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50 N.J.R. 1292(a) 
VOLUME 50, ISSUE 10, MAY 21, 2018 
RULE ADOPTIONS 
 
Reporter 
50 N.J.R. 1292(a) 
NJ - New Jersey Register  >  2018  >  MAY  >  MAY 21, 2018  >  RULE ADOPTIONS  
>  LAW AND PUBLIC SAFETY -- DIVISION OF CONSUMER AFFAIRS 
 
Agency 
 
LAW AND PUBLIC SAFETY > DIVISION OF CONSUMER AFFAIRS > OFFICE OF THE 
DIRECTOR 
 
Administrative Code Citation 
  
Adopted Amendments: N.J.A.C. 13:45B-13.2 and 13.5 
 
Adopted New Rule: N.J.A.C. 13:45B-13.5A 
Text 
  
Definitions; Registration Renewal 
Proposed: August 21, 2017, at 49 N.J.R. 2759(a). 
Adopted: April 23, 2018, by the Division of Consumer Affairs, Kevin 
Jespersen, Acting Director. 
Filed: April 25, 2018, as R.2018 d.116, with non-substantial changes 
not requiring additional public notice and comment (see N.J.A.C. 1:30-
6.3). 
Authority: N.J.S.A. 34:8-54. 
Effective Date: May 21, 2018. 
Expiration Date: June 16, 2022. 
Summary of Public Comments and Agency Responses: 

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50 N.J.R. 1292(a) 
 
 
 
The official comment period ended October 20, 2017. The Division 
received 297 comments from the following individuals: 
1. John Buck, President, National Institute for Home Care Accreditation 
2. William Miska, Managing Member, Health & Comfort Home Care Agency 
3. Jackie Major, Certified Senior Advisor, Director of Operations, 
Right at Home 
4. Linda Lowerre, Executive Director, On Call Health Professionals 
5. Steven Feinman, Executive Director, Visiting Angels 
6. Dennis Crippen, Proprietor, Synergy HomeCare of South Jersey 
7. Nancy Von Behren 
8. Ron Von Behren 
9. Deborah Scott 
10. Beverly Faner 
11. Sandra Goldman 
[page=1293] 12. Frank Impagliazzo 
13. Davidetta Neewilly 
14. Jessica Connolly 
15. Georgjean Maxwell 
16. Michele Zar 
17. Cindy Darling 
18. April Keller 
19. Bonnie L. Schroter, Office Manager Synergy HomeCare 
20. William Shea 
21. D. Lynette Chandler-Roslansky 
22. Kathy Cruz 
23. Stephen Rymal, Director, Griswold Home Care of Burlington, 
Gloucester/Salem and Hunterdon Counties of NJ 
24. Donna M. Riebel, Case Coordinator, Griswold Home Care 
25. Tabitha Kern 

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50 N.J.R. 1292(a) 
 
 
 
26. Dave Kern 
27. Nicole Bachich 
28. Sue McNierney 
29. Patrick Roslansky 
30. Christopher Capobianco, President and Owner, Twin Folks Inc., dba 
Home Instead Senior Care 
31. Andrea Sussman, MSW, Executive Director, SNS, LLC, dba Home Instead 
Senior Care 
32. Julie Shea, Owner, Wes & J Company Inc., dba Home Instead Senior 
Care 
33. Antonio Podia, Owner, SYNERGY HomeCare North West NJ 
34. Paul Euell, Franchise Owner 
35. Maria McArthur 
36. Dennis Crippen, Proprietor, SYNERGY HomeCare 
37. Joan Smeraski 
38. Frances P. Sykes 
39. Kathleen Connolly, Home Care Employee 
40. Sharon Kolas, Home Care Employee 
41. Joseph Bachich, Director, Griswold Home Care, Camden County, NJ 
42. Natalie Bachich 
43. Paul B. Freedman, ACSW, Executive Director, Jewish Family & 
Children's Service Monmouth County 
44. Olivia Michalkiewicz 
45. Ian S. Lagary 
46. Tracy Lagary 
47. Matthew P. Murphy, CEO, Griswold International, LLC 
48. Lori Grifa 
49. Joseph Mandala 
50. Barbara Brand 

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50 N.J.R. 1292(a) 
 
 
 
51. Nadine Green 
52. Doug Robertson, Licensure & Regulatory Affairs Specialist, Quality 
and Standards Department, Right at Home 
53. Jeff Gertsner 
54. Janel Tan 
55. Joseph Maddaloni, Jr. Est., Chief Executive Officer, Home Health 
Association of New Jersey 
56. Alexander Frattellone 
57. Maria Bachich, Director, Griswold Home Care, Cape Atlantic Office 
58. Jane Mandala 
59. Jeremy Tan 
60. Mark Rosenblum 
61. Mindy Rosenblum, President, Health Force 
62. Glenn Joseph Novak 
63. Karly Rich, Case Manager, Griswold Home Care Middlesex & Mercer 
County 
64. Astrid Bachich 
65. Theresa La Rosa 
66. Elisa VanBlerk 
67. Shawnda Blanks 
68. Joan Daisey, Caregiver 
69. Gregg Villany 
70. Jill Villany 
71. Dennis A. Lelli 
72. Karen Villany 
73. Dorothy Bulko 
74. Tangela Lane 
75. Melissa Thompson 
76. Virgile Rivet 

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50 N.J.R. 1292(a) 
 
 
 
77. Chrissy Buteas, President & CEO, Home Care & Hospice Association of 
NJ, Inc. 
78. Laurie Hunter 
79. Nina Bachich 
80. Lauren Prefer 
81. Kyle Brooks 
82. Patricia O'Malley, RN, MSN 
83. Kelsey Fehlhaber 
84. Heidi Snook 
85. Debra Sherman 
86. Brendan Sullivan 
87. Susan Divadi 
88. Sheila Sasnow 
89. Leon Scher 
90. Kimberly Murray 
91. Althea T. Bormida 
92. Russell Weiner 
93. Brendan Watson 
94. Annette Seborowski 
95. Stephanie Aderente 
96. John C. Riebel, Sr. 
97. Robert Herman 
98. Shane Martin 
99. Donna M Riebel 
100. Robert E. Maxwell 
101. Brian Carnette 
102. John C. Riebel, Jr. 
103. Leslie Barnoff 

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50 N.J.R. 1292(a) 
 
 
 
104. Veronica Bertuicci 
105. Teranice Adams 
106. Kathy Cruz 
107. Vincent Berutucci 
108. Roxanne Lacy 
109. Hannah Ingram 
110. Carol Jean Lieber 
111. Cindy Curnutte 
112. Nicole Hitchner 
113. Martin Rudnick 
114. K.R. Harquail 
115. Joan Fishbeir 
116. Sydell Cohen 
117. Jack Caporeia 
118. Abby Rudnick 
119. Avery Gardner 
120. Madeline Murray 
121. Maria Totoy 
122. Helen Torrance 
123. R.D. Bonniri 
124. Christine Graziano-Zill 
125. Carole Rogers 
126. John Hackett 
127. Lora Beaulieu 
128. Mark Zill 
129. Todd Zane Adams 
130. Eugene Neuzil 
131. Vito Puleio 

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50 N.J.R. 1292(a) 
 
 
 
132. Robert Forman 
133. Anita Kudwitt 
134. Muriel Jacobs 
135. Paula R. Davis 
136. Julia Harquail 
137. Teresa Calabrese 
138. Jill Ransome 
139. Eleanor D. Maxwell 
140. Donald Bundy 
[page=1294] 141. John M. Riebel 
142. Robert A. Bundy 
143. Beth Phillips 
144. Hazel Ransome 
145. Rose Riebel 
146. Kelly Burke 
147. Michael Duncan 
148. Sandra Duncan 
149. George Duncan 
150. Helen Schultz 
151. Diane Duncan 
152. Sheila Bandilla 
153. Diane Bickford 
154. Janet Cordon 
155. Tess Schott 
156. Carl Reich 
157. Amanda Duncan 
158. J. David Adunek 
159. Sally Thurber 

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50 N.J.R. 1292(a) 
 
 
 
160. Alfred Thurber 
161. Elizabeth Hardick 
162. Joanne Burns 
163. Joseph Schott 
164. James Tupino 
165. Susan Guerda 
166. Reginald Benesch 
167. Maryann Hatcher 
168. Andrew Padilla 
169. Joy Elmer 
170. Julia Eckert, RN, BSN 
171. Adam Eckert 
172. Ken Potts 
173. Jessica Kaznas 
174. Jonathan Kaznas 
175. Jordan Cootes 
176. Jacque Zitarosa 
177. Robert Zilinski 
178. Patricia Zilinski 
179. David M. Sykes 
180. Milan Jakula 
181. Randi Elman 
182. Vincent Ryan 
183. Dana Eisenberg 
184. Letisha Mosley 
185. Marie Galang 
186. Michael Sanfilippo 
187. Katie Mayerhoff 

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50 N.J.R. 1292(a) 
 
 
 
188. Marie Farrelly 
189. Toni Goldman 
190. Mary Ovitz 
191. Robert Muller 
192. Joan Lindenthal 
193. Frances Katz 
194. Bernie Scher 
195. David Cohen 
196. Furman H. Lacy 
197. Nancy Eller 
198. Charles Eckel 
199. Pat Fanarian 
200. Victoria Benesch 
201. Noia Tupino 
202. Chery Schott 
203. Linda M. Riebel Weiner 
204. Deb Exter 
205. Louis E. Spyes, Jr. 
206. Meryl Hallgreen 
207. Felicia Wolf 
208. Lorraine Baglio Wobern Smith 
209. Domenick Bertucci 
210. Robin Herman 
211. Tiara Smith 
212. Sheila Smith 
213. Jatiya Corbin 
214. Lisa Santiago 
215. Asigmia Stephensa 

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50 N.J.R. 1292(a) 
 
 
 
216. Carla Relson 
217. Weston Cutler 
218. Ben Daubell 
219. Asco Li 
220. Mary Sheis 
221. Marygard LaDian 
222. Miriam Holme 
223. Wayne Cummings 
224. Catherin Riccolsene 
225. Dorethea Macleroid 
226. Tracey Dobosz 
227. Joseph F. Dirimio Sr. 
228. Carol Dirimio 
229. Kristy Hoover 
230. Max Dauler 
231. Carl Riad 
232. Jimbo Daulie 
233. Robert M. Difrimio 
234. William Cummings 
235. John McGuaifo 
236. Beth DiCola 
237. Jackie Lireeleo 
238. Mary K. Krattenmaker 
239. Clestine Difrimio 
240. Alix Ninoptor 
241. Molly Vaulrie 
242. Frances Difrimio 
243. Kina E. Mears 

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50 N.J.R. 1292(a) 
 
 
 
244. Diriaume Holmes 
245. Stella Rose 
246. Galiut Gliny 
247. Pauline Pagan Torres 
248. Arlene T. Johnson 
249. Edith Chestnut 
250. Elsie Ailwyn 
251. Sandra Bivin 
252. Joan Fauner 
253. Charles H. Green 
254. Arlene Pollock 
255. Jennifer Lee Angelus 
256. Darlene Mashura 
257. Frances Plumline 
258. Catherine Love 
259. Steven Walker 
260. Penelope Tevis 
261. Robert Hee 
262. Regina Zuggi 
263. Helen Mull 
264. Dorinda A. Francis 
265. Babe Reihl 
266. Josephine Marella 
267. Shanice Rose 
268. Robert Ford 
269. Donna H. Shultz 
270. Dorothy A. Ryan 
271. Cindy Jauell 

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50 N.J.R. 1292(a) 
 
 
 
272. Frank Fisher 
273. Gerda Merog 
274. Brenda Berry 
275. Mary E. Gatto 
276. Bernadine M. Weiss 
277. Lenora R. Walters 
278. Jean Wright 
279. Vincent Nicolo 
280. Lawrence Baruff 
[page=1295] 281. Shirley Clark 
282. Irene Green 
283. Sherford Giels 
284. Pat Chapman 
285. Cherie Fisher 
286. Joyce DeLancey 
287. Pauline Welliers 
288. June M. Christopher 
289. Irene Wheldder 
290. Ruth Karmenski 
291. Kimberly Almuchy 
292. Louise Terruso 
293. Ann Barlet 
294. Cheryl Horsey 
295. Evelyn Santiago 
296. Cheryl Murphine 
297. Armazoine Nuskey 
1. COMMENT: Four commenters support the amendments and new rule. The 
commenters recognize the importance and value of accreditation. 

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50 N.J.R. 1292(a) 
 
 
 
RESPONSE: The Division thanks the commenters for their support. 
2. COMMENT: Nine commenters ask the Division to hold a public hearing 
on the amendments and new rule. 
RESPONSE: N.J.S.A. 52:14B-4 requires an agency to hold a public hearing 
if, within 30 days of the publication of the proposed rule in the New 
Jersey Register, sufficient public interest is shown in having a public 
hearing. N.J.A.C. 13:1E-4.3 states public interest is "sufficient" if 
"[a]t least 50 persons submit written requests to hold a public 
hearing." The commenters' request for a public hearing were submitted 
past the 30-day deadline for public hearing requests imposed by 
N.J.S.A. 52:14B-4, and there were only nine requests for a public 
hearing. As the standard for sufficient public interest set forth in 
N.J.A.C. 13:1E-4.3 has not been met, the Division need not hold a 
public hearing. As the nature of issues with the amendments and new 
rule were adequately covered by the written comments, the Division does 
not believe it is necessary to hold a public hearing. 
3. COMMENT: Many commenters contend that the amendments and new rule 
will increase costs for home health care. They are concerned that these 
increased costs will either force health care service firms to close or 
increase costs for those receiving services. Many contended that 
increasing costs would result in either patients reducing the amount of 
care they receive, patients turning to the "underground market" for 
unregulated services, or patients relying on Medicaid reimbursement to 
cover costs. Some of the commenters contend that forcing patients to 
rely on Medicaid would increase costs for New Jersey taxpayers. One 
commenter contends that increased costs would result in seniors leaving 
the State. Several commenters are concerned that increased costs would 
result in caregivers losing their jobs. Other commenters contend that 
the amendments and new rule would only benefit large health care 
service firms that can absorb the increased costs. 
RESPONSE: The Division recognizes that the amendments and new rule will 
impose costs on health care service firms. In the notice of proposal 
for the amendments and new rule, the Division identified that there 
will be a significant economic impact on health care service firms. The 
increased costs for health care service firms may very well lead to 
increased costs for home health care. While costs may increase, the 
Division must implement the requirements of P.L. 2014, c. 29, and 
cannot revise these statutory requirements. 
4. COMMENT: A commenter questions why a law was enacted without the 
input of the people who will be affected by that law. 

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50 N.J.R. 1292(a) 
 
 
 
RESPONSE: P.L. 2014, c. 29, was enacted after hearings in the 
Legislature, which provided an opportunity for interested parties to 
provide their input on the law. 
5. COMMENT: Several commenters contend that the amendments and new rule 
provide little benefit for consumers and are focused solely on 
administrative functions. 
RESPONSE: The Division believes that holding health care service firms 
to accreditation standards as required by P.L. 2014, c. 29, will ensure 
that all firms are meeting the same standards, which will protect the 
health, safety, and welfare of those who receive services from such 
firms. 
6. COMMENT: A commenter contends that the amendments and new rule 
violate the Administrative Procedure Act as they do not utilize 
approaches that accomplish the objectives of the statute while 
minimizing adverse consequences to small businesses. The commenter 
contends that the amendments and new rule will drive up costs. 
RESPONSE: The provisions in the amendments and new rule reiterate the 
requirements of P.L. 2014, c. 29, for accreditation and auditing. As 
such, they accomplish the objectives of the statute and meet the 
requirements of the Administrative Procedure Act. 
7. COMMENT: Several commenters request that it be made clear that any 
entity that places or facilitates the placement of a caregiver in a 
home must obtain a license as a health care service firm. 
RESPONSE: N.J.S.A. 34:8-45.1 dictates that any entities, except for 
home health care agencies, which place or arrange for the placement of 
personnel to provide companion services, health care, or personal care 
services in the home of a person with a disability or a senior citizen 
age 60 or older, be registered as a health care service firms. 
8. COMMENT: A commenter contends that health care service firms are 
already regulated by the Department of Health and the Board of Nursing 
and that health care service firms cannot afford the additional 
administrative fee audits will impose while keeping their services 
affordable. 
RESPONSE: Health care service firms are regulated by the Division of 
Consumer Affairs and not the Department of Health or the Board of 
Nursing. While both the Department of Health and the Board of Nurses 
may have rules that address care or the licensure of those who provide 
care, the rules of health care service firms is solely within the 
purview of the Division. Health care service firms are required to 
undergo audits pursuant to P.L. 2014, c. 29. As stated above, the 

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50 N.J.R. 1292(a) 
 
 
 
Division recognizes that the amendments and new rule will impose costs 
on health care service firms, but these costs are imposed due to the 
requirements of P.L. 2014, c. 29, and the Division cannot revise these 
statutory requirements. 
9. COMMENT: Two commenters contend that the home care industry is 
heavily regulated and see no value in the amendments and new rule. 
RESPONSE: The amendments and new rule were adopted pursuant to the 
dictates of P.L. 2014, c. 29, which requires health care service firms 
to hold accreditation and undergo audits. 
10. COMMENT: Many commenters contend that the notice of proposal failed 
to identify the economic impact of the amendments and new rule. The 
commenters provided estimates for the costs of audits that ranged from 
$ 15,000 to $ 30,000. Several commenters contend that accreditation 
would cost $ 7,740 a year while many others contend that this cost 
would be $ 175,000. The commenters contend that the failure of the 
Economic Impact statement to identify these costs means that the notice 
of proposal does not comply with the Administrative Procedure Act and 
cannot be adopted. 
RESPONSE: The Economic Impact statement recognized that the amendments 
and new rule will have a significant economic impact. The Division does 
not dispute the costs identified by the commenters, but points out that 
the wide disparity between those costs indicates that there is no 
consensus as to what they will be. The recognition in the notice of 
proposal that such costs would be significant satisfies the requirement 
that the Division identify possible costs as required under the 
Administrative Procedure Act. 
11. COMMENT: A commenter points out that the regulatory flexibility 
analysis stated the amendments and new rules impose no recordkeeping 
requirements. The commenter contends that this is incorrect as health 
care service firms will need to maintain records to comply with 
accreditation and auditing requirements. 
RESPONSE: The regulatory flexibility analysis accurately stated that 
the amendments and new rule do not impose recordkeeping requirements. 
Health care service firms may be required to keep records by 
accrediting entities or to meet auditing requirements, but these 
recordkeeping requirements are not directly imposed by the amendments 
and new rule. 
[page=1296] 12. COMMENT: A commenter supports the new definition for 
"companion services" in N.J.A.C. 13:45B-13.2. 
RESPONSE: The Division thanks the commenter for her support. 

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50 N.J.R. 1292(a) 
 
 
 
13. COMMENT: Three commenters recommend that the definition of 
"companion services" in N.J.A.C. 13:45B-13.2 be amended to read: 
"Companion 
services 
are 
basic 
supervision, 
household 
chores, 
companionship, and socialization services, which do not include 
assistance with Activities of Daily Living (ADL). These tasks and 
incidental touching would include helping with homemaking, shopping, 
food and meal preparation, housekeeping, laundry, transportation, and 
companionship/socialization in the individual's home. This 'incidental 
touching' would include normal physical contact or 'polite touching' 
such as holding the client's hand while getting in and out of the car, 
assisting with buttoning or fastening clothing, queuing touch, helping 
the client grasp a phone or other device, or touching that is needed to 
engage in games or other social activities. These tasks and physical 
contact are not intended for treatment, therapeutic, restorative or 
curative reasons, help with personal care and ADLs, do not require 
nursing judgment, and is solely in support of homemaking, companionship 
or IADL activities." 
RESPONSE: The definition of "companion services" is taken from P.L. 
2014, c. 29 and the Division declines to change the definition upon 
adoption, as it is in keeping with the statute. 
14. 
COMENT: 
A 
commenter 
opposes 
regulating 
companion 
services 
differently than personal care services. The commenter is concerned 
that businesses misclassified as registries, placement agencies, or 
Internet providers will be able to offer companion services by sending 
untrained individuals to provide care in the home. 
RESPONSE: Pursuant to P.L. 2014, c. 29, any and all entities that 
provide companion services must register as health care service firms. 
15. COMMENT: A commenter points out that the definition of "companion 
services" in N.J.A.C. 13:45B-13.2 references "household chores." The 
commenter contends that Medicaid does not cover household chores and 
that, therefore, firms providing companion services should not be 
required to comply with Medicaid requirements. 
RESPONSE: The definition of "companion services" in P.L. 2014, c. 29, 
includes the reference to "household chores," stating that such chores 
may be companion services. The definition in N.J.A.C. 13:45B-13.2 does 
not require firms to comply with Medicaid reimbursement requirements; 
entities that provide companion services are required by P.L. 2014, c. 
29, to register as health care service firms. 
16. COMMENT: A commenter contends that Division employees have told him 
that companions will now be required to become certified homemaker-home 
health aides. 

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50 N.J.R. 1292(a) 
 
 
 
RESPONSE: The commenter was misinformed. Individuals who provide 
companion services will not be required to become certified homemaker-
home health aides. 
17. COMMENT: A commenter contends that there are Internet-based 
entities that permit consumers to directly connect with companions to 
provide services. The commenter contends that this defies New Jersey 
law. The commenter points out that all entities providing companion 
services must register as health care service firms. The commenter asks 
how the Division will ensure that such entities are complying with New 
Jersey law. 
RESPONSE: The Division will investigate any allegations of entities 
that are violating the provisions of P.L. 2014, c. 29. 
18. COMMENT: A commenter opposes regulations that impose overtime pay 
after a companion works more than 40 hours in a week. 
RESPONSE: There are no Division rules that impose overtime pay for 
companions. 
19. COMMENT: A commenter contends that companions should be able to 
work independently. Another contends that the regulations should not 
require companions and babysitters to work for licensed agencies. 
RESPONSE: P.L. 2014, c. 29 dictates that any entity that provides 
companion services register as a health care service firm. The law does 
not 
prohibit 
companions 
from 
working 
independently 
or 
require 
companions or babysitters to work for a health care service firm. 
20. COMMENT: A commenter contends that Medicaid does not cover 
companion services and that health care service firms that provide 
companion services should not have to meet Federal Medicaid Program 
requirements. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
obtain accreditation, regardless of whether those firms limit the 
services they offer to companion services. 
21. COMMENT: A commenter requests that the Division post the name, 
address, registration number, phone number, and accreditation status of 
every health care service firm on its website. 
RESPONSE: The Division website lists the name, address, phone number, 
and registration expiration date of every health care service firm. The 
Division believes that this provides adequate information for consumers 
to identify the entities registered as health care service firms in New 
Jersey and that it is not necessary to list the additional information 
suggested by the commenter. 

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50 N.J.R. 1292(a) 
 
 
 
22. COMMENT: A commenter opposes requiring health care service firms to 
obtain accreditation as it will impose costs on firms. The commenter 
estimates that the annual cost of accreditation is $ 35,000. These 
costs will make homecare services unaffordable. 
RESPONSE: P.L. 2014, c. 29 dictates that all health care service firms 
obtain accreditation. 
23. COMMENT: A commenter contends that accrediting entities require 
mandatory in-service training that would cost health care service firms 
$ 50,000 per year for instructors, facilities, training materials, and 
certified homemaker-home health aide salaries. 
RESPONSE: Regardless of the costs imposed by accrediting entities, P.L. 
2014, c. 29 requires every health care service firm to obtain 
accreditation. 
24. COMMENT: A commenter contends that requiring health care service 
firms to obtain accreditation is a financial hardship. The commenter 
recommends that the Division audit health care service firms and 
increase licensing fees, so that the Division and the Board of Nursing 
can generate more income. The commenter recommends that the Division 
not adopt the accreditation requirement or, if the regulation is 
adopted, that it not apply until 2019. 
RESPONSE: P.L. 2014, c. 29 requires health care service firms to obtain 
accreditation. The Division cannot ignore this statutory requirement as 
the commenter recommends. The Division points out that registration 
fees are imposed to cover the cost of regulating health care service 
firms, not to generate income for the Division or the Board of Nursing. 
Pursuant to N.J.A.C. 13:45B-13.5, accreditation requirements will not 
be effective until one year from the adoption of the amendments and new 
rule. 
25. COMMENT: A commenter is concerned that health care service firms 
with little experience could become accredited and begin to accept 
Medicaid or other State or Federal funds. The commenter recommends that 
the Division institute a conditional accreditation requirement that 
would allow newly licensed health care service firms to operate for a 
period of time, so that firms could accumulate an operating history. 
This would provide accrediting bodies with the information they need to 
assess whether full accreditation for these firms is appropriate. 
RESPONSE: The Division has no authority over accrediting entities or 
their decisions as to which health care service firms should be 
accredited. P.L. 2014, c. 29 does not permit the Division to institute 
the conditional accreditation recommended by the commenter. 

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50 N.J.R. 1292(a) 
 
 
 
26. COMMENT: A commenter contends that many health care service firms 
are private pay firms and do not receive Medicaid funding. The 
commenter contends that such firms should not be held to the standards 
of the Federal Medicaid Program. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
obtain accreditation. The law does not make a distinction between 
health care service firms that receive Medicaid funding and those that 
do not. 
27. COMMENT: A commenter contends that most health care service firms 
do not provide skilled nursing services and are not providers for 
Medicaid or other State-funded programs that reimburse agencies. The 
commenter also contends that accreditation standards are related to 
skilled care and State-funded programs. This means that accreditation 
requirements often have nothing to do with the practices of health care 
service firms. 
[page=1297] RESPONSE: P.L. 2014, c. 29 requires all health care service 
firms to obtain accreditation regardless of the services they provide 
or the sources of reimbursement. 
28. COMMENT: A large number of commenters contend that requiring health 
care service firms that provide non-medical and non-skilled home care 
to meet Medicare accreditation standards serves no useful business 
purpose and increases costs for consumers. 
RESPONSE: P.L 2014, c. 29 requires all health care service firms to 
obtain accreditation, regardless of the services they provide. 
29. COMMENT: A number of commenters contend that Federal and Medicare 
standards make a distinction between skilled care and non-skilled care, 
and between medical care and non-medical care. The commenters contend 
that New Jersey laws and regulations must do the same. The commenters 
are concerned that the public will be confused if health care service 
firms that provide non-medical and non-skilled home care are required 
to comply with Medicare accreditation standards. The commenters believe 
that the public will be led to believe that non-medical care and non-
skilled care will be covered by Medicare or health insurance. 
RESPONSE: P.L. 2014, c. 29 does not make a distinction between skilled 
care and non-skilled care or between medical care and non-medical care. 
The law requires that every health care service firm that places or 
arranges for the placement of personnel to provide companion, 
healthcare, or personal care services must obtain accreditation. 
30. COMMENT: A commenter contends that requiring agencies that provide 
non-medical care to obtain accreditation is an intrusion into the 

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50 N.J.R. 1292(a) 
 
 
 
private life of senior citizens. The amendments and new rule will 
eliminate the ability of elderly citizens to make their own decisions. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
obtain accreditation. 
31. COMMENT: A commenter asks how often health care service firms will 
be required to renew accreditation. 
RESPONSE: Accreditation renewal periods are established by the 
accrediting entities recognized by the Department of Human Services. 
Health care service firms will be required to hold accreditation in 
order to renew annual registration with the Division. 
32. COMMENT: A commenter asks how the Division will deal with health 
care service firms that are unable to obtain accreditation. The 
commenter recommends that such firms be prohibited from providing 
services to consumers. 
RESPONSE: Pursuant to P.L. 2014, c. 29, a health care service firm 
cannot renew registration if it is not accredited. Such a health care 
service firm would need to cease providing services until it again 
obtains accreditation. 
33. COMMENT: A commenter recommends that, if a health care service firm 
is not permitted to renew registration, the Division prevent the owner 
of the firm, and his or her relatives, from opening a new health care 
service firm under a new firm name. 
RESPONSE: The Division does not have the authority to prohibit an owner 
or his or her relatives from opening a new health care service firm as 
the commenter recommends once it meets requisite accreditation 
standards. 
34. COMMENT: A commenter points out that health care service firm 
registration is renewed annually and that accreditation is renewed on a 
rolling basis depending on a firm's initial accreditation date. The 
commenter 
points 
out 
that 
accreditation 
could 
lapse 
between 
registration renewals. The commenter also points out that audits will 
be due on the same date for all health care service firms. The 
commenter asks how the Division will track accreditation and submission 
of audits to ensure that all firms comply with these requirements. The 
commenter recommends that health care service firms be required to 
submit proof of accreditation renewal within 10 days of renewing 
accreditation. 
RESPONSE: P.L. 2014, c. 29 requires health care service firms to obtain 
accreditation as a condition of being registered within 12 months of 
registration. In order to renew registration, health care service firms 

=== PDF PAGE 21 ===
 
50 N.J.R. 1292(a) 
 
 
 
will be required to submit evidence of accreditation. Health care 
service firms are required to notify the Division within 10 days if 
they lose accreditation. The Division believes that these requirements 
are sufficient to address accreditation status for health care service 
firms. 
35. COMMENT: A commenter contends that the term "homemaker agency" used 
in N.J.A.C. 13:45B-13.5(b) is outdated and that the term should be 
"home health agency, hospice agency, and health care service firm." The 
commenter contends that N.J.A.C. 10:60 is being amended to remove the 
term "homemaker." 
RESPONSE: The term "homemaker agency" is the term used in P.L. 2014, c. 
29, and it would be inappropriate to change that term as the commenter 
recommends. 
36. COMMENT: A commenter contends that the National Institute for Home 
Care Accreditation has entered into a Memorandum of Agreement with the 
Division of Consumers Affairs and the Division of Medical Assistance 
and Health Services to accredit health care service firms in New 
Jersey. The commenter also contends the Department of Human Services 
has amended N.J.A.C. 10:60-1.2, so that it no longer refers to specific 
accrediting bodies. The commenter believes that referencing N.J.A.C. 
10:60-1.2 in N.J.A.C. 13:45B-13.5A could be misleading. The commenter 
recommends that the Division remove reference to N.J.A.C. 10:60-1.2 
from N.J.A.C. 13:45B-13.5A, so that the regulation would require that 
accrediting bodies be recognized by the Commissioner of Human Services 
and enter into memorandums of understanding with the Division of 
Consumer Affairs. 
RESPONSE: N.J.A.C. 10:60-1.2 lists accrediting bodies and the Division 
is not aware of any rulemakings that would change this rule. The 
Division recognizes that the Department of Human Services recognizes 
the National Institute for Home Care Accreditation as an accrediting 
body without mention in N.J.A.C. 10:60-1.2, which is why the Division 
has entered into a memorandum with the National Institute for Home Care 
Accreditation and recognizes that health care service firms that hold 
this accreditation will satisfy the requirements of N.J.A.C. 13:45B-
13.5. P.L. 2014, c. 29 cites to N.J.A.C. 10:60-1.2 and it would be 
inappropriate for the Division to remove reference to this rule in 
N.J.A.C. 13:45B-13.5. 
37. COMMENT: A commenter recommends that N.J.A.C. 13:45B-13.5(d) be 
amended to require that notification to the Division be in writing. 
RESPONSE: 
The 
Division 
agrees 
that 
notification 
of 
change 
in 
accreditation status should be in writing and has changed N.J.A.C. 
13:45B-13.5(d) upon adoption to require that health care service firms 

=== PDF PAGE 22 ===
 
50 N.J.R. 1292(a) 
 
 
 
notify the Division in writing. This requirement does not impose a 
burdensome requirement on health care service firms and helps to ensure 
that the Division and health care service firms have documentary proof 
that notice was provided. 
38. COMMENT: A commenter contends that requiring accreditation and an 
audit is redundant. Health care service firms should be required to 
obtain accreditation or submit an audit, but not both. 
RESPONSE: P.L. 2014, c. 29 requires both accreditation and an audit. 
The Division must comply with the requirements of the statute. 
39. COMMENT: A commenter contends that there is conflict between 
Division standards, accrediting standards, and the standards an audit 
would address. The commenter identified conflict with required calls by 
nurses, with standards requiring either that a nurse make these calls 
or allowing a nurse designee to make them, whether the required 60-day 
visit to a home replace a nurse phone call if they are made in the same 
month, and whether unlicensed individuals will still be permitted to 
provide home-base services. The commenter asks how these conflicts will 
be resolved. 
RESPONSE: The Division does not believe that the commenter has 
identified conflicts that necessitate changes to its rules. It may be 
true that some accrediting bodies do not require that nurses make 
telephone calls or allow home visits to replace phone calls. The fact 
that accrediting bodies do not require the same standards as the 
Division is not a conflict. Health care service firms are required to 
meet the standards imposed by the Division for registration and the 
Division 
does 
not 
believe 
that 
accrediting 
bodies 
will 
deny 
accreditation because a health care service firm is meeting a more 
stringent standard than the ones identified by the accrediting bodies. 
40. COMMENT: A commenter contends that no other industry regulated by 
the Division of Consumer Affairs has to be accredited or undergo 
audits. 
The 
commenter 
contends 
that 
most 
health 
care 
service 
[page=1298] firms are part of a franchise and that franchisors provide 
sufficient oversight of health care service firms. 
RESPONSE: P.L. 2014, c. 29 requires health care service firms to obtain 
accreditation and to undergo audits regardless of oversight imposed by 
franchisors. 
41. COMMENT: A commenter recommends that the Director hire more 
inspectors 
and 
increase 
inspections 
as 
opposed 
to 
requiring 
accreditation and audits. 

=== PDF PAGE 23 ===
 
50 N.J.R. 1292(a) 
 
 
 
RESPONSE: P.L. 2014, c. 29 requires accreditation and audits and the 
Division must comply with these statutory requirements. 
42. COMMENT: A commenter contends that many health care service firms 
that have committed fraud were accredited and asks how accreditation 
will protect consumers. 
RESPONSE: Accreditation is imposed by P.L. 2014, c. 29. Allegations of 
fraud will be investigated by the Division and could result in 
revocation of registration. 
43. COMMENT: A commenter points out that the financial auditing 
requirements in the new rules do not provide for civil or criminal 
penalties and do not provide guidance for the purpose of the audit. The 
commenter contrasts this with Federal Medicaid Program audits that have 
a clear purpose and impose civil and criminal penalties for non-
compliance. 
RESPONSE: Auditing requirements are imposed by P.L. 2014, c. 29. 
Failure to comply with this statutory requirement would affect a health 
care service firm's registration. 
44. COMMENT: A commenter contends that the amendments and new rule 
require health care service firms to undergo three audits, a biannual 
audit by the Division of Consumer Affairs, a survey from an accrediting 
body, and an audit every three years. All of these audits address 
compliance with laws and regulations. The commenter contends that this 
is over regulation and a waste of time and money. 
RESPONSE: The commenter is incorrect that there is an existing biannual 
audit by the Division. Accreditation and auditing requirements are 
imposed by P.L. 2014, c. 29. 
45. COMMENT: A commenter asks how the Division will evaluate audit 
results and address compliance irregularities. 
RESPONSE: The Division will review audits to determine if they identify 
fiscal irregularities or failure to comply with statutory and 
regulatory requirements. 
46. COMMENT: A commenter asks why an audit performed by a certified 
public accountant is required when a certified public accountant would 
be unfamiliar with regulations on health care service firms. The 
commenter contends that accreditation is required to ensure that health 
care service firms are complying with regulations. 
RESPONSE: P.L. 2014, c. 29 requires an audit performed by a certified 
public accountant. 

=== PDF PAGE 24 ===
 
50 N.J.R. 1292(a) 
 
 
 
47. COMMENT: Two commenters ask if the audit submitted every three 
years will have to address the previous three years of operation by a 
health care service firm or only the last year. One of the commenters 
recommends that the audit requirement and registration renewal 
requirement be scheduled to coincide. 
RESPONSE: Audits will need to cover the previous three years. N.J.A.C. 
13:45B-13.5A(a) requires an audit to be submitted with the renewal of 
registration. 
48. COMMENT: A commenter contends that an accounting firm needs an 
audit guide, compliance guidelines, or a prescribed form in order to 
perform an audit. The commenter asks if the Division will develop these 
documents. 
RESPONSE: P.L. 2014, c. 29 requires an audit to comply with the 
Statement on Auditing Standards issued by the American Institute of 
Certified Public Accountants. 
49. COMMENT: Several commenters contend that, for private pay health 
care service firms, accreditation provides a standard for financial 
oversight and an audit is not necessary. The commenters contend that no 
other industries require private companies to have financial records 
audited unless public money is involved. One commenter contends that 
requiring health care service firms that do not receive Medicaid 
funding to comply with auditing requirements would violate the privacy 
rights of such agencies. The commenters recommend that audits only be 
required when a health care service firm accepts Medicaid or other 
State funding. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms, 
regardless of how they are reimbursed for services, to submit an audit. 
50. COMMENT: A commenter contends that audits could cost firms $ 10,000 
to $ 40,000. The commenter is concerned that these costs could force 
some health care service firms out of business and raise costs for home 
care. The commenter recommends that the audit requirement only apply to 
health care service firms that receive more than $ 500,000 in public 
funds. 
RESPONSE: The Division recognizes that auditing will impose significant 
costs on health care service firms. P.L. 2014, c. 29 requires all 
health care service firms to submit audits, regardless of whether they 
are reimbursed with public funds. 
51. COMMENT: A commenter points to American Institute of Certified 
Public Accountants statements that say that audits address "an entity's 
financial position, results of operations, and cash flow." The 

=== PDF PAGE 25 ===
 
50 N.J.R. 1292(a) 
 
 
 
commenter asks what purpose is served requiring such information from 
health care service firms which do not receive Medicaid funding. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
submit audits. 
52. COMMENT: Many commenters contend that requiring health care service 
firms that provide non-medical and non-skilled home care to undergo 
audits serves no useful business purpose. The commenters point out that 
audits are expensive and will not insure compliance with statutory or 
regulatory requirements. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
submit audits. 
53. COMMENT: Three commenters contend that submitting the audit 
required by N.J.A.C. 13:45B-13.5A will be very costly and is 
unreasonable. One of the commenter recommends that the Division amend 
N.J.A.C. 13:45B-13.5A to require the submission of financial statements 
and tax returns as opposed to an audit. 
RESPONSE: P.L. 2014, c. 29 requires all health care service firms to 
submit audits. The Division could not allow firms to substitute 
financial statements and tax returns for the statutorily mandated 
audits. 
54. COMMENT: A commenter recommends that N.J.A.C. 13:45B-13.5A(b) be 
amended to define the information that must be included in an audit of 
compliance with laws and rules governing health care service firms. The 
commenter recommends that the Division accept an accreditation entity's 
report on compliance to satisfy this auditing requirement. 
RESPONSE: P.L. 2014, c. 29 requires an audit to comply with the 
Statements on Auditing Standards issued by the American Institute of 
Certified 
Public 
Accountants. 
The 
Division 
could 
not 
accept 
accreditation reports as a substitute for the statutorily mandated 
audit. 
Federal Standards Statement 
A Federal standards analysis is not required because there are no 
Federal laws or standards applicable to the adopted amendments or new 
rule. 
Regulations 
  

=== PDF PAGE 26 ===
 
50 N.J.R. 1292(a) 
 
 
 
Full text of the adoption follows (additions to proposal indicated in 
boldface with asterisks *thus*; deletions from proposal indicated in 
brackets with asterisks *[thus]*): 
SUBCHAPTER 13.  HEALTH CARE SERVICE FIRMS 
13:45B-13.2  Definitions 
As used in this subchapter, the following terms shall have the 
following meanings unless the context clearly indicates otherwise: 
"Companion 
services" 
means 
non-medical, 
basic 
supervision 
and 
socialization services that do not include assistance with activities 
of daily living and that are provided in an individual's home. 
"Companion services" may include the performance of household chores. 
"Health care service firm" means any person who operates a firm that 
employs individuals directly or indirectly for the purpose of assigning 
the employed individuals to provide health care, personal care, or 
companion services either directly in the home or at a care-giving 
facility, and who, in addition to paying wages or salaries to the 
employed individuals while on assignment, pays or is required to pay 
Federal social security taxes and State and Federal unemployment 
insurance; carries or is required to carry worker's compensation 
[page=1299] insurance; and sustains responsibility for the action of 
the employed individuals while they render health care services. 
. . . 
13:45B-13.5    Registration renewal 
(a) (No change.) 
(b) Commencing with the first registration renewal after *[(12 months 
after the effective date of this amendment)]* *May 21, 2019*, and for 
every succeeding renewal, a health care service firm shall submit 
evidence that it is accredited by an accrediting body recognized by the 
Department of Human Services as an accrediting body for homemaker 
agencies participating in the Medicaid program, as set forth in 
N.J.A.C. 10:60-1.2. 
(c) Notwithstanding (b) above, a health care service firm that obtained 
its initial registration less than 12 months prior to renewal of 
registration shall not be required to submit evidence of accreditation 
when renewing registration for the first time. 
(d) If a health care service firm is no longer accredited as required 
under (b) above, either because of failure to renew accreditation or 
through actions taken by the accrediting body, the health care service 

=== PDF PAGE 27 ===
 
50 N.J.R. 1292(a) 
 
 
 
firm shall notify the Division *in writing* within 10 days of losing 
accreditation. 
13:45B-13.5A  Audits 
(a) Commencing *[(three years from the effective date of this rule)]* 
*May 21, 2021*, and every third year from that date, a health care 
service firm shall submit an audit to the Division that complies with 
the requirements of (b) below as part of the renewal of registration 
required under N.J.A.C. 13:45B-13.5. 
(b) The audit required by (a) above shall: 
1. Be conducted by a certified public accountant licensed in New Jersey 
and shall encompass an examination of the health care service firm's 
financial records, financial statements, the general management of its 
operations, and its internal control systems; 
2. Include an audit report with an unqualified opinion and shall be 
accompanied by any management letters prepared by the auditor in 
connection with the audit commenting on the internal controls or 
management practices of the health care service firm; and 
3. Be divided into two components of which: 
i. One is a compliance component that evaluates the health care service 
firm's compliance with laws and rules governing health care service 
firms; and 
ii. One is a financial component that includes an audit of the 
financial statements and accompanying notes, as specified in the 
Statements on Auditing Standards issued by the American Institute of 
Certified Public Accountants. 
 
NEW JERSEY REGISTER 
Copyright © 2018 by the New Jersey Office of Administrative Law 
 
 
End of Document 
