[Rev. 2/10/2015 5:33:14
PM--2014R2]
CHAPTER 450 - COUNTY HOSPITALS AND HOSPITAL
DISTRICTS
GENERAL PROVISIONS
NRS 450.005 Definitions.
NRS 450.006 “Allied
health profession” defined.
NRS 450.008 “Purchasing
group” defined.
COUNTY HOSPITALS
Definitions
NRS 450.010 “Taxpayers”
defined.
Establishment
NRS 450.020 Procedure.
NRS 450.030 Petition
signed by at least 30 percent of taxpayers; submission of question at next
general election.
NRS 450.040 Petition
signed by at least 50 percent of taxpayers; submission of question at next
primary or general election.
NRS 450.043 Motion
of board of county commissioners; submission of question at special election or
next primary or general election.
NRS 450.045 Approval
of bond issue; appointment of board of hospital trustees; issuance and sale of
bonds.
NRS 450.050 Administration,
control and government of county hospitals acquired by purchase or construction
under provisions of certain legislative acts.
NRS 450.060 Acquisition
of additional building or site when board of hospital trustees assumes control
of existing hospital.
Board of Hospital Trustees
NRS 450.070 Number;
election; terms of office.
NRS 450.080 Office
of hospital trustee nonpartisan.
NRS 450.090 Selection
of county commissioners for membership on board.
NRS 450.100 Oath
and bond.
NRS 450.110 Vacancies.
NRS 450.120 Officers
of board.
NRS 450.130 Compensation
and expenses of trustees.
NRS 450.135 Interest
in purchase of supplies prohibited; exception.
NRS 450.140 Meetings
of board; quorum.
NRS 450.150 General
powers and duties of board.
NRS 450.160 Rules
and regulations.
NRS 450.165 Board
authorized to acquire building or other facility for provision of health care
in county adjacent to county where hospital is established; board authorized to
issue special obligations to finance facility.
NRS 450.170 Visits
and examinations of hospital; report to board of county commissioners.
NRS 450.175 Hospital
advisory board in certain counties: Appointment; powers and duties;
compensation of members.
NRS 450.180 Employment
or removal of employees or appointed persons; contract for medical services.
NRS 450.191 Contract
for management of hospital.
NRS 450.200 Condemnation
of property for use by hospital.
NRS 450.210 Approval
of plans and specifications for construction of hospital; advertisement of
bids.
NRS 450.220 Gifts
and bequests to hospital: Title vested in county; control by board of hospital
trustees.
Finances
NRS 450.230 Budget.
NRS 450.240 Management
of county hospital by board; levy of tax for maintenance and operation.
NRS 450.250 Control
of expenditures by board; lease of buildings; deposit of money in hospital fund
or separate account.
NRS 450.255 Mortgage
or pledge of personal property of hospital; acquisition of real property for
expansion.
NRS 450.260 Collection
or settlement of claims.
Bonds
NRS 450.270 Maximum
amount.
NRS 450.280 Purposes
and procedure for issuance of general obligation bonds at request of board of
hospital trustees.
NRS 450.290 Issuance
of general and special obligation bonds by board of county commissioners.
NRS 450.300 Applicability
of Local Government Securities Law.
NRS 450.310 Schedules
of fees, rates and charges for services, facilities and commodities.
Administration
NRS 450.390 Hospital
for benefit of county; payment of charges; exclusion of persons from use of
hospital.
NRS 450.400 Extension
of privileges and use of hospital to certain nonresidents: Notice; removal of
person to resident county; payment for temporary care; action for recovery of
charges.
NRS 450.410 Admission
of paying patients; charges.
NRS 450.420 Board
of county commissioners to determine status of patient; charges fixed by board
of hospital trustees; costs chargeable to county; exceptions.
NRS 450.425 Board
of county commissioners may levy ad valorem tax to pay cost of services
rendered at hospital to certain persons admitted for emergency treatment.
NRS 450.430 Equal
privileges of practitioners; exception; rights of patients; loss of hospital
privileges not adverse action against physician in certain circumstances.
NRS 450.440 Staff
of physicians: Organization; affiliation with university; rotation of service;
assistance.
NRS 450.450 General
administration of hospital subject to regulations of trustees.
NRS 450.455 Program
for training resident physicians.
NRS 450.460 School
for training nurses.
NRS 450.470 Room
for examination of persons alleged to have mental illness; room for custodial
supervision of persons with mental illness and dangerous persons.
NRS 450.480 Use
of paramedics for emergency care authorized.
NRS 450.485 Contract
for use of facility for intermediate care or facility for skilled nursing.
Transfer
NRS 450.490 Conveyance
or lease of hospital to corporation.
NRS 450.500 Conveyance
or lease of hospital to nonprofit corporation.
NRS 450.510 County
whose population is less than 100,000 may contract with community nonprofit
hospital for care of indigent patients; enlargement or alteration of hospital.
Miscellaneous Provisions
NRS 450.520 Determination
that emergency exists before submission of certain questions at special
election.
NRS 450.525 Membership
of hospital in purchasing group.
NRS 450.530 Purchase
of supplies, materials and equipment without complying with certain
requirements for competitive bidding.
COUNTY HOSPITAL DISTRICTS
NRS 450.550 Definitions.
NRS 450.560 Establishment
of district on motion of board of county commissioners.
NRS 450.570 Notice
of intent to establish district: Contents; publication.
NRS 450.580 Objections
to formation of district; hearing.
NRS 450.590 Establishment
of district: Petition of owners of property; adoption, contents and publication
of resolution of intention to establish district; exception.
NRS 450.600 Hearing
on petition.
NRS 450.610 Resolution
creating district.
NRS 450.620 Enactment
of ordinance regarding number, terms and election of trustees; service of board
of county commissioners ex officio as board of trustees.
NRS 450.625 Trustees
of district that includes territory within more than one county.
NRS 450.630 General
powers and duties of board of trustees; rules and regulations.
NRS 450.640 Employees
and staff of hospital: Appointment to board of chief of staff of physicians for
district hospital; appointment by board of chief executive officer and
necessary assistants for hospital; compensation; removal; admission.
NRS 450.650 Budgets.
NRS 450.660 Tax
levies; disposition of proceeds.
NRS 450.665 Powers
of board of trustees: Borrowing of money and incurrence or assumption of
indebtedness; limitations and conditions.
NRS 450.670 Powers
of board of trustees: Issuance and sale of bonds for certain purposes.
NRS 450.675 Powers
of board of trustees: Mortgage or pledge of personal property and acquisition
of real property.
NRS 450.680 Election
concerning issuance of bonds; applicability of Local Government Securities Law.
NRS 450.690 Donations.
NRS 450.700 Board
of trustees to determine status of patient and fix charges.
NRS 450.710 Creation
of district for sole purpose of contracting for services of hospital.
NRS 450.715 Authority
of board of trustees to contract for services of hospital.
NRS 450.720 Contract
for management of district hospital.
NRS 450.725 Membership
of district hospital in purchasing group.
NRS 450.730 Purchase
of supplies, materials and equipment without complying with certain
requirements for competitive bidding.
NRS 450.750 Board
of county commissioners in certain districts deemed local government
responsible for transferring certain payments of money.
NRS 450.751 Dissolution
of hospital district in county whose population is less than 700,000:
Determination that dissolution is in best interest required; ordinance of board
of county commissioners; considerations; duties of county clerk.
NRS 450.753 Dissolution
of hospital district: Right of qualified electors to protest; dissolution
prohibited if majority of qualified electors protest; dissolution by final
ordinance; recital of protests.
NRS 450.755 Dissolution
of hospital district: Hearing; full consideration of all protests required;
adoption of final ordinance of dissolution or ordinance of nondissolution by
board of county commissioners.
NRS 450.757 Dissolution
of hospital district: County clerk must file final ordinance of dissolution;
locations.
NRS 450.759 Dissolution
of hospital district in county whose population is less than 700,000: Unpaid
taxes, levies and assessments are lien on property; power of board of county
commissioners to collect.
NRS 450.760 Dissolution
of hospital district in county whose population is less than 700,000: Retirement
of outstanding debt and other obligations; levy of property tax; disposition of
property.
MISCELLANEOUS PROVISIONS
NRS 450.800 County
or district hospital may contract for services.
NRS 450.810 Lease
of naming rights relating to public hospital; ordinance establishing procedures
for lease; enterprise fund for proceeds of lease, fees or charges and other
money received for public hospital.
_________
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GENERAL PROVISIONS
NRS 450.005 Definitions. As
used in this chapter, unless the context otherwise requires, the words and
terms defined in NRS 450.006 and 450.008 have the meanings ascribed to them in those
sections.
(Added to NRS by 1975, 641; A 1977, 961; 1979, 150; 1991, 1133; 1999, 191)
NRS 450.006 “Allied health profession” defined. “Allied
health profession” means:
1. Psychology as defined in chapter 641 of NRS; or
2. Oriental medicine or acupuncture as
defined in chapter 634A of NRS.
(Added to NRS by 1999, 190; A 2001, 1830)
NRS 450.008 “Purchasing group” defined. “Purchasing
group” means a cooperative organization of hospitals and other health care
organizations that affiliate for the purpose of combining their purchasing
power to secure a lower cost for their purchases of supplies, materials and
equipment than would be available to the members of the purchasing group
individually.
(Added to NRS by 1999, 191)
COUNTY HOSPITALS
Definitions
NRS 450.010 “Taxpayers” defined. For
the purposes of NRS 450.010 to 450.510, inclusive, “taxpayers” include only citizens
of the United States of the age of 18 years and upward who, at the time of
filing their petition, are registered electors of the county in which an
election is proposed to be held and whose names appear on the latest assessment
roll of the county as owners of real or personal property.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,
365]—(NRS A 1975, 79; 1987, 295; 1995, 332)
Establishment
NRS 450.020 Procedure. Any
county or group of counties may establish a public hospital in the manner prescribed
in NRS 450.030 and 450.040.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]
NRS 450.030 Petition signed by at least 30 percent of taxpayers; submission
of question at next general election. Whenever
the board of county commissioners of any county is presented with a petition
signed by at least 30 percent of the taxpayers in such county or in each of a
group of counties asking that an annual tax be levied for the establishing and
maintenance of a public hospital, at a place in the county or counties named
therein, and specifying the maximum amount of money proposed to be expended in
purchasing or building the hospital, including the acquisition of a site, the
board of county commissioners shall, after a compliance with and subject to the
provisions of NRS 350.011 to 350.0165, inclusive, submit the question
of issuing bonds therefor to the qualified electors of the county at the next
general election to be held in the county, as provided in NRS 350.020 to 350.070, inclusive.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]
+ [Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165]—(NRS A 1965, 632; 1969,
1603; 1981, 962)
NRS 450.040 Petition signed by at least 50 percent of taxpayers; submission
of question at next primary or general election.
1. Whenever the board of county
commissioners of any county is presented with a petition signed by at least 50
percent of the taxpayers in the county or in each of a group of counties asking
that an annual tax be levied for the establishment and maintenance of a public
hospital, at a place in the county or counties named therein, and specifying
the maximum amount of money proposed to be expended in purchasing or building
the hospital, including the acquisition of a site, the board of county
commissioners shall forthwith comply with the provisions of NRS 350.011 to 350.0165, inclusive, and shall submit the
proposal to issue bonds for the project to the county debt management
commission for each of the counties.
2. Upon the receipt of the approval
thereof of each such commission, each board of county commissioners shall
submit the question of issuing bonds for the hospital project designated in the
petition to the qualified electors of the county at the next primary or general
election, as provided in NRS 350.020 to
350.070, inclusive.
3. If the petition designated in
subsection 1 indicates the hospital is to serve more than one county, each
county designated shall submit to the commission and to the qualified electors
of the county a bond question authorizing the issuance of the county’s bonds
for the project in a maximum principal amount at least sufficient to defray the
county’s proportional share of the maximum amount designated in the petition to
be expended for the project based upon the last assessed valuation of the
taxable property in the county and the valuation of that property in all the
counties designated in the petition.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]
+ [Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165]—(NRS A 1965, 633; 1969,
1603; 1981, 962;
1993, 1078;
1995, 773)
NRS 450.043 Motion of board of county commissioners; submission of question
at special election or next primary or general election. Whenever the board of county commissioners of
any county on its own motion desires to establish a county hospital, the board
shall:
1. Specify the maximum amount of money
proposed to be expended in purchasing or building the hospital, including the
acquisition of a site;
2. Comply with the provisions of NRS 350.011 to 350.0165, inclusive; and
3. Upon the receipt of the approval of the
county debt management commission of the proposal to issue the county hospital
bonds, submit the question of issuing bonds for the project to the qualified
electors of the county at a special election or the next primary or general
election, as provided in NRS 350.020 to
350.070, inclusive.
(Added to NRS by 1965, 633; A 1969, 1604; 1981, 963; 1993, 1078; 1995, 773)
NRS 450.045 Approval of bond issue; appointment of board of hospital
trustees; issuance and sale of bonds. Whenever
a question of issuing bonds submitted to the qualified electors of any county
pursuant to NRS 450.030, 450.040
or 450.043 has been approved as provided in NRS 350.070, the board or boards of county
commissioners shall immediately proceed to appoint the board of hospital
trustees and shall proceed to issue and sell the bonds as provided in NRS 450.010 to 450.510,
inclusive, subject to the provisions of the Local Government Securities Law.
(Added to NRS by 1965, 633; A 1969, 1604; 1985, 293)
NRS 450.050 Administration, control and government of county hospitals
acquired by purchase or construction under provisions of certain legislative
acts. In all cases where any
county hospital has been acquired by purchase, construction or otherwise, in
any of the several counties of this State under or by virtue of any act of the
Legislature other than NRS 450.010 to 450.510, inclusive, and has been governed and
administered thereunder by the board of county commissioners, or otherwise, the
board of county commissioners is authorized and empowered forthwith to appoint
a board of hospital trustees for such county hospital. Thereafter, all the
provisions of NRS 450.010 to 450.510,
inclusive, relative to the maintenance of hospitals, election of hospital
trustees, maintenance of a training school for nurses, provision for suitable
care for such hospitals and persons with disabilities, and the administration
and government of county hospital and patients therein shall be immediately
applicable and controlling with respect to the future administration, control
and government of such hospital in like manner and with the same force and
effect as if an election had been duly held in accordance with the provisions
of NRS 450.010 to 450.510,
inclusive, and a majority of all the votes cast had been in favor of
establishing such hospital.
[1.1:169:1929; added 1953, 126]—(NRS A 1965, 633)
NRS 450.060 Acquisition of additional building or site when board of
hospital trustees assumes control of existing hospital. In all counties where existing hospitals are
taken over by a board of hospital trustees, as provided in NRS 450.010 to 450.510,
inclusive, additional necessary buildings and sites may be acquired only if a
bond issue is approved by the voters at a primary, general or special election
according to the terms of NRS 450.010 to 450.510, inclusive, as if no hospital then existed. In
a county whose population is 100,000 or more, in cases where buildings or parts
thereof have been constructed but remain unfinished and unequipped, the board
of hospital trustees may complete the building or buildings or part or parts
thereof and furnish and equip them from the board’s current receipts, without a
bond issue.
[16:169:1929; A 1937, 194; 1941, 14; 1931 NCL §
2240]—(NRS A 1969, 1543; 1979, 548; 1993, 1079)
Board of Hospital Trustees
NRS 450.070 Number; election; terms of office.
1. Except in counties where the board of
county commissioners is the board of hospital trustees, the board of hospital
trustees for the public hospital consists of five trustees, who must:
(a) Be residents of the county or counties
concerned.
(b) Be elected as provided in subsection 2.
2. In any county:
(a) Whose population is less than 100,000,
hospital trustees must be elected for terms of 4 years in the same manner as
other county officers are elected.
(b) Whose population is 100,000 or more but less
than 700,000, hospital trustees must be elected from the county at large for
terms of 4 years.
[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,
165]—(NRS A 1959, 556; 1965, 634; 1967, 1255; 1969, 338, 1390, 1543; 1971,
1537; 1973, 127; 1975, 1101; 1979, 548; 1989, 1927; 2011, 1265)
NRS 450.080 Office of hospital trustee nonpartisan. Except
in counties where the board of county commissioners is the board of hospital
trustees:
1. The offices of hospital trustees are
hereby declared to be nonpartisan, and the names of candidates for such offices
shall appear alike upon the ballots of all parties at all primary elections.
2. At the general election only the names
of those candidates, not to exceed twice the number of hospital trustees to be
elected, who received the highest numbers of votes at the primary election
shall appear on the ballot.
[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,
165]—(NRS A 1973, 274; 1975, 1102)
NRS 450.090 Selection of county commissioners for membership on board.
1. In any county whose population is
700,000 or more, the board of county commissioners is, ex officio, the board of
hospital trustees, and the county commissioners shall serve as hospital
trustees during their terms of office as county commissioners.
2. In any county whose population is less
than 700,000, the board of county commissioners may enact an ordinance
providing that the board of county commissioners is, ex officio, the board of
hospital trustees. If such an ordinance is enacted in a county:
(a) The county commissioners shall serve as
hospital trustees during their terms of office as county commissioners; and
(b) If hospital trustees have been elected
pursuant to NRS 450.070 and 450.080,
the term of office of each hospital trustee who is serving in that capacity on
the effective date of the ordinance is terminated as of the effective date of
the ordinance.
3. A board of county commissioners shall
not enact an ordinance pursuant to subsection 2 unless it determines that:
(a) The county has fully funded its indigent care
account created pursuant to NRS 428.010;
(b) The county has fulfilled its duty to
reimburse the hospital for indigent care provided to qualified indigent
patients; and
(c) During the previous calendar year:
(1) At least one of the hospital’s
accounts payable was more than 90 days in arrears;
(2) The hospital failed to fulfill its
statutory financial obligations, such as the payment of taxes, premiums for
industrial insurance or contributions to the Public Employees’ Retirement
System;
(3) One or more of the conditions relating
to financial emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or
(4) The hospital received notice from the
Federal Government or the State of Nevada that the certification or licensure
of the hospital was in imminent jeopardy of being revoked because the hospital
had not carried out a previously established plan of action to correct
previously noted deficiencies found by the regulatory body.
4. Except in counties where the board of
county commissioners is the board of hospital trustees, in any county whose population
is 100,000 or more but less than 700,000, the board of hospital trustees for
the public hospital must be composed of the five regularly elected or appointed
members, and, in addition, three county commissioners selected by the chair of
the board of county commissioners shall serve as voting members of the board of
hospital trustees during their terms of office as county commissioners.
5. Except in counties where the board of
county commissioners is the board of hospital trustees, in any county whose
population is less than 100,000, the board of hospital trustees for the public
hospital must be composed of the five regularly elected or appointed members,
and, in addition, the board of county commissioners may, by resolution, provide
that:
(a) One county commissioner selected by the chair
of the board of county commissioners shall serve as a voting member of the
board of hospital trustees during his or her term of office as county
commissioner;
(b) A physician who is the chief of the staff of
physicians for the public hospital shall serve as a voting member of the board
of hospital trustees; or
(c) Both a county commissioner appointed pursuant
to the provisions of paragraph (a) and a physician appointed pursuant to the
provisions of paragraph (b) shall serve as voting members of the board of
hospital trustees.
Ê The term of
office of a member appointed pursuant to the provisions of paragraph (b) is 2
years and begins on the date the board of county commissioners appoints the
member.
[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,
165]—(NRS A 1960, 407; 1967, 1255; 1969, 1544; 1975, 1102; 1979, 549; 1989, 1928; 1995, 791; 1997, 571; 2001, 467; 2011, 1265)
NRS 450.100 Oath and bond. Within
10 days after their appointment or election, trustees shall qualify by taking
the oath of office. No bond shall be required of them.
[Part 3:169:1929; A 1955, 244]
NRS 450.110 Vacancies. Except
in counties where the board of county commissioners is the board of hospital
trustees, a vacancy in the board of hospital trustees occasioned by a
resignation, removal or otherwise must be reported to the board or boards of
county commissioners and must be filled in the same manner as the original
appointment. An appointee shall hold office:
1. Until the next following general
election in the usual manner; or
2. If the appointee is a physician
appointed to fill the vacancy of a member appointed pursuant to the provisions
of paragraph (b) of subsection 5 of NRS 450.090,
for the unexpired term of that member.
[5:169:1929; NCL § 2229]—(NRS A 1975, 1103; 2001, 468)
NRS 450.120 Officers of board. Except
as provided in subsection 3:
1. Within 10 days after their appointment
or election, the trustees shall organize as a board of hospital trustees by the
election of one of their number as chair, one as secretary, and by the election
of such other officers as they may deem necessary.
2. The county treasurer of the county in
which the hospital is located shall be the treasurer of the board of hospital
trustees. The treasurer shall receive and pay out all the moneys under the
control of the board, as ordered by it, but shall receive no compensation from
the board of hospital trustees.
3. In counties where the board of county
commissioners is the board of hospital trustees, the chair of the board of
county commissioners may be the chair of the board of hospital trustees or the
board of county commissioners may, at its first meeting in January of each
year, designate another of its members to serve as chair of the board of
hospital trustees for a term of 1 year. The vice chair of the board of county
commissioners may be the vice chair of the board of hospital trustees, or the
board of county commissioners may, at its first meeting in January of each
year, designate another of its members to serve as vice chair of the board of
hospital trustees for a term of 1 year. The county clerk shall be the secretary
of the board of hospital trustees. The county clerk shall receive no
compensation from the board of hospital trustees.
[Part 3:169:1929; A 1955, 244]—(NRS A 1975, 1103; 1977, 931)
NRS 450.130 Compensation and expenses of trustees.
1. Except in counties where the board of
county commissioners is the board of hospital trustees, in any county whose
population is less than 100,000:
(a) A hospital trustee is entitled to receive a
salary as follows:
(1) The chair and secretary of the board
of hospital trustees are entitled to receive $85 for each meeting of the board
or a committee appointed by the board that they attend, not to exceed $510 per
month.
(2) The other trustees are entitled to
receive $80 for each meeting of the board or a committee appointed by the board
that they attend, not to exceed $480 per month.
(b) In addition to the salary required by
paragraph (a), the board of hospital trustees may provide to each member of the
board the same health insurance coverage as the board provides to its
employees.
2. Except in counties where the board of
county commissioners is the board of hospital trustees, in any county whose
population is 100,000 or more, a hospital trustee, subject to the provisions of
subsection 3, is entitled to receive a salary of $100 per month and the chair
of the board of hospital trustees is entitled to receive a salary of $200 per
month.
3. Before any hospital trustee is entitled
to any compensation as provided in subsection 2, he or she must first have
devoted a minimum of 1 day during the month exclusively to the business and
affairs of the hospital, exclusive of regular meetings of the board of hospital
trustees.
4. Any trustee of any county hospital is
entitled to receive reimbursement for any cash expenditures actually made for
personal expenses incurred as a trustee. An itemized statement of all those
expenses and money paid out must be made under oath by each of the trustees and
filed with the secretary. An itemized statement may be allowed only by an
affirmative vote of all trustees present at a meeting of the board.
5. In counties where the county
commissioners are the board of hospital trustees, they shall serve without
compensation, but are allowed the per diem allowance and traveling expenses
fixed by law.
[Part 3:169:1929; A 1955, 244]—(NRS A 1973, 319;
1975, 1103; 1979,
549; 1993,
921; 1995,
792; 2001,
364)
NRS 450.135 Interest in purchase of supplies prohibited; exception. A trustee shall not have a personal pecuniary
interest, either directly or indirectly, in the purchase of any supplies for
the hospital unless the supplies are purchased by competitive bidding.
(Added to NRS by 1977, 1114)
NRS 450.140 Meetings of board; quorum.
1. The board of hospital trustees shall
hold meetings at least once each month, and shall keep a complete record of all
its transactions.
2. Except as otherwise provided in NRS 241.0355:
(a) In counties where three county commissioners
are not members of the board, three members of the board constitute a quorum
for the transaction of business.
(b) And except as otherwise provided in paragraph
(c), in counties where three county commissioners are members of the board, any
five of the members constitute a quorum for the transaction of business.
(c) In counties where the board of county
commissioners is the board of hospital trustees, a majority of the board
constitutes a quorum for the transaction of business.
[Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165] +
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]—(NRS A 1960, 93, 407; 1991, 288; 2001, 1129)
NRS 450.150 General powers and duties of board. The
board of hospital trustees, in general, shall carry out the spirit and intent
of NRS 450.010 to 450.510,
inclusive, in establishing and maintaining a county public hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]
NRS 450.160 Rules and regulations. The
board of hospital trustees shall make and adopt such bylaws, rules and
regulations for its own guidance and for the government of the hospital, and
such rules and regulations governing the admission of physicians to the staff,
as may be deemed expedient for the economic and equitable conduct thereof, not
inconsistent with NRS 450.010 to 450.510, inclusive, or the ordinances of the city or
town wherein such hospital is located.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,
194]—(NRS A 1963, 346)
NRS 450.165 Board authorized to acquire building or other facility for
provision of health care in county adjacent to county where hospital is
established; board authorized to issue special obligations to finance facility.
1. A board of hospital trustees may
acquire a building or other facility for the provision of health care in a
county adjacent to the county or one of the counties where the county hospital
is established, may operate such a facility, and may, but need not, enter into
a contract with a private hospital or other person to operate such a facility,
but only if no tax is levied or appropriation made from the county general fund
in the county or counties where the county hospital is established for the
maintenance and operation of the county hospital. The board of hospital
trustees may use money in the hospital fund or in any separate account
established by the board for this purpose.
2. To finance the acquisition of the
additional facility, the board of hospital trustees may issue, without any
election, special obligations payable only from revenues of the additional
facility or from those revenues and the revenues of the county hospital and any
related facilities. These obligations are not an indebtedness of the county or
counties where the county hospital is established or of the county in which the
additional facility is located.
3. As used in this section, “acquire” and
“acquisition” have the meaning attributed to them in NRS 350.506.
(Added to NRS by 1995, 332)
NRS 450.170 Visits and examinations of hospital; report to board of county
commissioners.
1. One of the hospital trustees shall
visit and examine the hospital twice each month.
2. During the first week in February of
each year, the board shall file with the board of county commissioners a report
of the proceedings of the board of hospital trustees with reference to the
hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]
NRS 450.175 Hospital advisory board in certain counties: Appointment; powers
and duties; compensation of members.
1. In counties where the board of county
commissioners is the board of hospital trustees, the board of hospital trustees
may appoint a hospital advisory board which shall exercise powers and duties
delegated to the advisory board by the board of hospital trustees.
2. Members of a hospital advisory board
must be appointed by a majority vote of the board of hospital trustees and
shall serve at the pleasure of the board.
3. Members of the hospital advisory board
may receive compensation for their services in an amount not to exceed $500 per
month.
(Added to NRS by 1975, 1101; A 1995, 793; 2011, 917)
NRS 450.180 Employment or removal of employees or appointed persons;
contract for medical services. The
board of hospital trustees may:
1. Appoint a chief executive officer and
necessary assistants, and fix their compensations.
2. Employ physicians and interns, either
full-time or part-time, as the board determines necessary, and fix their
compensations.
3. Remove those appointees and employees.
4. Control the admission of physicians and
interns to the staff by promulgating appropriate rules, regulations and
standards governing those appointments.
5. Contract with individual physicians or
private medical associations for the provision of certain medical services as
may be required by the hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]—(NRS
A 1963, 346; 1979,
444; 1987,
387; 2005,
2557)
NRS 450.191 Contract for management of hospital.
1. The governing body of a county hospital
may contract with a company which manages hospitals for the rendering of
management services in a county hospital under the ultimate authority of the
governing body.
2. The agreement may provide:
(a) That the administrator of the hospital must
be an employee of the company which manages the hospital; and
(b) That the hospital may, in accordance with the
requirements of NRS 450.530, purchase supplies,
materials and equipment through the purchasing contracts of the company which
manages the hospital, or through a purchasing group, without complying with the
requirements for competitive bidding set forth in chapter
332 of NRS.
(Added to NRS by 1975, 1101; A 1979, 444; 1987, 295; 1999, 191)
NRS 450.200 Condemnation of property for use by hospital. If the board of hospital trustees and the
owners of any property desired by the board of hospital trustees for hospital
purposes in the county or counties where the county hospital is established cannot
agree as to the price to be paid therefor, the board of hospital trustees shall
report the facts to the board or boards of county commissioners. Condemnation
proceedings shall be instituted by the board or boards of county commissioners
and prosecuted in the name of the county or counties by the district attorney
for such county as may be concerned.
[7:169:1929; NCL § 2231]—(NRS A 1995, 333)
NRS 450.210 Approval of plans and specifications for construction of
hospital; advertisement of bids. No
hospital buildings shall be erected or constructed until the plans and
specifications have been made therefor and adopted by the board of hospital
trustees, and bids advertised for according to law for other county public
buildings.
[8:169:1929; NCL § 2232]
NRS 450.220 Gifts and bequests to hospital: Title vested in county; control
by board of hospital trustees. Any
person, firm, organization, corporation or society desiring to make donations
of money, personal property or real property for the benefit of a county public
hospital shall have the right to vest title of the money, personal property or
real property so donated in the county or counties where the county hospital is
established to be controlled, when accepted, by the board of hospital trustees
according to the terms of the deed, gift, devise or bequest of such property.
[15:169:1929; NCL § 2239]—(NRS A 1995, 333)
Finances
NRS 450.230 Budget. The board
of hospital trustees shall file with the board of county commissioners a budget
as required of all governmental agencies of this state by chapter 354 of NRS, and in the fiscal management
of the affairs of the public hospital and all other institutions under the
supervision, government and control of the board of hospital trustees, the
board of hospital trustees are governed by the provisions of chapter 354 of NRS.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,
194]—(NRS A 1963, 455; 1965, 747; 1975, 13; 1987, 296)
NRS 450.240 Management of county hospital by board; levy of tax for maintenance
and operation.
1. In all counties where a tax for the
establishment and maintenance of a public hospital has been authorized by a
majority of the voters voting for a bond issue in accordance with law, the
supervision, management, government and control of the county hospital vests in
and must be exercised by the board of hospital trustees for the county public
hospital, and the institution must thereafter be operated by the board of
hospital trustees.
2. Annually, upon the request of the board
of hospital trustees, the board of county commissioners may levy a tax for the
maintenance and operation of the county public hospital, excluding the
establishment, maintenance or operation of any facility located outside the
county or counties where the county hospital is established.
3. The resolution adopted by the board of
county commissioners imposing a tax levy for a county public hospital must
state:
(a) The portion of the levy which is necessary to
retire hospital bonds and any other outstanding hospital securities, and to pay
interest thereon;
(b) The portion of the levy which is necessary to
pay for the care of indigent patients; and
(c) The portion of the levy which is necessary to
pay for the cost of new equipment, replacement of old equipment and other
improvements to the hospital not covered by specific bond issues or other
securities and not included in the cost of care of indigent patients as
provided in paragraph (b). The cost must be prorated to the county in
accordance with the number of patient days of care of county patients.
4. The board of county commissioners may
not levy a tax for the care of indigents in the county public hospital as a
hospital expense unless the levy and its justification are included in the
budget for the hospital fund submitted to the Department of Taxation as
provided by law.
[1:67:1931; 1931 NCL § 2243] + [2:67:1931; A 1937,
167; 1941, 15; 1943, 39; 1943 NCL § 2243.01]—(NRS A 1957, 239; 1965, 945; 1969,
1605; 1975, 1745; 1987,
387; 1995,
333)
NRS 450.250 Control of expenditures by board; lease of buildings; deposit of
money in hospital fund or separate account.
1. The board of hospital trustees has the
exclusive control of:
(a) The expenditures of all money collected to
the credit of the hospital fund.
(b) The purchase of the site or sites.
(c) The purchase or construction of any hospital
building or buildings.
(d) The supervision, care and custody of the
grounds, rooms or buildings purchased, constructed, leased or set apart for
that purpose.
2. With the approval of the board of
county commissioners of the county or counties where the county hospital is
established, the board of hospital trustees may lease buildings in that county
or those counties for medical purposes or for purposes of related health care
activities.
3. All money received for the hospital
must be deposited in the county treasury of the county in which the hospital is
situated to the credit of the hospital fund, and paid out only upon warrants
drawn by the board of hospital trustees of the county or counties upon properly
authenticated vouchers of the board of hospital trustees, after their approval
by the county auditor, except that all money received for a hospital may be
deposited in a separate account established and administered by the board of
hospital trustees under the provisions of NRS
354.603.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,
194]—(NRS A 1971, 1349; 1975, 1811; 1979, 550, 1407, 1408; 1981, 686, 1771; 1993, 1974; 1995, 333)
NRS 450.255 Mortgage or pledge of personal property of hospital; acquisition
of real property for expansion. The
board of trustees of a county hospital, with the approval of the board of
county commissioners, if the board of county commissioners is not the board of
hospital trustees, may, by resolution:
1. Mortgage or pledge the personal
property of the hospital, including accounts receivable, and enter into
agreements for the sale and leasing back to the hospital of its personal
property to provide security for acquiring money for the operation of the
hospital; and
2. Acquire real property for the expansion
of the hospital by entering into a contract for purchase of a type and duration
and on such terms as the governing body determines, including a contract
secured by a mortgage or other security interest in the real property.
(Added to NRS by 1987, 295; A 1997, 3100)
NRS 450.260 Collection or settlement of claims. The
board of hospital trustees may:
1. By proper legal action, collect claims
due to the public hospital.
2. Accept as settlement of a claim due an
amount less than that of the claim.
3. Pay from the hospital fund all fees and
expenses necessarily incurred by the board in connection with the collection of
claims.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,
194]—(NRS A 1987,
296)
Bonds
NRS 450.270 Maximum amount. Whenever
any county or counties in this state shall have provided for the appointment
and election of hospital trustees, and have voted for the issuance of bonds for
hospital purposes, as authorized by law, each such county shall issue bonds in
such sums and amounts as the board of hospital trustees shall certify to the
board of county commissioners to be necessary for the purpose stated in the
bond question approved at the election, but such bonds in the aggregate shall
not exceed the maximum amount authorized by the bond question.
[Part 6:169:1929; NCL § 2230]—(NRS A 1965, 634)
NRS 450.280 Purposes and procedure for issuance of general obligation bonds
at request of board of hospital trustees.
1. Whenever the board of hospital trustees
of any county deems it advisable that bonds be issued for the enlargement,
maintenance, repair, improvement or reconstruction of a public hospital,
including, without limitation, the construction, installation and other
acquisition of additional fixtures, structures, and buildings for the public
hospital, equipment and furnishings therefor, and additional sites therefor, or
any combination thereof, the board shall, by resolution, request the board of
county commissioners of the county to issue general obligation bonds therefor
and shall specify in the resolution the maximum amount of money proposed to be
expended for any of those purposes.
2. Thereupon the board of county
commissioners shall:
(a) Comply with the provisions of NRS 350.011 to 350.0165, inclusive; and
(b) Upon the receipt of the approval of the
county debt management commission of the proposal to issue the county hospital
bonds, submit the question of issuing the bonds to the qualified electors of
the county at a special election or the next primary or general election, as
provided in NRS 350.020 to 350.070, inclusive.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,
365]—(NRS A 1965, 634; 1969, 1605; 1981, 963; 1993, 1079; 1995, 773)
NRS 450.290 Issuance of general and special obligation bonds by board of
county commissioners.
1. Subject to the provisions of NRS 450.010 to 450.510,
inclusive, for any hospital project stated in a bond question approved as
provided in NRS 350.070, the board of
county commissioners, at any time, in the name and on the behalf of the county,
may issue:
(a) General obligation bonds, payable from taxes;
and
(b) General obligation bonds, payable from taxes,
which payment is additionally secured by a pledge of gross or net revenues
derived from the operation of the hospital facilities, and, if so determined by
the board of county commissioners, further secured by a pledge of gross or net
revenues derived from any other income-producing project of the county or from
any license or other excise taxes levied by the county for revenue, as may be
legally made available for their payment.
2. The board of county commissioners of
any county, in the name and on behalf of the county, may issue, for any
hospital project, without the securities being authorized at any election,
special obligation municipal securities payable solely from net revenues or
gross revenues derived from the operation of hospital facilities.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,
365]—(NRS A 1965, 635; 1969, 1606; 1975, 1158; 1977, 777; 1979, 550; 1981, 510; 1983, 1670)
NRS 450.300 Applicability of Local Government Securities Law. Subject to the provisions of NRS 450.290, for any hospital facilities authorized by
NRS 450.010 to 450.510,
inclusive, the board of county commissioners may, on the behalf and in the name
of the county, borrow money, otherwise become obligated, and evidence obligations
by the issuance of bonds and other county securities, and in connection with
the undertaking or facilities, the board may otherwise proceed as provided in
the Local Government Securities Law.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,
365]—(NRS A 1965, 635; 1969, 1606; 1985, 293)
NRS 450.310 Schedules of fees, rates and charges for services, facilities
and commodities. In order to
insure the payment of the general obligation bonds of the county, the payment
of which is additionally secured by a pledge of revenues of such hospital
facilities, of any such other income-producing project and of any such excise
taxes, as provided in NRS 450.290, or other such
additionally secured general obligation securities of the county, there may be
established and maintained, and from time to time revised, a schedule or
schedules of fees, rates and charges for services, facilities and commodities
rendered by or through such facilities and any such other income-producing
project and a schedule or schedules of any such excise taxes, as the case may
be, by the board of hospital trustees for such hospital facilities and
otherwise by the board of county commissioners, in an amount sufficient for
that purpose and also sufficient to discharge any covenant in the proceedings
authorizing the issuance of any of the bonds or other securities, including any
covenant for the establishment of reasonable reserve funds.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,
365]—(NRS A 1965, 636; 1969, 1607)
Administration
NRS 450.390 Hospital for benefit of county; payment of charges; exclusion of
persons from use of hospital.
1. Every county hospital in this State
being supported by public money, and every hospital established under NRS 450.010 to 450.510,
inclusive, must be for the benefit of that county or counties and of any person
falling sick or being injured or maimed within its limits, but the governing
body of the hospital may extend the privileges and use of the hospital to
persons residing outside of the county or counties upon such terms and
conditions as the governing body may by its rules and regulations prescribe.
2. Every inhabitant or person who is not a
pauper and every relative required by the laws of this State to support an
inhabitant or person who is a pauper shall pay to the governing body, or an
officer it designates, a reasonable compensation for occupancy, nursing, care,
medicine and attendance, other than medical or surgical attendance, according
to the rules and regulations prescribed by the governing body. If after demand
by the governing body, or its designated officer, the inhabitant, person or
relative fails, refuses or neglects to pay the compensation, it may be
recovered in a suit at law brought by the governing body.
3. The hospital is subject to such
reasonable rules and regulations as the governing body may adopt in order to
render the use of the hospital of the greatest benefit to the greatest number
of people.
4. The governing body may exclude from the
use of the hospital any and all inhabitants and persons who willfully violate
those rules and regulations.
5. The provisions of this section do not
prohibit the hospital from exercising other powers granted to it by the
provisions of this chapter.
[9:169:1929; NCL § 2233] + [1:132:1941; 1931 NCL §
2245]—(NRS A 1987,
388)
NRS 450.400 Extension of privileges and use of hospital to certain
nonresidents: Notice; removal of person to resident county; payment for
temporary care; action for recovery of charges.
1. When the privileges and use of the
hospital are extended to a resident of another county who is reasonably
believed to be indigent, as defined in NRS
439B.310, and who is:
(a) Entitled under the laws of this state to
relief, support, care, nursing, medicine or medical or surgical aid from the
other county; or
(b) Injured, maimed or falls sick in the other
county,
Ê the
governing head shall notify the board of county commissioners of that county
within 3 working days after the person is admitted to that hospital.
2. The notice must be in writing and
addressed to the board of county commissioners of that county.
3. Except in the case of an injury
suffered in a motor vehicle accident, the board of county commissioners
receiving the notice shall cause the person to be removed immediately to that
county, and shall pay a reasonable sum to the hospital for the temporary
occupancy, care, nursing, medicine, and attendance, other than medical or
surgical attendance, furnished to the person.
4. If the board of county commissioners
neglects or refuses to remove the person, or if in the opinion of the attending
physician it is not advisable to remove the person, the governing head has a
legal claim against the county for all charges for occupancy, nursing, care,
medicine, and attendance, other than medical or surgical attendance,
necessarily furnished, and may recover those charges in a suit at law.
[2:132:1941; A 1949, 588; 1943 NCL § 2245.01]—(NRS A 1983, 1943; 1991, 1000; 1993, 1974)
NRS 450.410 Admission of paying patients; charges.
1. Supervising boards of county hospitals
may:
(a) Provide for treatment to sick or injured
persons and require the payment of reasonable charges therefor.
(b) Contract for the provision of such treatment
on a periodic prepaid basis with any person authorized by the Commissioner of
Insurance pursuant to title 57 of NRS to arrange for or provide health care
services on a periodic prepaid basis.
Ê The
treatment of such persons must not be permitted to interfere with the treatment
of purely charitable cases.
2. Every person treated by a county
hospital and required to pay charges for hospitalization, shall pay the charges
fixed by the supervising board therefor, which charges, when paid, must be paid
forthwith into the county treasury and deposited to the credit of the hospital
fund.
3. Every person treated by a county
hospital and required to pay charges to the hospital has the right to the
services of a physician or surgeon of the person’s own choice, and has the
right to employ such special nurses as may be necessary, but the cost of the
physician, surgeon or nurses must not become a claim against the county.
4. Supervising boards shall fix and
determine reasonable charges to be paid by sick and injured persons treated by
county hospitals, which charges must include the board and lodging of the
person and the customary use of hospital facilities by the person admitted.
[1:124:1941; 1931 NCL § 2244] + [2:124:1941; 1931 NCL
§ 2244.01] + [3:124:1941; 1931 NCL § 2244.02] + [4:124:1941; 1931 NCL §
2244.03]—(NRS A 1987,
389; 1997,
907)
NRS 450.420 Board of county commissioners to determine status of patient;
charges fixed by board of hospital trustees; costs chargeable to county;
exceptions.
1. The board of county commissioners of
the county in which a public hospital is located may determine whether patients
presented to the public hospital for treatment are subjects of charity. Except
as otherwise provided in NRS 439B.330,
the board of county commissioners shall establish by ordinance criteria and
procedures to be used in the determination of eligibility for medical care as
medical indigents or subjects of charity.
2. The board of hospital trustees shall
fix the charges for treatment of those persons able to pay for the charges, as
the board deems just and proper. The board of hospital trustees may impose an
interest charge of not more than 12 percent per annum on unpaid accounts. The
receipts must be paid to the county treasurer and credited to the hospital
fund. In fixing charges pursuant to this subsection the board of hospital
trustees shall not include, or seek to recover from paying patients, any
portion of the expense of the hospital which is properly attributable to the
care of indigent patients.
3. Except as provided in subsection 4 of
this section and subsection 3 of NRS
439B.320, the county is chargeable with the entire cost of services
rendered by the hospital and any salaried staff physician or employee to any
person admitted for emergency treatment, including all reasonably necessary
recovery, convalescent and follow-up inpatient care required for any such
person as determined by the board of trustees of the hospital, but the hospital
shall use reasonable diligence to collect the charges from the emergency
patient or any other person responsible for the support of the patient. Any
amount collected must be reimbursed or credited to the county.
4. The county is not chargeable with the
cost of services rendered by the hospital or any attending staff physician or
surgeon to the extent the hospital is reimbursed for those services pursuant to
NRS 428.115 to 428.255, inclusive.
[14:169:1929; NCL § 2238]—(NRS A 1969, 875; 1975,
1305; 1977, 480;
1983, 1943;
1985, 1463;
1987, 389, 878; 1993, 1975)
NRS 450.425 Board of county commissioners may levy ad valorem tax to pay
cost of services rendered at hospital to certain persons admitted for emergency
treatment.
1. The board of county commissioners of a
county in which a county hospital is established may, upon approval by a
majority of the voters voting on the question in an election held throughout
the county, levy an ad valorem tax of not more than 2.5 cents on each $100 of
assessed valuation upon all taxable property in the county, to pay the cost of
services rendered in the county by the hospital pursuant to subsection 3 of NRS 450.420. The approval required by this subsection
may be requested at any primary or general election.
2. Any tax imposed pursuant to this
section is in addition to the taxes imposed pursuant to NRS 428.050, 428.185 and 428.285. The proceeds of any tax levied
pursuant to this section are exempt from the limitations imposed by NRS 354.59811, 428.050 and 428.285 and must be excluded in
determining the maximum rate of tax authorized by those sections.
(Added to NRS by 1987, 878; A 1989, 2086; 1991, 482; 1993, 1079; 1995, 334)
NRS 450.430 Equal privileges of practitioners; exception; rights of
patients; loss of hospital privileges not adverse action against physician in
certain circumstances.
1. Except as otherwise provided in NRS 450.440, in the management of the public hospital,
no discrimination may be made against physicians, podiatric physicians or
dentists licensed under the laws of this state or licensed practitioners of the
allied health professions, and all such physicians, dentists, podiatric
physicians and practitioners have privileges in treating patients in the
hospital in accordance with their training and ability, except that
practitioners of the allied health professions may not be members of the staff
of physicians described in NRS 450.440.
Practitioners of the allied health professions are subject to the bylaws and
regulations established by the board of hospital trustees.
2. The patient has the right to employ, at
the patient’s own expense, his or her own physician, if that physician is a
member of the hospital staff, or the patient’s own nurse, and when acting for
any patient in the hospital, the physician employed by the patient has charge
of the care and treatment of the patient, and the nurses in the hospital shall
comply with the directions of the physician concerning that patient, subject to
the regulations established by the board of hospital trustees.
3. If a physician loses privileges at a
hospital because the physician no longer holds a faculty or clinical
appointment with the University of Nevada School of Medicine or the University
of Nevada, Las Vegas, School of Dental Medicine, as required pursuant to NRS 450.440, that action shall not be deemed to be an
adverse action by the hospital against the physician.
[Part 11:169:1929; A 1955, 194]—(NRS A 1957, 780;
1975, 641; 1979,
150; 2001,
1830; 2011,
917)
NRS 450.440 Staff of physicians: Organization; affiliation with university;
rotation of service; assistance.
1. Except as otherwise provided in
subsection 2, the board of hospital trustees shall organize a staff of
physicians composed of each regular practicing physician, podiatric physician
and dentist in the county in which the hospital is located who requests staff
membership and meets the standards set forth in the regulations prescribed by
the board of hospital trustees.
2. The board of hospital trustees may,
after consulting with the chief of staff of the hospital and the deans of the
University of Nevada School of Medicine and the University of Nevada, Las
Vegas, School of Dental Medicine, organize a staff of physicians composed of
physicians, podiatric physicians and dentists who are affiliated with the
University of Nevada School of Medicine or the University of Nevada, Las Vegas,
School of Dental Medicine who request staff membership and meet the
requirements set forth in subsection 3. If the board of hospital trustees
organizes a staff of physicians in accordance with this subsection, the board
of hospital trustees may require:
(a) Not more than 60 percent of the staff of
physicians to be so affiliated before January 1, 2013.
(b) Not more than 85 percent of the staff of
physicians to be so affiliated on or after January 1, 2013, and before January
1, 2018.
(c) The staff of physicians to have such an
affiliation in such a percentage as the board of hospital trustees deems
appropriate on or after January 1, 2018.
3. Except as otherwise provided in
subsection 4, if the board of hospital trustees decides to organize the staff
of physicians in accordance with subsection 2, a physician, podiatric physician
or dentist who requests staff membership must:
(a) Meet the standards set forth in the
regulations prescribed by the board of hospital trustees; and
(b) Hold a faculty or clinical appointment with
the University of Nevada School of Medicine or the University of Nevada, Las
Vegas, School of Dental Medicine and maintain that appointment while he or she
is on the staff of physicians.
4. If the board of hospital trustees
decides to organize the staff of physicians in accordance with subsection 2,
the board of hospital trustees may enter into a contract with a physician or
group of physicians who do not meet the requirements of subsection 3 if the
physician or group of physicians will be the exclusive provider of certain
services for the hospital. Such services may include, without limitation,
radiology, pathology, emergency medicine and neonatology services.
5. The provisions of subsections 2 and 3
shall not be deemed to prohibit a physician, podiatric physician or dentist who
is on the staff of physicians from being affiliated with another institution of
higher education.
6. The staff shall organize in a manner
prescribed by the board so that there is a rotation of service among the
members of the staff to give proper medical and surgical attention and service
to the indigent sick, injured or maimed who may be admitted to the hospital for
treatment.
7. The board of hospital trustees or the
board of county commissioners may offer the following assistance to members of
the staff to attract and retain them:
(a) Establishment of clinic or group practice;
(b) Malpractice insurance coverage under the
hospital’s policy of professional liability insurance;
(c) Professional fee billing; and
(d) The opportunity to rent office space in
facilities owned or operated by the hospital, as the space is available, if
this opportunity is offered to all members of the staff on the same terms and conditions.
[Part 11:169:1929; A 1955, 194]—(NRS A 1963, 346;
1967, 996; 1979,
150, 1408,
1409; 2001, 1830; 2005, 2557; 2011, 917)
NRS 450.450 General administration of hospital subject to regulations of
trustees. When a county hospital
is established, the physicians, nurses, attendants, the persons sick therein,
and all persons approaching or coming within the limits of the same, and all
furniture and other articles used or brought there shall be subject to such
rules and regulations as the board of hospital trustees may prescribe.
[10:169:1929; NCL § 2234]
NRS 450.455 Program for training resident physicians. A board of hospital trustees may institute and
maintain training programs in the county hospital for resident physicians,
including interns and postgraduates. Such programs must meet the standards for
recognition by the American Medical Association and for accreditation by the
Liaison Committee on Graduate Medical Education.
(Added to NRS by 1963, 455; A 1979, 676)
NRS 450.460 School for training nurses. The
board of hospital trustees may establish and maintain in connection with a
county hospital and as a part thereof a training school for nurses. Upon
completion of the prescribed course of training the board of hospital trustees
shall give diplomas to such nurses as complete the course satisfactorily.
[12:169:1929; NCL § 2236]
NRS 450.470 Room for examination of persons alleged to have mental illness;
room for custodial supervision of persons with mental illness and dangerous
persons.
1. If the county hospital is located at
the county seat, the board of hospital trustees shall, at all times, provide a
suitable room that may be used for the examination of persons who are alleged
to have mental illness and who are to be brought before the judge of the
district court for proceedings to determine the issue of involuntary
court-ordered admission as provided in chapter
433A of NRS. This section does not prohibit or limit the examination of
persons alleged to have mental illness at a private hospital as provided in chapter 433A of NRS.
2. The board of trustees of such a county
hospital, in cooperation with the local law enforcement agencies, may provide a
suitable room that may be used for the custodial supervision of persons who are
alleged to:
(a) Have mental illness; or
(b) Be dangerous to themselves or others.
[13:169:1929; NCL § 2237]—(NRS A 1967, 1679; 1975,
1634; 1993, 834)
NRS 450.480 Use of paramedics for emergency care authorized. A hospital or rescue unit which meets minimum
requirements established by the State Board of Health, or an ambulance service
which meets minimum requirements established by the State Board of Health in a
county whose population is less than 100,000, or a county or district board of
health in a county whose population is 100,000 or more, may use paramedics, as
defined in NRS 450B.095, for the
rendering of emergency medical care to the sick or injured:
1. At the scene of an emergency and during
transport to a hospital;
2. While in a hospital emergency
department; and
3. Until responsibility for care is
assumed by the regular staff of the hospital.
(Added to NRS by 1973, 610; A 1975, 37; 1987, 2206; 1993, 2827; 2013, 937)
NRS 450.485 Contract for use of facility for intermediate care or facility
for skilled nursing. The board of
hospital trustees may contract for the use of a facility for intermediate care
or a facility for skilled nursing for the treatment of patients who may safely
be discharged to such a facility.
(Added to NRS by 1987, 295)
Transfer
NRS 450.490 Conveyance or lease of hospital to corporation.
1. The board of county commissioners of
any county for which a public hospital has been established or is administered
pursuant to NRS 450.010 to 450.510,
inclusive, and whose public hospital is the only hospital in the county, may
convey the hospital for an amount not less than its appraised value or lease it
for a term of not more than 50 years to any corporation if all of the following
conditions are met:
(a) The corporation must provide in its articles
of incorporation for an advisory board for the hospital. The advisory board
must consist of persons who represent a broad section of the people to be
served by the hospital.
(b) The corporation must contract to:
(1) Care for indigent patients at a charge
to the county which does not exceed the actual cost of providing that care, or
in accordance with NRS 439B.300 to 439B.340, inclusive, if applicable; and
(2) Receive any person falling sick or
maimed within the county.
(c) The corporation must agree to accept all the
current assets, including accounts receivable, to assume all the current
liabilities, and to take over and maintain the records of the existing public
hospital.
(d) The agreement must provide for the transfer
of patients, staff and employees, and for the continuing administration of any
trusts or bequests pertaining to the existing public hospital.
(e) The agreement must provide for the assumption
by the corporation of all indebtedness of the county which is attributable to
the hospital, and:
(1) If the hospital is conveyed, for
payment to the county of an amount which is not less than the appraised value
of the hospital, after deducting any indebtedness so assumed, immediately or by
deferred installments over a period of not more than 30 years.
(2) If the hospital is leased, for a
rental which will, over the term of the lease, reimburse the county for its
actual capital investment in the hospital, after deducting depreciation and any
indebtedness so assumed. The lease may provide a credit against the rental so
required for the value of any capital improvements made by the corporation.
2. If any hospital which has been conveyed
pursuant to this section ceases to be used as a hospital, unless the premises
so conveyed are sold and the proceeds used to erect or enlarge another hospital
for the county, the hospital so conveyed reverts to the ownership of the
county. If any hospital which has been leased pursuant to this section ceases
to be used as a hospital, the lease is terminated.
(Added to NRS by 1981, 1186; A 1987, 879)
NRS 450.500 Conveyance or lease of hospital to nonprofit corporation.
1. Except as otherwise provided in NRS 450.490, the board of county commissioners of any
county for which a public hospital has been established pursuant to NRS 450.010 to 450.510,
inclusive, or established otherwise but administered pursuant to NRS 450.010 to 450.510,
inclusive, may convey the hospital, or lease it for a term of not more than 50
years, to a nonprofit corporation if all of the following conditions are met:
(a) The governing body of the nonprofit
corporation must be composed initially of the incumbent members of the board of
hospital trustees, as individuals. The articles of incorporation must provide
for:
(1) A membership of the corporation which
is broadly representative of the public and includes residents of each
incorporated city in the county and of the unincorporated area of the county or
a single member which is a nonprofit corporation whose articles of
incorporation provide for a membership which is broadly representative of the
public and includes residents of each incorporated city in the county and of
the unincorporated area of the county;
(2) The selection of the governing body by
the membership of the corporation or, if the corporation has a single member,
by the single member;
(3) The governing body to select its
members only to fill a vacancy for an unexpired term; and
(4) The terms of office of members of the
governing body, not to exceed 6 years.
(b) The nonprofit corporation must contract to:
(1) Care for indigent patients at a charge
to the county which does not exceed the actual cost of providing such care, or
in accordance with NRS 439B.300 to 439B.340, inclusive, if applicable; and
(2) Receive any person falling sick or
maimed within the county.
(c) The nonprofit corporation must agree to
accept all the current assets, including accounts receivable, to assume all the
current liabilities, and to take over and maintain the records of the existing
public hospital.
(d) The agreement must provide for the transfer
of patients, staff and employees, and for the continuing administration of any
trusts or bequests pertaining to the existing public hospital.
(e) The agreement must provide for the assumption
by the corporation of all indebtedness of the county which is attributable to
the hospital, and:
(1) If the hospital is conveyed, for
payment to the county of its actual capital investment in the hospital, after
deducting depreciation and any indebtedness so assumed, immediately or by
deferred installments over a period of not more than 30 years.
(2) If the hospital is leased, for a
rental which will over the term of the lease reimburse the county for its
actual capital investment in the hospital, after deducting depreciation and any
indebtedness so assumed. The lease may provide a credit against the rental so
required for the value of any capital improvements made by the corporation.
2. Boards of county commissioners which
have joint responsibility for a public hospital may jointly exercise the power
conferred by subsection 1, and are subject jointly to the related duties.
3. If any hospital which has been conveyed
pursuant to this section ceases to be used as a nonprofit hospital, unless the
premises so conveyed are sold and the proceeds used to erect or enlarge another
nonprofit hospital for the county, the hospital so conveyed reverts to the
ownership of the county. If any hospital which has been leased pursuant to this
section ceases to be used as a nonprofit hospital, the lease is terminated.
(Added to NRS by 1969, 215; A 1975, 575; 1981, 1186; 1985, 597; 1987, 880)
NRS 450.510 County whose population is less than 100,000 may contract with
community nonprofit hospital for care of indigent patients; enlargement or
alteration of hospital.
1. The board of county commissioners of
any county whose population is less than 100,000 may contract with any
nonprofit corporation to which a public hospital has been conveyed or leased,
for the care of indigent patients from the contracting county and the receiving
of other persons falling sick or being maimed or injured within the contracting
county. The contract must be consistent with the provisions of NRS 439B.300 to 439B.340, inclusive, if applicable.
2. The contracting county may participate
in the enlargement or alteration of the hospital.
(Added to NRS by 1969, 216; A 1969, 1545; 1979, 551; 1987, 881; 1993, 2661)
Miscellaneous Provisions
NRS 450.520 Determination that emergency exists before submission of certain
questions at special election.
1. For the purposes of NRS 450.043, 450.060 and 450.280, a special election may be held only if the
board of county commissioners determines, by a unanimous vote, that an
emergency exists.
2. The determination made by the board is
conclusive unless it is shown that the board acted with fraud or a gross abuse
of discretion. An action to challenge the determination made by the board must
be commenced within 15 days after the board’s determination is final.
3. As used in this section, “emergency”
means any unexpected occurrence or combination of occurrences which requires
immediate action by the board to prevent or mitigate a substantial financial
loss to the county or to enable the board to provide an essential service to
the residents of the county.
(Added to NRS by 1993, 1078; A 1995, 334)
NRS 450.525 Membership of hospital in purchasing group.
1. A county hospital may, with the
approval of the governing body of the hospital, become a member of a purchasing
group for the purpose of purchasing supplies, materials and equipment used by
the county hospital.
2. A county hospital that becomes a member
of a purchasing group may, in accordance with the requirements of NRS 450.530, purchase supplies, materials and
equipment through the purchasing group without complying with the requirements
for competitive bidding set forth in chapter 332
of NRS.
(Added to NRS by 1999, 190)
NRS 450.530 Purchase of supplies, materials and equipment without complying
with certain requirements for competitive bidding. A
county hospital that is authorized pursuant to NRS
450.191 or 450.525 to purchase supplies,
materials and equipment in accordance with this section through the purchasing
contracts of the company that manages the hospital or through a purchasing
group may purchase the supplies, materials and equipment without complying with
the requirements for competitive bidding set forth in chapter 332 of NRS if:
1. The documents pertaining to the
proposed purchase, including, without limitation, the prices available to the
company or purchasing group, are summarized in writing and, together with a
sworn statement by an officer or agent of the company or purchasing group that
the prices were obtained by the company or purchasing group through a process
of competitive bidding, are presented to the governing body of the county
hospital at its next regularly scheduled meeting; and
2. The governing body, after reviewing the
summary and statement, finds that the proposed purchase will be made at a lower
price than the lowest price reasonably obtainable by the hospital through
competitive bidding pursuant to chapter 332
of NRS or available to the hospital pursuant to NRS 333.470 and approves the proposed
purchase.
(Added to NRS by 1999, 190)
COUNTY HOSPITAL DISTRICTS
NRS 450.550 Definitions. As
used in NRS 450.550 to 450.760,
inclusive, unless the context otherwise requires:
1. “Board of trustees” means:
(a) A board of hospital trustees:
(1) Elected pursuant to NRS 450.620 and a physician who is appointed pursuant
to subsection 1 of NRS 450.640, if applicable; or
(2) Appointed pursuant to NRS 450.625 and a physician who is appointed pursuant
to subsection 1 of NRS 450.640, if applicable; or
(b) A board of county commissioners, if that
board enacts an ordinance which provides that the board of county commissioners
is, ex officio, the board of hospital trustees, and a physician who is
appointed pursuant to subsection 1 of NRS 450.640,
if applicable.
2. “District hospital” means a hospital
constructed, maintained and governed pursuant to NRS
450.550 to 450.760, inclusive.
(Added to NRS by 1969, 1387; A 1989, 1011; 1993, 1975; 1995, 793; 1997, 3100, 3135; 1999, 639, 2076; 2001, 468; 2005, 1448)
NRS 450.560 Establishment of district on motion of board of county
commissioners.
1. The board of county commissioners of
any county may of its own motion establish a hospital district in the manner
prescribed in NRS 450.550 to 450.750,
inclusive. The establishment of a hospital district is in addition to any other
powers granted to a board of county commissioners pursuant to NRS 450.010 to 450.510,
inclusive.
2. Except as otherwise provided in this
subsection, a hospital district specified in subsection 1 may include territory
within more than one county. If the establishment of such a district is
proposed by a board of county commissioners, the district may be established
only if the board of county commissioners of each county included within the
district, other than the county of the board of county commissioners that
proposes to establish the district, adopts a resolution approving the
establishment of the district.
(Added to NRS by 1969, 1387; A 1997, 3100, 3135; 1999, 639)
NRS 450.570 Notice of intent to establish district: Contents; publication. The notice of intent to establish a hospital
district must:
1. State the name of the proposed district
and the name of the county or counties in which the proposed district is
located.
2. State the time and place fixed by the
board of county commissioners for a hearing on the proposed establishment of
the district.
3. Describe the territory or specify the
exterior boundaries of the territory proposed to be included within the
district, which boundaries, so far as practicable, must be the centerlines of
highways.
4. Be published once a week for 2
successive weeks before the time fixed for the hearing in a newspaper
designated by the board of county commissioners.
(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639)
NRS 450.580 Objections to formation of district; hearing.
1. At or before the time fixed for the
hearing of the proposed establishment of a hospital district, any person
interested may file written objections to the establishment of the district
with the clerk of the board of county commissioners that proposes to establish
the district.
2. At the hearing, the board of county
commissioners shall hear and consider any objections filed pursuant to subsection
1.
3. The board may:
(a) Sustain any objections filed pursuant to
subsection 1;
(b) Change or alter the boundaries of the
proposed district to conform to the requirements of the district; and
(c) Exclude from the district any land that will
not be benefited by the establishment of the district.
(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639)
NRS 450.590 Establishment of district: Petition of owners of property;
adoption, contents and publication of resolution of intention to establish
district; exception.
1. Except as otherwise provided in
subsection 3, if 25 percent or more of the holders of title or evidence of
title to lands lying within the proposed district, whose names appear as such
upon the last county assessment roll, present a petition to the board of county
commissioners of the county in which the land lies, setting forth the exterior
boundaries of the proposed district and asking that the district so described
be established within a county hospital district pursuant to the provisions of NRS 450.550 to 450.750,
inclusive, the board of county commissioners shall adopt a resolution declaring
the intention of the board to include the territory within a county hospital
district, naming the district and describing its exterior boundaries.
2. The resolution must:
(a) Fix a time and place for the hearing of the
proposed establishment of the district not less than 30 days after its
adoption.
(b) Direct the clerk of the board of county
commissioners to publish:
(1) The notice of intention of the board
of county commissioners to establish the county hospital district; and
(2) The time and place fixed for the
hearing.
(c) Designate that the notice must be published
in a newspaper of general circulation published in the county and circulated in
the proposed county hospital district, or if there is no newspaper so published
and circulated, then in a newspaper of general circulation circulated in the
proposed district.
3. The provisions of this section do not
apply to a proposed hospital district if it includes territory within more than
one county.
(Added to NRS by 1969, 1388; A 1997, 3101, 3136; 1999, 639)
NRS 450.600 Hearing on petition. Upon
the hearing of the petition, the board of county commissioners shall determine
whether or not the petition complies with the requirements and purposes of NRS 450.550 to 450.750,
inclusive, and must hear all competent and relevant testimony offered in
support or in objection thereto.
(Added to NRS by 1969, 1388)
NRS 450.610 Resolution creating district. If
after a hearing, the board of county commissioners determines that the creation
of the proposed hospital district is desirable, the board shall by resolution
provide for the creation of such district, designating the name of the district
and establishing the boundaries of the district.
(Added to NRS by 1969, 1388)
NRS 450.620 Enactment of ordinance regarding number, terms and election of
trustees; service of board of county commissioners ex officio as board of
trustees.
1. Except as otherwise provided in
subsection 2 and NRS 450.625, if a hospital
district is created pursuant to NRS 450.550 to 450.750, inclusive, the board of county commissioners
shall provide by ordinance for:
(a) The number of members of the board of
trustees;
(b) The term of office of the trustees, which
must not exceed 4 years; and
(c) The times and manner of the election of the
trustees, which must be nonpartisan.
2. If a hospital district specified in
subsection 1 does not include territory within more than one county, the board
of county commissioners may enact an ordinance providing that the board of
county commissioners is, ex officio, the board of hospital trustees of the
district hospital. If such an ordinance is enacted in a county:
(a) The county commissioners shall serve as the
hospital trustees of the district hospital during their terms of office as
county commissioners; and
(b) If hospital trustees have been elected
pursuant to subsection 1, the term of office of each hospital trustee of the
district hospital who is serving in that capacity on the effective date of the
ordinance is terminated as of the effective date of the ordinance.
3. Except as otherwise provided in NRS 450.710, a board of county commissioners shall not
enact an ordinance pursuant to subsection 2 unless it determines that:
(a) The county has fully funded its indigent care
account created pursuant to NRS 428.010;
(b) The county has fulfilled its duty to
reimburse the hospital for indigent care provided to qualified indigent
patients; and
(c) During the previous calendar year:
(1) At least one of the hospital’s
accounts payable was more than 90 days in arrears;
(2) The hospital failed to fulfill its
statutory financial obligations, including the payment of taxes, premiums for
industrial insurance or contributions to the Public Employees’ Retirement
System;
(3) One or more of the conditions relating
to financial emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or
(4) The hospital received notice from the
Federal Government or the State of Nevada that the certification or license of
the hospital was in imminent jeopardy of being revoked because the hospital had
not carried out a previously established plan of action to correct previously
noted deficiencies found by the regulatory body.
(Added to NRS by 1969, 1388; A 1995, 793; 1997, 572, 3102, 3137; 1999, 639, 2077)
NRS 450.625 Trustees of district that includes territory within more than
one county.
1. If a hospital district created pursuant
to NRS 450.550 to 450.750,
inclusive, includes territory within more than one county, the board of
trustees of the hospital district must consist of three members of the board of
county commissioners that created the district and:
(a) Three members of the board of county
commissioners of each county other than the county of the board of county
commissioners that created the district, if the portion of the county included
in the district is two-thirds or more of the total area of the county;
(b) Two members of the board of county
commissioners of each county other than the county of the board of county
commissioners that created the district, if the portion of the county included
in the district is more than one-third of the total area of the county but less
than two-thirds of the total area of the county; or
(c) One member of the board of county
commissioners of each county other than the county of the board of county
commissioners that created the district, if the portion of the county included
in the district is one-third or less of the total amount of the area of the
county.
2. Each member of the board of trustees
appointed pursuant to this section must be appointed by the board of county
commissioners of which he or she is a member.
3. The term of office of the members of
the board of trustees is 3 years.
4. A member who ceases to be a member of
the board of county commissioners that appointed him or her ceases to be a
member of the board of trustees.
5. Any vacancy must be filled for the
unexpired term by the board of county commissioners that appointed the member
who created the vacancy.
(Added to NRS by 1997, 3099; A 1997, 3134; 1999, 639)
NRS 450.630 General powers and duties of board of trustees; rules and
regulations. The board of trustees
shall:
1. Carry out the spirit and intent of NRS 450.550 to 450.750,
inclusive, in establishing and maintaining a hospital in each district created
pursuant to NRS 450.550 to 450.750,
inclusive.
2. Make and adopt bylaws, rules and regulations:
(a) For its own guidance and the government of
any such hospital; and
(b) Fixing the charges for treatment of patients.
(Added to NRS by 1969, 1388; A 1987, 390)
NRS 450.640 Employees and staff of hospital: Appointment to board of chief
of staff of physicians for district hospital; appointment by board of chief
executive officer and necessary assistants for hospital; compensation; removal;
admission. The board of trustees
may:
1. After the board is formed pursuant to
the provisions of NRS 450.620 or 450.625, increase the number of members who serve on
the board by appointing, as a voting member of the board, one physician who is
the chief of staff of physicians for a district hospital. The term of office of
a member who is appointed pursuant to this subsection is 2 years, commencing on
the date of appointment by the board of trustees. A vacancy in the term of a
member appointed pursuant to this subsection must be filled in the same manner
as the original appointment for the remainder of the unexpired term.
2. Appoint a chief executive officer and
necessary assistants for each hospital, and fix the compensations of such
persons.
3. Employ physicians, surgeons and
interns, as the board determines necessary, and fix their compensation.
4. Remove such appointees and employees.
5. Remove persons who are appointed or
employed pursuant to this section.
6. Control the admission of physicians,
surgeons and interns to the staff by promulgating rules, regulations and
standards governing such appointments.
(Added to NRS by 1969, 1389; A 1987, 390; 2001, 469)
NRS 450.650 Budgets. The board
of trustees of each county hospital district shall prepare annual budgets in
accordance with NRS 354.470 to 354.626, inclusive.
(Added to NRS by 1969, 1389; A 2011, 2731)
NRS 450.660 Tax levies; disposition of proceeds.
1. At the time of making the levy of
county taxes for that year, each board of trustees shall levy a tax sufficient,
together with the revenue which will result from application of the rate to the
net proceeds of minerals, to raise the amount so budgeted upon any real and
personal property that is subject to taxation within the boundaries of the
district. Any tax levied on interstate or intercounty telephone lines, power
lines and other public utility lines pursuant to this section must be based
upon valuations as established by the Nevada Tax Commission pursuant to the
provisions of NRS 361.315 to 361.330, inclusive.
2. When levied, the tax must be:
(a) Entered upon the assessment rolls of each
county that is included within the district; and
(b) Collected in the same manner as state and
county taxes.
3. When the tax is collected it must be:
(a) Placed in the treasury of the county in which
the district hospital is located;
(b) Credited to the current expense fund of the
district; and
(c) Used only for the purpose for which it was
raised.
(Added to NRS by 1969, 1389; A 1989, 49; 1993, 1976; 1997, 3103, 3138; 1999, 639; 2013, 3139)
NRS 450.665 Powers of board of trustees: Borrowing of money and incurrence
or assumption of indebtedness; limitations and conditions.
1. The board of trustees may borrow money
and incur or assume indebtedness on behalf of the county hospital district if
the total amount of the indebtedness, excluding revenue bonds and other
securities constituting special obligations which are not debts, does not
exceed an amount equal to 10 percent of the total of the last assessed
valuation of taxable property, excluding motor vehicles, located within the
district.
2. The board of trustees shall not borrow
money or issue securities to evidence such borrowing until the board has
obtained the approval of the:
(a) Debt management commission; and
(b) Board of county commissioners,
Ê of each
county in which the hospital district is located.
(Added to NRS by 1989, 1011; A 1995, 774; 1997, 3103, 3138; 1999, 639)
NRS 450.670 Powers of board of trustees: Issuance and sale of bonds for
certain purposes. The board of
trustees may issue and sell, for each district in its jurisdiction:
1. General obligation bonds, payable from
taxes;
2. General obligation bonds, payment of
which is additionally secured by a pledge of gross or net revenues derived from
the operation of hospital facilities; and
3. Special obligation bonds, payable
solely from gross or net revenues derived from the operation of hospital
facilities,
Ê for the
purpose of providing funds for the purchase of hospital equipment, the
acquisition of property, the construction of buildings and improvement of
property owned by the district for use in any one county hospital district.
(Added to NRS by 1969, 1389; A 1989, 1011)
NRS 450.675 Powers of board of trustees: Mortgage or pledge of personal
property and acquisition of real property. The
board of trustees, with the approval of the board of county commissioners, if
the board of county commissioners is not the board of hospital trustees, or, if
the district in which the hospital is located includes territory within more
than one county, with the approval of the board of county commissioners of each
of those counties, may, by resolution:
1. Mortgage or pledge the personal
property of the hospital, including accounts receivable, and enter into
agreements for the sale and leasing back to the hospital of its personal
property to provide security for acquiring money for the operation of the
hospital; and
2. Acquire real property for the expansion
of the hospital by entering into a contract for purchase of a type and duration
and on such terms as the governing body determines, including a contract
secured by a mortgage or other security interest in the real property.
(Added to NRS by 1997, 3100)
NRS 450.680 Election concerning issuance of bonds; applicability of Local
Government Securities Law.
1. If a board of trustees desires to avail
itself of the power conferred by NRS 450.670 and
submission to the voters is required by the provisions of NRS 350.020 to 350.070, inclusive, the board shall submit
the question of issuing the bonds to the registered voters of the district in
accordance with those provisions.
2. The provisions of the Local Government
Securities Law apply to any bonds authorized to be issued pursuant to NRS 450.670, except to the extent those provisions are
inconsistent with the provisions of NRS 450.550 to 450.750, inclusive.
(Added to NRS by 1969, 1389; A 1981, 964; 1989, 1012)
NRS 450.690 Donations. Any
person, firm, organization, corporation or society desiring to make donations
of money, personal property or real property for the benefit of any district
hospital may make such donations to the district. Any such donation is
effective when accepted by the board of trustees according to the terms of the
deed, gift, devise or bequest of such property.
(Added to NRS by 1969, 1389)
NRS 450.700 Board of trustees to determine status of patient and fix
charges.
1. The board of trustees may determine
whether patients presented to the district hospital for treatment are subjects
of charity. Except as otherwise provided in NRS 439B.330, the board of trustees
shall establish the criteria and procedures to be used in the determination of
eligibility for medical care as medical indigents or subjects of charity.
2. The board of trustees shall fix the
charges for treatment of those persons who are able to pay for the treatment.
The receipts for those charges must be paid to the county treasurer of the
county in which the district hospital is located and credited to the fund for
the district.
(Added to NRS by 1969, 1389; A 1987, 390, 881; 1997, 3104, 3138; 1999, 639)
NRS 450.710 Creation of district for sole purpose of contracting for
services of hospital.
1. A board of county commissioners may
create a hospital district in an area where no hospital district exists for the
sole purpose of contracting with a public agency or a privately owned hospital
to provide the services of a hospital to the residents of the district. If such
a contract is executed, the board of trustees:
(a) Shall prepare a budget pursuant to NRS 450.650;
(b) Shall levy a tax pursuant to NRS 450.660;
(c) May accept donations pursuant to NRS 450.690;
(d) May determine medical indigency pursuant to NRS 450.700; and
(e) May borrow money and incur or assume
indebtedness pursuant to NRS 450.665.
2. A board of county commissioners shall
not create a hospital district pursuant to this section unless it determines
that:
(a) The proposed hospital district constitutes a
geographic area of the county that is not served by adequate medical services;
(b) There is no county hospital or the county
hospital is not capable of providing the necessary services; and
(c) The proposal is approved by a majority of the
votes cast on the issue by persons in the proposed hospital district.
3. If a hospital district is created
pursuant to this section, the board of county commissioners may be designated
by ordinance as, ex officio, the board of trustees of the hospital district,
notwithstanding the provisions of subsection 3 of NRS
450.620.
(Added to NRS by 1999, 2075)
NRS 450.715 Authority of board of trustees to contract for services of
hospital. The board of trustees
may contract with a public agency or a privately owned hospital to provide the
services of a hospital to the residents of the hospital district if it determines
that:
1. There is a need to provide medical
services to the residents of the district which are not being provided by the
district; or
2. It is less costly or more efficient to
provide the services of a hospital to the residents of the district by
contracting with a public agency or a privately owned hospital.
(Added to NRS by 1999, 2075)
NRS 450.720 Contract for management of district hospital.
1. The board of trustees may contract with
a company which manages hospitals for the rendering of management services in a
district hospital.
2. The agreement may provide:
(a) That the chief executive officer of the hospital
must be an employee of the company which manages the hospital; and
(b) That the hospital may, in accordance with the
requirements of NRS 450.730, purchase supplies,
materials and equipment through the purchasing contracts of the company which
manages the hospital, or through a purchasing group, without complying with the
requirements for competitive bidding set forth in chapter
332 of NRS.
(Added to NRS by 1999, 2076)
NRS 450.725 Membership of district hospital in purchasing group.
1. A district hospital may, with the
approval of the board of trustees, become a member of a purchasing group for
the purpose of purchasing supplies, materials and equipment used by the
district hospital.
2. A district hospital that becomes a
member of a purchasing group may, in accordance with the requirements of NRS 450.730, purchase supplies, materials and
equipment through the purchasing group without complying with the requirements
for competitive bidding set forth in chapter 332
of NRS.
(Added to NRS by 1999, 2076)
NRS 450.730 Purchase of supplies, materials and equipment without complying
with certain requirements for competitive bidding. A
district hospital that is authorized pursuant to NRS
450.720 or 450.725 to purchase supplies,
materials and equipment in accordance with this section through the purchasing
contracts of the company that manages the hospital or through a purchasing
group may purchase the supplies, materials and equipment without complying with
the requirements for competitive bidding set forth in chapter 332 of NRS if:
1. The documents pertaining to the
proposed purchase, including, without limitation, the prices available to the
company or purchasing group, are summarized in writing and, together with a
sworn statement by an officer or agent of the company or purchasing group that
the prices were obtained by the company or purchasing group through a process
of competitive bidding, are presented to the board of trustees at its next
regularly scheduled meeting; and
2. The board of trustees, after reviewing
the summary and statement, finds that the proposed purchase will be made at a
lower price than the lowest price reasonably obtainable by the hospital through
competitive bidding pursuant to chapter 332
of NRS or available to the hospital pursuant to NRS 333.470 and approves the proposed
purchase.
(Added to NRS by 1999, 2076)
NRS 450.750 Board of county commissioners in certain districts deemed local
government responsible for transferring certain payments of money. For the purposes of NRS 422.380 to 422.390, inclusive, if a hospital district
created pursuant to NRS 450.550 to 450.750, inclusive, includes territory within more
than one county, the board of county commissioners of the county in which the
hospital is located shall be deemed to be the local government responsible for
transferring payments of money to the Department for treatment of patients
pursuant to the provisions of NRS 422.380
to 422.390, inclusive.
(Added to NRS by 1997, 3099; A 2009, 2299)
NRS 450.751 Dissolution of hospital district in county whose population is
less than 700,000: Determination that dissolution is in best interest required;
ordinance of board of county commissioners; considerations; duties of county
clerk. In a county whose
population is less than 700,000:
1. Except as otherwise provided in
subsection 2, if a majority of the members of the board of county commissioners
determine that it is in the best interests of the county and of the hospital
district that the hospital district be dissolved, the board of county
commissioners shall so determine by ordinance, after there is first found,
determined and recited in the ordinance that:
(a) All outstanding indebtedness and bonds of all
kinds of the hospital district have been paid; and
(b) The services of the hospital district are no
longer needed or can be more effectively performed by an existing unit of
government.
2. If the hospital district includes
territory within more than one county, the hospital district may be dissolved
only if a majority of the members of the board of county commissioners of each
county included within the district take the actions described in subsection 1.
3. In determining pursuant to subsection 1
whether the dissolution of a hospital district is in the best interests of the
county and of the hospital district, a board of county commissioners must
consider, without limitation, whether:
(a) The hospital district is capable of providing
sufficient health care services to the residents of the county or counties
within the territory of the hospital district in an economical manner;
(b) The basic health care needs of the residents
of the county or counties within the territory of the hospital district will be
met if the hospital district is dissolved;
(c) There have been substantial changes in the
financial status of the hospital district during the immediately preceding 2
years; and
(d) There has been an increased tax burden on the
residents of the county or counties within the territory of the hospital
district during the immediately preceding 2 years.
4. The county clerk of each county within
which any territory of the hospital district is located shall thereupon certify
a copy of the ordinance to the board of trustees of the hospital district and
shall mail written notice to all qualified electors who reside within the
hospital district in his or her county, containing:
(a) The adoption of the ordinance;
(b) The determination of the board of county
commissioners of that county that the district should be dissolved; and
(c) The time and place for the hearing on the
dissolution.
(Added to NRS by 2005, 1446; A 2011, 1266)
NRS 450.753 Dissolution of hospital district: Right of qualified electors to
protest; dissolution prohibited if majority of qualified electors protest;
dissolution by final ordinance; recital of protests.
1. On or before the date fixed for the
hearing on the dissolution of a hospital district, any qualified elector who
resides within the hospital district may protest against the dissolution of the
hospital district by filing a written protest with the county clerk of the
county in which the elector resides.
2. If, at or before the time fixed by the
ordinance and notice, written protest is filed pursuant to subsection 1 by a
majority of the qualified electors who reside within the hospital district, the
hospital district must not be dissolved. If any written protests are filed and:
(a) If the hospital district does not include
territory within more than one county, the board of county commissioners
determines that the protests so filed represent less than a majority of the
qualified electors who reside within the hospital district, the board may
complete the dissolution by the adoption of a final ordinance of dissolution,
which ordinance must contain a recital of the protests, and the recital is
binding and conclusive for all purposes; or
(b) If the hospital district includes territory
within more than one county, the board of county commissioners of each county
included within the hospital district determines that the protests so filed
represent less than a majority of the qualified electors who reside within the
hospital district, the dissolution may be completed by the adoption of a final
ordinance of dissolution by the board of county commissioners of each county
included within the hospital district, which ordinance must contain a recital
of the protests, and the recital is binding and conclusive for all purposes.
(Added to NRS by 2005, 1446)
NRS 450.755 Dissolution of hospital district: Hearing; full consideration of
all protests required; adoption of final ordinance of dissolution or ordinance
of nondissolution by board of county commissioners. Except
as otherwise provided in subsection 2 of NRS 450.753,
at the place, date and hour specified for the hearing on the dissolution of a
hospital district in the notice mailed pursuant to NRS
450.751 or at any subsequent time to which the hearing may be adjourned,
the board of county commissioners of each county within which any territory of
the hospital district is located shall give full consideration to all protests
which have been filed pursuant to NRS 450.753 and
shall hear all persons desiring to be heard and shall thereafter adopt either
the final ordinance of dissolution or an ordinance determining that the
hospital district must not be dissolved. The dissolution may be completed by
the adoption of a final ordinance of dissolution by the board of county
commissioners of each county included within the hospital district.
(Added to NRS by 2005, 1447)
NRS 450.757 Dissolution of hospital district: County clerk must file final
ordinance of dissolution; locations. Within
30 days after the effective date of each ordinance which is required for the
dissolution of a hospital district pursuant to NRS
450.753 or 450.755, each county clerk shall
file a copy of the ordinance in his or her office and shall cause to be filed
an additional copy of the ordinance in the Office of the Secretary of State,
which filings must be without fee and must otherwise be filed in the same
manner as articles of incorporation are required to be filed under chapter 78 of NRS.
(Added to NRS by 2005, 1447)
NRS 450.759 Dissolution of hospital district in county whose population is
less than 700,000: Unpaid taxes, levies and assessments are lien on property;
power of board of county commissioners to collect. In
a county whose population is less than 700,000:
1. All outstanding and unpaid tax sales
and levies and all special assessment liens of a dissolved hospital district
are valid and remain a lien against the property against which they are
assessed or levied until paid, subject to the limitations of liens provided by
general law. Taxes and special assessments paid after the dissolution of a
hospital district must be placed in the general fund of the county in which the
district hospital was located.
2. The board of county commissioners of
the county in which the district hospital was located has the same power to
enforce the collection of all special assessments and outstanding tax sales of
the hospital district as the hospital district had if it had not been dissolved.
(Added to NRS by 2005, 1447; A 2011, 1267)
NRS 450.760 Dissolution of hospital district in county whose population is
less than 700,000: Retirement of outstanding debt and other obligations; levy
of property tax; disposition of property. In
a county whose population is less than 700,000:
1. Before dissolving a hospital district
pursuant to NRS 450.751 to 450.760,
inclusive, the board of county commissioners of the county in which the
district hospital is located shall determine whether the proceeds from the
taxes currently being levied in the hospital district, if any, for the
operation of the hospital and the repayment of debt are sufficient to repay any
outstanding obligations of the hospital district within a reasonable period
after the dissolution of the hospital district. If there are no taxes currently
being levied for the hospital district or the taxes being levied are not
sufficient to repay the outstanding obligations of the hospital district within
a reasonable period after the dissolution of the hospital district, before
dissolving the hospital district pursuant to NRS
450.751 to 450.760, inclusive:
(a) If the hospital district does not include
territory within more than one county, the board of county commissioners may
levy a property tax on all of the taxable property in the hospital district
that is sufficient, when combined with any revenue from taxes currently being
levied in the hospital district, to repay the outstanding obligations of the
hospital district within a reasonable period after the dissolution of the
hospital district; or
(b) If the hospital district includes territory
within more than one county, the board of county commissioners of each county
within which any territory of the hospital district is located may levy a
property tax on all of the taxable property in the county that is within the
hospital district that is sufficient, when combined with any revenue from taxes
currently being levied in the hospital district, to repay the outstanding obligations
of the hospital district within a reasonable period after the dissolution of
the hospital district.
2. The allowed revenue from taxes ad
valorem determined pursuant to NRS
354.59811 does not apply to any additional property tax levied pursuant to
subsection 1. If the hospital district is being managed by the Department of
Taxation pursuant to NRS 354.685 to 354.725, inclusive, at the time of
dissolution, the rate levied pursuant to subsection 1 must not be included in
the total ad valorem tax levy for the purposes of the application of the
limitation in NRS 361.453, but the rate
levied when combined with all other overlapping rates levied in the State must
not exceed $4.50 on each $100 of assessed valuation. A board of county
commissioners shall discontinue any rate levied pursuant to subsection 1 on a
date that will ensure that no taxes are collected for this purpose after the
outstanding obligations of the hospital district have been paid in full.
3. If, at the time of the dissolution of
the hospital district pursuant to NRS 450.751 to 450.760, inclusive, there are any outstanding loans,
bonded indebtedness or other obligations of the hospital district, including,
without limitation, unpaid obligations to organizations such as the Public
Employees’ Retirement System, unpaid salaries or unpaid loans made to the
hospital district by the county, the taxes being levied in the hospital
district at the time of dissolution must continue to be levied and collected in
the same manner as if the hospital district had not been dissolved until all
outstanding obligations of the hospital district have been paid in full, but
for all other purposes, the hospital district shall be considered dissolved
from the date on which each board of county commissioners of each county
included within the hospital district has adopted a final ordinance of
dissolution pursuant to NRS 450.753 or 450.755.
4. If the hospital district is being
managed by the Department of Taxation pursuant to NRS 354.685 to 354.725, inclusive, at the time of
dissolution, the management ceases upon dissolution, but the board of county
commissioners of the county in which the district hospital was located shall
continue to make such financial reports to the Department of Taxation as the
Department deems necessary until all outstanding obligations of the hospital
district have been paid in full.
5. The property of the dissolved hospital
district may be retained by the board of county commissioners of the county in
which the district hospital was located for use as a hospital or disposed of in
any manner the board deems appropriate.
6. Any proceeds of the sale or other
transfer of the property of the dissolved hospital district and any proceeds
from taxes which had been levied and received by the hospital district before
dissolution, whether levied for operating purposes or for the repayment of
debt, must be used by the board of county commissioners of the county in which
the district hospital was located to repay any indebtedness of the hospital
district.
(Added to NRS by 1999, 86; A 2005, 1448; 2011, 1267)
MISCELLANEOUS PROVISIONS
NRS 450.800 County or district hospital may contract for services.
1. In addition to having the powers
conferred under chapter 277 of NRS, a county
or district hospital may contract with a private hospital or other organization
for emergency medical services, including the transportation of patients, or
any other services performed in connection with or related to the operation of
a hospital. The services may be performed by the parties to the contract or the
parties may establish a separate organization for that purpose.
2. A county or district hospital may enter
into a contract to provide services:
(a) For persons, whether or not admitted to the
hospital, if those services are performed in connection with or related to the
operation of the hospital.
(b) Necessary for the health and welfare of the
general public.
(Added to NRS by 1981, 511; A 1987, 391)
NRS 450.810 Lease of naming rights relating to public hospital; ordinance
establishing procedures for lease; enterprise fund for proceeds of lease, fees
or charges and other money received for public hospital.
1. The board of county commissioners of a
county in which a public hospital is located may adopt, by ordinance,
procedures for the lease of naming rights relating to the public hospital,
including, without limitation, the lease of naming rights to:
(a) Buildings, improvements, facilities, rooms,
features, fixtures and sites located within the boundaries of the public
hospital; and
(b) Activities, events, programs, chairs,
fellowships and memorials held or established at the public hospital.
2. If a board of county commissioners
leases naming rights in accordance with the procedures adopted pursuant to this
section, the board shall create an enterprise fund exclusively for the proceeds
of the lease of all such naming rights, for fees or charges for use of the
hospital and for any gifts, grants, donations, bequests, devises or money from
any other source received for the public hospital. Any interest or other income
earned on the money in the fund, after deducting any applicable charges, must
be credited to the fund. Money that remains in the fund at the end of a fiscal
year does not revert to the county general fund and the balance in the fund
must be carried forward to the next fiscal year. The money in the fund may only
be used to pay for expenses directly related to the costs of the public
hospital for construction, improvement, operation, maintenance or programs.
3. The procedures adopted pursuant to
subsection 1 must, without limitation:
(a) Prohibit the lease of naming rights for a
public hospital to that public hospital;
(b) Provide that the board of county
commissioners may reject any name proposed pursuant to a lease of naming
rights;
(c) Provide for the development of selection
criteria for awarding a lease of naming rights, including procedures for
circumstances in which more than one request for the lease of naming rights is
submitted to the board of county commissioners;
(d) Provide that the name must be consistent with
the mission of the public hospital;
(e) Prohibit the use of a name that:
(1) Is false, misleading or deceptive;
(2) Promotes unlawful or illegal goods,
service or activities;
(3) Promotes or encourages hate, violence
or antisocial behavior;
(4) Implies an endorsement by the county
or a public official of any good, service or activity;
(5) Is libelous or defamatory;
(6) Contains text or an image that is
likely to be confused with safety, traffic or emergency signage; or
(7) Is associated with a person who has
been convicted of a felony;
(f) Provide that the term of a lease does not
exceed 20 years; and
(g) Provide that the board of county
commissioners:
(1) Shall require the change of a name
authorized pursuant to a lease or revoke a lease before the expiration of its
term if a change of circumstances results in a violation of the provisions of
paragraph (d) or (e); and
(2) May require the change of a name
authorized pursuant to a lease or revoke a lease before the expiration of its
term for any other purpose in accordance with the procedures adopted pursuant
to subsection 1.
4. The terms of a lease granted pursuant
to this section may be renegotiated and renewed. Each such renewal must provide
that the term of the lease does not exceed 20 years.
5. A lease of naming rights pursuant to
this section and the procedures adopted pursuant thereto are not subject to the
requirements for competitive bidding set forth in chapter
332 of NRS.
(Added to NRS by 2009, 2653)
