Nrs: Chapter 450 - County Hospitals And Hospital Districts

Link to law: https://www.leg.state.nv.us/NRS/NRS-450.html
Published: 2015

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[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.

_________

_________

 

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)