

 

  1. At least annual review of staff qualifications and credentials;

 

  1. At least annual review of staff orientation and staff education;

 

  1. Establishment of objective criteria for evaluation of the resident care provided by each service area;

 

  1. Evaluation of resident care services, staffing, infection prevention and control, housekeeping, sanitation, safety, maintenance of physical plant and equipment, resident care statistics, and discharge planning services;

 

  1. Review of medication errors and adverse drug reactions by the pharmacist; and

 

  1. Evaluation by residents and their families of care and services provided by the

 

  • The results of the quality improvement program shall be submitted to the licensed operator at least annually and shall include, at a minimum, the deficiencies found and recommendations for corrections or improvements. Deficiencies that jeopardize resident safety shall be reported to the licensed operator

 

  • The administrator shall implement measures to ensure that corrections or improvements are

 

8:36-21.2       Use of restraints

 

  • The facility shall develop policies and procedures that support a restraint-free environment for all

 

  • The use of any restraining device shall be based on an assessment and shall require a physician, advanced practice nurse or physician assistant order.

 

  • The least restrictive device shall be used, in compliance with the prescriber’s order.

 

  • A specific plan of care shall be developed for the use of any restraining device.

 

8:36-21.3       Personal care services

 

  • The facility shall monitor that residents are maintaining personal hygiene, receiving medications as prescribed (which includes the renewal of prescriptions as necessary and the disposition of outdated or discontinued medications), and are offered the opportunity to participate in appropriate social and recreational activities, in accordance with residents’ personal

 

  • Personal care services shall include education in assistance with activities of daily living and supervision of personal

 

 COMPREHENSIVE PERSONAL CARE HOMES

 

8:36-22.1       Eligibility

 

  • Eligibility for conversion to a comprehensive personal care home shall be open exclusively to the following:

 

  1. Freestanding residential health care facilities which were either licensed or certificate of need approved on or before December 20, 1993;

 

  1. Residential health care beds located within a long-term care facility that were licensed or certificate of need approved on or before December 20, 1993;

 

  1. Licensed long-term care beds; and

 

  1. “Class C” boarding homes which were licensed by the Department of Community Affairs or under construction with approval from the Department of Community Affairs on or before December 20,

 

  • Eligibility for the construction of new comprehensive personal care beds shall be open exclusively to the following:

 

  1. Existing comprehensive personal care homes and existing facilities proposing conversion to a comprehensive personal care home that wish to add a limited number of beds. Within any five-year period the new construction of no more than 20 beds as an addition to an existing or proposed comprehensive personal care home may be proposed in accordance with N.J.A.C. 8:36-2.

 

  1. Eligible facilities that wish to add more than 20 beds shall apply for approval as an assisted living residence.

 

  1. Hospice programs which have been Medicare-certified for at least 12 consecutive months. If approved the facility shall be constructed using the most current New Jersey Uniform Construction Code, N.J.A.C. 5:23-3, Use Group I-2, applicable at the time plans are

 

  1. The facility shall be occupied exclusively by persons who are eligible for hospice services.

 

  • Only applications proposing either conversion of the eligible facility’s entire compliment of licensed beds, or conversion of one or more separate and distinct units, wings, floors or other areas within the facility, shall receive consideration for approval to convert to comprehensive personal

 

8:36-22.2       Services provided to residents

 

Each comprehensive personal care home shall comply with the following: N.J.A.C. 8:36-1 through 15, 16.8(c), 16.15, 16.16, 17 (except 17.5(a)4), and 18

through 22.

 

8:36-22.3       Physical plant

 

  • Each comprehensive personal care home shall, at a minimum:

 

  1. Maintain substantial compliance with the New Jersey Uniform Construction Code, N.J.A.C. 5:23-3, and the Uniform Fire Code, N.J.A.C. 5:70, Use Group I-2 of the subcode;

 

  1. Maintain a comprehensive automatic fire-suppression system throughout the facility. Buildings presently in Use Group I-2 or buildings which comply with the construction requirements for an I-2 use may apply to the Department for an exemption to this requirement, provided they can document compliance with the New Jersey Uniform Fire Code, N.J.A.C. 5:70, with regard to construction type;

 

  1. Maintain compliance with N.J.A.C. 5:23-7, regarding barrier-free accessibility, applicable at the time plans are

 

  1. Provide smoke detectors in all resident bedrooms, living rooms, and public areas; and

 

  1. Provide corridor widths of at least 36 inches of clear

 

  • Ventilation requirements for comprehensive personal care homes are as follows:

 

  1. Means of ventilation shall be provided either by a window with an openable area or by mechanical ventilation for every habitable room. If mechanical ventilation is used, there shall be at least two air changes per

 

  1. Means of ventilation shall be provided for every bathroom or water closet compartment (toilet). Ventilation shall be provided either by a window with an openable area or by mechanical

 

  1. All hallway corridors and passageways shall have a minimum of two outside air changes per

 

  • Interior wall, ceiling and floor finishes shall be in compliance with the Uniform Construction Code, N.J.A.C. 5:23.

 

  • Residential units occupied by one person shall have a minimum of 80 square feet of clear and useable floor area. (“Clear and useable floor area” means space exclusive of closets, bathroom and, if provided, )

 

  • In units occupied by more than one resident, there shall be a minimum of 50 additional square feet of clear floor

 

  • No residential unit in a comprehensive personal care home may be occupied by more than two individuals. An exception may be considered in those instances where an eligible facility at the time of conversion to a comprehensive personal care home has more than two individuals in a unit. However, as attrition occurs the number of individuals per residential unit shall be reduced to no more than

 

8:36-22.4       Other requirements

 

Each comprehensive personal care home administrator, manager, or their designee shall explain to all residents assisted living concepts, services to be provided based on these concepts, and all charges for these services.

 

8:36-22.5       Prohibition of resident discharge on conversion of facility

 

An eligible existing facility converting to a comprehensive personal care home shall not discharge any current resident solely because of the conversion. If compliance with this section results in more than two individuals per residential unit, the facility shall apply for the exception noted at N.J.A.C. 8:36-22.3(f).

 

8:36-22.6       Combination of license categories

 

Another licensed bed category may be located within a distinct and separate section of the comprehensive personal care home. The comprehensive personal care home shall comply fully with all licensure requirements applicable to each licensed component.

 

8:36-22.7       Supplemental Security Income recipients

 

  • In converting to a comprehensive personal care home from a residential health care facility or Class “C” boarding home, the facility shall maintain its existing residents who are Supplemental Security Income (SSI) eligible recipients and those who are former psychiatric

 

  • On an ongoing, annual basis, at least five percent of each comprehensive personal care home’s residents shall be SSI-eligible recipients, at least half of whom shall be former psychiatric patients. This percentage shall be computed based on the number of resident days per calendar year. The facility shall report this information to the Long-Term Care Licensing and Certification Program by April 15 of each year for the prior calendar

 

  1. Facilities approved for conversion to comprehensive personal care which maintain less than the five percent SSI-eligible requirement noted above shall have one year from the date of licensure as comprehensive personal care to comply.

 

  1. In the event that the Supplemental Security Income payment rate for Comprehensive Personal Care Homes is set at a level below the SSI payment rate for residential health care facilities, the five percent occupancy requirements for SSI-eligible residents noted above shall not take effect. However, comprehensive personal care homes shall maintain their existing residents who are Supplemental Security Income-eligible, as required

 

  • Subsections (a) and (b) above shall not apply when a continuing care retirement community (CCRC) contracts to provide assisted living services pursuant to a continuing care agreement. These subsections do apply, however, when a CCRC provides assisted living to a person who is not a party to a continuing care

 

  • Subsections (a) and (b) above shall not apply when a new comprehensive personal care home is constructed and dedicated exclusively to the care of residents who require hospice