N.J. Admin. Code § 5:19-9.2

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

Section 5:19-9.2 - Content of notice of rights

(a) Each resident shall be provided with a document entitled "Bill of Rights for Continuing Care Retirement Community Residents in Independent Living," which document shall, in 12-point or larger type, contain each of the rights described below.

1. Unless a resident has violated the continuing care agreement or facility rules, or the facility has cancelled the agreement with sufficient notice and cause, or if the facility for sound business reasons decides to raze or to otherwise cease operating the structure, or the part of it, in which the resident's unit is located, a resident may occupy the resident's chosen unit for as long as the resident can function independently, with or without the assistance of an aide or aides. Any determination that the resident can no longer function independently, with or without the assistance of an aide or aides, shall be made by the director of medical services of the facility and be subject to the requirements of section 4 of P.L. 2013, c. 167 (52:27D-360.4) and N.J.A.C. 5:19-11. The facility shall also timely notify the resident in writing of any right that the resident may have to appeal that determination.

2. Each resident shall have privacy within the resident's unit, except that personnel must be admitted for contracted services or to respond to an emergency or complaint.

3. Any resident may serve or participate in a local, State, or national residents' association, or other similar organization without discrimination or reprisal.

4. Each resident shall retain and be able to exercise all constitutional, civil, and other rights to which the resident is entitled by law.

5. Each resident shall be treated with respect, courtesy, consideration, and dignity.

6. Any resident or legal representative of the resident may refuse medication or treatment after being fully informed of the possible benefits or risks.

7. Each resident has the right to express complaints without fear of interference, discharge, or reprisal, and the right to contact the Office of the Ombudsman for the Institutionalized Elderly, or any advocate or agency which provides health, social, legal, or other services to advocate on behalf of residents if the resident feels that the rights of the resident or of other persons are being violated.

8. Each resident has the right to expect the facility to investigate promptly and try to resolve all concerns the resident expresses. A record shall be kept of all written complaints made to the facility's senior management concerning residents' rights. This record shall be available to only the particular resident or the resident's legal representative, immediate family members, the residents' physicians, and agents of the State of New Jersey or other appropriate governmental agency. Each resident may file a complaint with any agency, including the appropriate State office, without fear of reprisal from the facility. Residents may also request that their complaints remain anonymous.

9. The facility shall not modify or reduce the scope of provided services, with the exception of modifications required by State or Federal assistance programs, without providing the residents with a minimum of 30-days' prior notice of the modification or reduction. All services to be provided shall be listed in a form designated by the Department pursuant to 5:19-6.4(a)2.

10. Each resident is entitled to 30-days' advance written notice prior to the increase of any fees.

11. A resident may choose any outside physician as the resident's primary care physician.

12. A resident may hire a private caregiver or companion at the resident's own expense and responsibility, as long as the caregiver or companion complies with the facility's policies and procedures.

13. Each resident is entitled to view or receive a copy of the resident's own medical record, free of charge.

14. Each resident may participate personally, or through a legal representative, in all decisions regarding the resident's own health care.

15. Each resident or legal representative of the resident shall receive, upon request, a complete explanation of the resident's medical condition, any recommended treatment, and the possible benefits or risks involved.

16. A resident may appoint a legal representative with a durable power of attorney to handle financial matters if the resident is unable to do so.

17. Pursuant to section 4 of the "New Jersey Advance Directives for Health Care Act," P.L. 1991, c. 201 (26:2H-56), a resident may execute an advance directive concerning the use of life-sustaining treatment, and may appoint a legal representative with a durable power of attorney to act on behalf of the resident with regard to health care decisions. The resident has the right to expect that the provisions of the advance directive will be executed to the fullest extent possible.

18. Each resident shall receive every service, as contracted in the continuing care agreement that was executed upon the resident's admission, unless waived in writing by the resident, with the exception of changes required by State or Federal law or permitted in the continuing care agreement.

19. A resident shall have the right to receive guests and visitors at the facility, and the right to allow guests to stay for a reasonable temporary period of time in a guest apartment or unit in the facility, subject to reasonable policies and procedures of the facility.

20. A resident may leave and return to the resident's independent living unit at will, provided the resident informs the facility if the resident will be temporarily absent overnight, or for a longer period of time. The facility shall notify residents in writing as to whether they will be charged a per diem fee or other charges during any such time that they are absent from the facility.

21. A resident has the right to refuse to perform work or services for the facility without coercion, discrimination, or reprisal by the facility.

22. No resident shall be requested or required to accept any restriction of the rights or privileges of a resident as set forth in this section.

23. A resident may request from the facility, and shall receive without undue delay and without cost, a copy of the rights of nursing home residents, as provided in section 5 of P.L. 1976, c. 120 (30:13-5).

24. A resident may request from the facility, and shall receive without undue delay and without cost, a copy of the rights of residents of assisted living facilities, as provided in section 1 of P.L. 2011, c. 58 (26:2H-128).

25. A resident may request from the facility, and shall receive without undue delay and without cost, a copy of the "Bill of Rights for Continuing Care Retirement Community Residents in Independent Living," as provided in section 5 of P.L. 2013, c. 167 (52:27D-360.5).

26. A resident who is insured by a health maintenance organization has the right to be referred by the resident's primary care physician to the nursing care unit that is part of the resident's facility instead of any other unit, provided that the unit has the capacity to provide the services needed and that it is in the best interests of the resident, and further provided that the facility accepts the applicable reimbursement rate. This right also applies to any resident being discharged from a hospital or similar facility.

27. A resident shall receive, upon request without undue delay and without cost, a fee schedule for any uncovered service before agreeing to the performance of that service.

28. Each resident shall have the right to receive a copy of the facility's annual disclosure statement, including certified financial statements, once they have been filed with the Department without undue delay and without cost.

29. A resident who is experiencing financial difficulties may thoroughly investigate with the facility any financial assistance which may be available to allow the resident to remain at the facility. The facility shall provide sustaining charitable assistance, unless the facility can demonstrate that:

i. Providing this assistance would adversely affect the financial health of the facility;

ii. The resident has violated the terms of the continuing care agreement or providing this assistance would violate the terms of the continuing care agreement; or

iii. Providing this assistance would cause the facility to violate a covenant in a loan agreement.

30. A resident may remain in a facility despite financial difficulty until the facility demonstrates to the Department that the entrance fee the resident paid, if applicable, has been fully earned by the facility, using the formula set forth under the Department regulations for rescission and removal, pursuant to 5:19-6.5(f). A resident shall not be permitted to remain at the facility if the financial difficulty is due to the resident's misrepresentation to the facility about the extent of the resident's assets or income or if the resident gives away significant assets while residing at the facility. The facility shall notify the resident in writing of any right that the resident may have to appeal that determination.

31. Each resident shall be informed of Medicare and Medicaid program benefits and shall receive assistance in accessing these benefits to the extent that they are available at the facility.

N.J. Admin. Code § 5:19-9.2

Adopted by 47 N.J.R. 710(a), effective 4/6/2015.