[Rev. 2/10/2015 5:31:40
PM--2014R2]
CHAPTER 449 - MEDICAL FACILITIES AND OTHER
RELATED ENTITIES
GENERAL PROVISIONS
NRS 449.001 Definitions.
NRS 449.0015 “Agency
to provide nursing in the home” defined.
NRS 449.0021 “Agency
to provide personal care services in the home” defined.
NRS 449.0025 “Board”
defined.
NRS 449.0031 “Community
triage center” defined.
NRS 449.0032 “Division”
defined.
NRS 449.0033 “Facility
for hospice care” defined.
NRS 449.0038 “Facility
for intermediate care” defined.
NRS 449.00385 “Facility
for modified medical detoxification” defined.
NRS 449.00387 “Facility
for refractive surgery” defined.
NRS 449.0039 “Facility
for skilled nursing” defined.
NRS 449.004 “Facility
for the care of adults during the day” defined.
NRS 449.0045 “Facility
for the dependent” defined.
NRS 449.00455 “Facility
for the treatment of abuse of alcohol or drugs” defined.
NRS 449.0046 “Facility
for the treatment of irreversible renal disease” defined.
NRS 449.0055 “Facility
for transitional living for released offenders” defined.
NRS 449.008 “Halfway
house for recovering alcohol and drug abusers” defined.
NRS 449.009 “Health
Division” defined. [Repealed.]
NRS 449.0105 “Home
for individual residential care” defined.
NRS 449.0115 “Hospice
care” defined.
NRS 449.012 “Hospital”
defined.
NRS 449.013 “Independent
center for emergency medical care” defined.
NRS 449.0145 “Licensed
practical nurse” defined.
NRS 449.0151 “Medical
facility” defined.
NRS 449.01513 “Medication
aide - certified” defined.
NRS 449.01515 “Mobile
unit” defined.
NRS 449.0152 “Nursing
assistant” defined.
NRS 449.0153 “Nursing
pool” defined.
NRS 449.0155 “Obstetric
center” defined.
NRS 449.0156 “Palliative
services” defined.
NRS 449.0157 “Provider
of health care” defined.
NRS 449.0159 “Provider
of supported living arrangement services” defined.
NRS 449.0165 “Psychiatric
hospital” defined.
NRS 449.0167 “Registered
nurse” defined.
NRS 449.017 “Residential
facility for groups” defined.
NRS 449.0175 “Rural
clinic” defined.
NRS 449.0177 “Rural
hospital” defined.
NRS 449.0185 “Supported
living arrangement services” defined.
NRS 449.019 “Surgical
center for ambulatory patients” defined.
NRS 449.0195 “Terminally
ill” defined.
LICENSING AND REGULATION
General Provisions
NRS 449.030 License
required to operate or maintain medical facility or facility for the dependent
and to operate program of hospice care.
NRS 449.0301 Exemptions.
NRS 449.0302 Board
to adopt standards, qualifications and other regulations.
NRS 449.0303 Authority
of Board to require licensing of other facilities.
NRS 449.0305 Businesses
that provide referrals to residential facilities for groups: License required;
standards and regulations; provision of referrals; prohibited acts; civil
penalties.
NRS 449.0306 Money
received from licensing of facilities to be deposited in State General Fund;
expenditure of state or federal money.
NRS 449.0307 Powers
of Division.
NRS 449.0308 Authority
of Division to collect actual cost of enforcing provisions from unlicensed
medical facility or facility for the dependent; exception.
Licensing
NRS 449.040 Application
for license: Filing; contents.
NRS 449.050 Fees.
NRS 449.065 Surety
bond for initial license and renewal of license to operate facility for
intermediate care, facility for skilled nursing, residential facility for
groups, home for individual residential care, agency to provide personal care
services in home and agency to provide nursing in home; exemption; exception.
NRS 449.067 Substitute
for surety required for facility for intermediate care, facility for skilled
nursing, residential facility for groups, home for individual residential care,
agency to provide personal care services in home and agency to provide nursing
in home.
NRS 449.068 Surety
bond required for initial license and renewal of license to operate facility
for refractive surgery.
NRS 449.069 Substitute
for surety bond required for facility for refractive surgery.
NRS 449.080 Issuance,
validity and transferability of license.
NRS 449.085 Form
and contents of license.
NRS 449.087 Amendment
of license required for addition of certain services; requirements for approval
of amendment; revocation of approval; standards.
NRS 449.089 Expiration
and renewal of license.
NRS 449.091 Provisional
license.
NRS 449.092 Applicant
for issuance or renewal of license for home for individual residential care to
attest to knowledge of and compliance with certain guidelines concerning safe
and appropriate injection practices.
NRS 449.093 Training
to recognize and prevent abuse of older persons: Persons required to receive;
frequency; topics; costs; actions for failure to complete.
NRS 449.094 Continuing
education requirements concerning care of persons with dementia for certain
employees of facilities for skilled nursing, facilities for intermediate care
and residential facilities for groups.
Background Investigations
NRS 449.119 “Facility,
hospital, agency, program or home” defined.
NRS 449.121 Exemption
for facility for the treatment of abuse of alcohol or drugs; exception.
NRS 449.122 Investigation
of applicant for license to operate facility, hospital, agency, program or
home.
NRS 449.123 Initial
and periodic investigations of employee, employee of temporary employment
service or independent contractor of facility, hospital, agency, program or
home; penalty.
NRS 449.1235 Temporary
employment service prohibited from sending ineligible employee to facility,
hospital, agency, program or home; temporary employment service to provide
certain information regarding its employees.
NRS 449.124 Maintenance
and availability of certain records regarding employee, employee of temporary
employment service or independent contractor of facility, hospital, agency,
program or home.
NRS 449.125 Termination
of employment or contract of employee, employee of temporary employment service
or independent contractor of facility, hospital, agency, program or home who
has been convicted of certain crime; period in which to correct information
regarding conviction; liability of facility, hospital, agency, program or home.
Inspections
NRS 449.131 Entry
and inspection of building and premises by Division, State Fire Marshal and
Chief Medical Officer.
NRS 449.132 Inspection
of medical facility and facility for dependent by Division of Public and
Behavioral Health and Aging and Disability Services Division.
NRS 449.133 Report
of results of inspections of medical facilities and facilities for dependent by
Division; disclosure of results of inspections of facilities for skilled
nursing, facilities for intermediate care and residential facilities for
groups.
NRS 449.134 Facility
for intermediate care, facility for skilled nursing, residential facility for
groups or home for individual residential care to provide immediate
notification of certain deficiencies to certain persons.
Disciplinary Action
NRS 449.160 Grounds
for denial, suspension or revocation of license; revocation of license in
connection with certain nuisance activity; log of complaints; information
concerning complaint, investigation and disciplinary action to be provided to
facility for the care of adults during the day; written report of complaints
and disciplinary actions.
NRS 449.163 Administrative
sanctions: Imposition by Division; disposition of money collected.
NRS 449.165 Administrative
sanctions: Regulations of Board.
NRS 449.170 Denial,
suspension or revocation of license or imposition of sanctions: Notice; appeal;
adoption of regulations.
NRS 449.171 Authority
of Division to take control over medical records of medical facility or
facility for dependent upon suspension of license or cessation of operation;
confidentiality; sharing of records with appropriate authorities.
NRS 449.172 Residential
facility for groups: Duties of Division and operator upon suspension or
revocation of license for abuse, neglect or isolation of occupants.
NRS 449.174 Additional
grounds for denial, suspension or revocation of license to operate certain
facility, hospital, agency, program or home.
Miscellaneous Provisions
NRS 449.181 Medical
facility that has custody of child pursuant to court order to adopt policy
relating to medical care and medications for child; employees to receive copy
of policy.
NRS 449.183 Facility
for intermediate care, facility for skilled nursing and residential facility
for groups to adopt written policy concerning readmission after temporary
transfer of patient or resident.
NRS 449.184 Operator
of residential facility for groups, facility for intermediate care or facility
for skilled nursing to post certain information in conspicuous place.
NRS 449.186 Supervision
of residential facility for groups.
NRS 449.187 Supervision
of facility for skilled nursing or facility for intermediate care.
NRS 449.189 Physician
and nurse required to operate independent center to provide emergency medical
care.
NRS 449.191 Medical
facility not required to allow abortions.
NRS 449.192 Admission
of dentist to membership on medical staff of hospital.
NRS 449.193 Facility
for intermediate care, facility for skilled nursing, residential facility for
groups or home for individual residential care to provide itemized statement of
charges upon request to certain persons.
NRS 449.1935 Agency
to provide personal care services in the home authorized to provide certain
services to certain persons.
NRS 449.194 Certain
employees of agency to provide personal care services in the home immune from
civil liability resulting from rendering emergency care or assistance.
NRS 449.195 Waiver
of deductible or copayment; conditions.
NRS 449.196 Requirements
for program of hospice care.
NRS 449.197 Provision
of care by facility for hospice care.
NRS 449.198 Requirements
for obstetric center.
NRS 449.199 Residential
facility for groups and homes for individual residential care prohibited from
providing accommodations to persons not meeting requirements for admission;
exception.
NRS 449.201 Certification
required for alcohol and drug abuse programs operated or provided by facility
for transitional living for released offenders.
NRS 449.202 Classification
of hospitals.
NRS 449.203 Designation
of hospital as primary stroke center; Division to maintain list of hospitals so
designated; regulations.
NRS 449.2035 Designation
of hospital as STEMI receiving center; Division to maintain list of hospitals
so designated; regulations.
NRS 449.204 Misleading
name or other designation of facility prohibited.
Prohibited Acts; Penalties
NRS 449.205 Retaliation
or discrimination against employees and certain other persons: Prohibition
under certain circumstances; medical facility prohibited from restricting right
to make report or take certain other actions.
NRS 449.207 Retaliation
or discrimination against employees and certain other persons: Violation; civil
action for certain acts of retaliation or discrimination; damages; equitable
relief; rebuttable presumption; civil penalty; time limit for bringing action.
NRS 449.208 Retaliation
or discrimination against employees or certain other persons: Written notice
regarding protections and legal remedies for certain acts of retaliation or
discrimination; posting of notice; inclusion of notice in employee handbook.
NRS 449.209 Prohibition
against medical facility or employee of medical facility making certain
referrals to residential facilities for groups; civil penalties; system to
track violations.
NRS 449.210 Penalties
for unlicensed operation: Medical facility or facility for dependent;
residential facility for groups or home for individual residential care.
NRS 449.220 Action
to enjoin violations.
NRS 449.240 Institution
and conduct of prosecutions.
REQUIREMENTS RELATING TO STAFFING
NRS 449.241 Definitions.
NRS 449.2413 “Certified
nursing assistant” defined.
NRS 449.2414 “Health
care facility” defined.
NRS 449.2416 “Licensed
nurse” defined.
NRS 449.2418 “Unit”
defined.
NRS 449.242 Establishment
of staffing committee by certain hospitals in larger counties; membership; duty
to develop documented staffing plan; duty to consider certain requests;
quarterly meetings; reporting to Legislature.
NRS 449.2421 Certain
health care facilities in larger counties required to make available to
Division written policy that allows refusal of or objection to work assignments
and documented staffing plan; requirements of staffing plan and flexibility for
adjustments.
NRS 449.2423 Certain
health care facilities in larger counties to adopt written policy to allow
nurse or certified nursing assistant to refuse or object to work assignments;
requirements of policy; maintenance of records of refusals of and objections to
work assignments.
NRS 449.2428 Division
required to ensure that certain health care facilities comply with provisions;
regulations.
MISCELLANEOUS PROVISIONS
NRS 449.243 Itemized
list of charges required; use of Uniform Billing and Claims Forms authorized;
contracted rates; summary of charges.
NRS 449.244 Certain
costs for examination or treatment of victims of sexual offenses to be charged
to county. [Repealed.]
NRS 449.245 Release
of child from hospital; provision of authorization for release and other
information to Division of Child and Family Services; disclosure of
information; penalty.
NRS 449.2455 Authority
of hospital to enter into agreement with Armed Forces of United States for
provision of medical care by certain medical officers.
NRS 449.246 Hospital
or obstetric center to provide information relating to voluntary acknowledgment
or establishment of paternity before discharging unmarried woman who has borne
child; regulations.
NRS 449.2465 Persons
entitled to results of tests performed at laboratory regarding patient of rural
hospital.
NRS 449.247 Powers
and duties of Division and State Board of Nursing with respect to nursing
assistants and medication aides - certified and training of nursing assistants
and medication aides - certified; provision of information to State Board of
Nursing.
NRS 449.2475 Unlicensed
insurer not allowed to make payment directly to person who received services in
certain circumstances; limitation on civil and criminal liability.
NRS 449.248 Additional
services to be provided by agency to provide nursing in home.
NRS 449.2485 Return
to dispensing pharmacy of unused prescription drug dispensed to patient of
facility for skilled nursing or facility for intermediate care for purpose of
reissuing drug or transferring drug.
NRS 449.2486 Facility
for care of adults during the day to maintain and provide certain information;
form in which information to be provided.
NRS 449.2487 Notice
to be provided by certain facilities which offer independent living.
NRS 449.2488 Department
to develop brochure and website to assist persons who are 55 years of age or
older in determining appropriate level of care and type of housing; information
to be included in brochure and website.
FACILITIES FOR REFRACTIVE SURGERY
NRS 449.2489 Definitions.
NRS 449.24891 “Ophthalmologist”
defined.
NRS 449.24892 “Postoperative
care” defined.
NRS 449.24893 “Preoperative
care” defined.
NRS 449.24894 “Surgical
treatment for a refractive error of the eye” defined.
NRS 449.24895 Certain
persons not required to obtain license to operate and maintain facility; filing
of affidavit with Division required.
NRS 449.24896 Surgical
treatments at facility must be performed by licensed ophthalmologist;
availability of ophthalmologist.
NRS 449.24897 Order
to cease and desist operation for failure to obtain license; injunction;
penalties.
NRS 449.24898 Collaboration
between ophthalmologist and optometrist authorized pursuant to NRS 636.374.
NEVADA HEALTH FACILITIES ASSISTANCE ACT
NRS 449.250 Short
title.
NRS 449.260 Definitions.
NRS 449.270 State
Department to constitute sole agency of State for certain purposes.
NRS 449.280 Duties
of State Department.
NRS 449.300 Inventory
of existing health facilities; development of program for construction of
facilities.
NRS 449.310 Requirements
of program for construction of health facilities.
NRS 449.320 Application
for federal money; deposit of money.
NRS 449.340 State
Department to prescribe minimum standards; standards to supersede local
ordinances and regulations; penalty.
NRS 449.345 Restriction
on adoption of regulations concerning construction, maintenance, operation or
safety of building, structure or other property.
NRS 449.360 Application
for construction of health facility: Filing; compliance with federal and state
requirements.
NRS 449.370 Application
for construction of health facility: Notice and hearing; approval and
forwarding.
NRS 449.380 Inspection
of construction of health facility; certification by State Department.
NRS 449.390 Authority
to receive and distribute federal money; Health Facilities Assistance Fund;
deposits, use and controls.
NRS 449.400 State
Public Health Facilities Construction Assistance Fund: Creation;
administration.
NRS 449.410 State
assistance for construction of certain projects; eligibility of project for
assistance.
NRS 449.420 Amount
of state assistance: Allocations; payments.
NRS 449.430 Money
from State Public Health Facilities Construction Assistance Fund to be paid in
installments.
INTERMEDIARY SERVICE ORGANIZATIONS
General Provisions
NRS 449.4304 “Intermediary
service organization” defined.
NRS 449.4308 Authority
to provide services.
Certification
NRS 449.431 Certificate
required; exception; penalty.
NRS 449.4311 Application
for certificate: Contents.
NRS 449.4312 Application
for certificate: Social security number required. [Effective until the date of
the repeal of 42 U.S.C. § 666, the federal law requiring each state to
establish procedures for withholding, suspending and restricting the
professional, occupational and recreational licenses for child support
arrearages and for noncompliance with certain processes relating to paternity
or child support proceedings.]
NRS 449.4313 Application
for certificate: Statement regarding obligation of child support; grounds for
denial; duty of Division. [Effective until the date of the repeal of 42 U.S.C.
§ 666, the federal law requiring each state to establish procedures for
withholding, suspending and restricting the professional, occupational and
recreational licenses for child support arrearages and for noncompliance with
certain processes relating to paternity or child support proceedings.]
NRS 449.4314 Application
for certificate: Fee.
NRS 449.4317 Issuance
of certificate; nontransferability.
NRS 449.4318 Form
and contents of certificate.
NRS 449.4319 Expiration
and renewal of certificate.
NRS 449.432 Application
for renewal of certificate: Information concerning business license required;
conditions which require denial.
NRS 449.4321 Grounds
for denial, suspension or revocation of certificate.
NRS 449.4322 Suspension
of certificate for failure to pay child support or comply with certain
subpoenas or warrants; reinstatement of certificate. [Effective until the date
of the repeal of 42 U.S.C. § 666, the federal law requiring each state to
establish procedures for withholding, suspending and restricting the
professional, occupational and recreational licenses for child support
arrearages and for noncompliance with certain processes relating to paternity
or child support proceedings.]
NRS 449.4324 Provisional
certificate.
NRS 449.4325 Deposit
of money received; expenses of Division to enforce provisions.
NRS 449.4327 Regulations;
powers of Division.
Background Investigations
NRS 449.4329 Initial
and periodic investigations of employee, employee of temporary employment
service or independent contractor; penalty.
NRS 449.43295 Temporary
employment service prohibited from sending ineligible employee to organization;
temporary employment service to provide certain information regarding its
employees.
NRS 449.433 Maintenance
and availability of certain records regarding employee, employee of temporary
employment service or independent contractor of organization.
NRS 449.4331 Termination
of employment or contract of employee, employee of temporary employment service
or independent contractor who has been convicted of certain crime; period in
which to correct information regarding conviction; liability of organization.
NRS 449.4332 Additional
grounds for denial, suspension or revocation of certificate.
Disciplinary Action; Enforcement
NRS 449.4335 Administrative
sanctions: Imposition by Division; consequences of failure to pay; use of money
collected.
NRS 449.4336 Administrative
sanctions: Regulations.
NRS 449.4337 Notice
by Division of disciplinary action; exception; appeal.
NRS 449.4338 Action
to enjoin violations.
NRS 449.4339 Prosecution
by district attorney.
PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION
AND DEEP SEDATION; NATIONAL ACCREDITATION; INSPECTIONS OF SURGICAL CENTERS FOR
AMBULATORY PATIENTS AND CERTAIN PHYSICIANS’ OFFICES AND FACILITIES
NRS 449.435 Definitions.
NRS 449.436 “Conscious
sedation” defined.
NRS 449.437 “Deep
sedation” defined.
NRS 449.438 “General
anesthesia” defined.
NRS 449.439 “Physician”
defined.
NRS 449.441 Exemption
from provisions if physician’s office or facility only administers certain type
of pain medication.
NRS 449.442 Permit
required for certain physicians’ offices and facilities to offer services;
national accreditation required; cessation of services for failure to maintain
accreditation.
NRS 449.443 Application
for permit; fee; inspection by Division; term of permit.
NRS 449.444 Application
for renewal of permit; fee.
NRS 449.445 National
accreditation required of surgical center for ambulatory patients; inspection
by Division; cessation of operation for failure to maintain accreditation.
NRS 449.446 Annual
inspections of holders of permits and surgical centers for ambulatory patients;
correction of deficiencies identified in inspections; reporting of inspections
to Legislature.
NRS 449.447 Disciplinary
action for certain violations or failure to correct deficiency; notification to
professional licensing board of violations; administrative sanctions.
NRS 449.448 Regulations.
ACCOUNTING; FINANCIAL REPORTS; FEES; ENSURING QUALITY OF CARE
NRS 449.450 Definitions.
NRS 449.460 Powers
of Director.
NRS 449.465 Authority
of Director to impose fees; maximum amount of fees collected; fee for support
of Legislative Committee on Health Care.
NRS 449.470 Director
may use staff or contract for services.
NRS 449.476 Committee
to ensure quality of care: Formation by hospital; general requirements.
NRS 449.485 Hospital
required to use discharge form prescribed by Director; electronic monthly
reporting; exception to electronic reporting; use of information by Department.
NRS 449.490 Financial
statements and reports required to be filed with Department; additional
reporting requirements for hospitals with 100 or more beds; availability of
complete current charge master.
NRS 449.500 Director
to carry out analyses and studies concerning cost of health care.
NRS 449.510 Director
to prepare and file summaries, compilations or other reports; public
inspection; collection, maintenance, disclosure or publication of contracts or
identification of party to contract prohibited.
NRS 449.520 Reports
to Governor and legislative committees; development of comprehensive plan by
Legislative Committee on Health Care.
NRS 449.530 Administrative
fine for violation.
WITHHOLDING OR WITHDRAWAL OF LIFE-SUSTAINING TREATMENT
NRS 449.535 Short
title; uniformity of application and construction.
NRS 449.540 Definitions.
NRS 449.550 “Attending
physician” defined.
NRS 449.560 “Declaration”
defined.
NRS 449.570 “Life-sustaining
treatment” defined.
NRS 449.575 “Person”
defined.
NRS 449.581 “Provider
of health care” defined.
NRS 449.585 “Qualified
patient” defined.
NRS 449.590 “Terminal
condition” defined.
NRS 449.600 Declaration
relating to use of life-sustaining treatment.
NRS 449.610 Form
of declaration directing physician to withhold or withdraw life-sustaining
treatment.
NRS 449.613 Form
of declaration designating another person to decide to withhold or withdraw
life-sustaining treatment.
NRS 449.617 Time
declaration becomes operative; duty of providers of health care.
NRS 449.620 Revocation
of declaration; entry of revocation in medical records of declarant.
NRS 449.622 Recording
determination of terminal condition and declaration.
NRS 449.624 Treatment
of qualified patients; withholding or withdrawal of artificial nutrition and
hydration; treatment of pregnant patient.
NRS 449.626 Written
consent to withhold or withdraw life-sustaining treatment.
NRS 449.628 Transfer
of care of declarant.
NRS 449.630 Immunity
from civil and criminal liability and discipline for unprofessional conduct.
NRS 449.640 Consideration
of declaration and other factors; failure to follow directions of patient.
NRS 449.645 Assumption
of validity of declaration; presumption of intent to use, withhold or withdraw
life-sustaining treatment not created.
NRS 449.650 Death
does not constitute suicide or homicide; effect of declaration on policy of
insurance; prohibiting or requiring execution of declaration prohibited as
condition for insurance or receipt of health care.
NRS 449.660 Penalties.
NRS 449.670 Actions
contrary to reasonable medical standards not required; mercy-killing, assisted
suicide or euthanasia not authorized.
NRS 449.680 Other
right or responsibility regarding use of life-sustaining treatment or
withholding or withdrawal of medical care not limited.
NRS 449.690 Validity
of declaration executed in another state; effect of previously executed
instrument.
PHYSICIAN ORDERS FOR LIFE-SUSTAINING TREATMENT
NRS 449.691 Definitions.
NRS 449.6912 “Attending
physician” defined.
NRS 449.6915 “Do-not-resuscitate
identification” defined.
NRS 449.6916 “Do-not-resuscitate
order” defined.
NRS 449.6918 “Emergency
care” defined.
NRS 449.692 “Health
care facility” defined.
NRS 449.6922 “Incompetent”
defined.
NRS 449.6924 “Life-resuscitating
treatment” defined.
NRS 449.6925 “Life-sustaining
treatment” defined.
NRS 449.6928 “Other
types of advance directives” defined.
NRS 449.693 “Physician
Order for Life-Sustaining Treatment form” or “POLST form” defined.
NRS 449.6932 “Provider
of health care” defined.
NRS 449.6934 “Representative
of the patient” defined.
NRS 449.694 Board
required to prescribe standardized POLST form; requirements.
NRS 449.6942 Physician
required to explain POLST form under certain circumstances and to complete
POLST form upon request of patient; validity.
NRS 449.6944 Revocation
of POLST form; entry of revocation in medical records of patient.
NRS 449.6946 Conflict
with other advance directive or do-not-resuscitate identification.
NRS 449.6948 Immunity
from civil and criminal liability and discipline for unprofessional conduct.
NRS 449.695 Provider
of health care required to comply with valid POLST form; modification by
physician; transfer of care of patient; exceptions.
NRS 449.6952 Assumption
of validity of POLST form; presumption of intent of patient not created if
patient has revoked or not executed POLST form.
NRS 449.6954 Death
does not constitute suicide or homicide; effect of POLST form on policy of
insurance; prohibiting or requiring execution of POLST form prohibited as
condition for insurance or receipt of health care.
NRS 449.6956 Unlawful
acts; penalty.
NRS 449.6958 Actions
contrary to reasonable medical standards not required; mercy-killing,
euthanasia or assisted suicide not authorized; rights associated with other
advance directives not impaired; right to make decisions concerning emergency
care or life-sustaining treatment not affected.
NRS 449.696 Validity
of POLST form executed in another state.
NRS 449.697 Regulations.
PATIENT’S RIGHTS
NRS 449.700 Facility
to provide necessary services or arrange for transfer of patient; explanation
of need for transfer and alternatives available.
NRS 449.705 Facility
to forward medical records upon certain transfers of patient.
NRS 449.710 Specific
rights: Information concerning facility; treatment; billing; visitation.
NRS 449.715 Specific
rights: Designation of persons authorized to visit patient in facility.
NRS 449.720 Specific
rights: Care; refusal of treatment and experimentation; privacy; notice of
appointments and need for care; confidentiality of information concerning
patient.
NRS 449.725 Owner
and administrator of certain facility prohibited from receiving money or
property by will of resident or former resident or from life insurance proceeds
of resident or former resident; exception.
NRS 449.730 Patient
to be informed of rights upon admission to facility; required disclosures and
notices.
NRS 449.740 Procedure
to insert implant in breast of patient: Informed consent required; withdrawal
of consent; penalty.
NRS 449.750 Procedure
to insert implant in breast of patient: Contents of explanation form and
consent form; fee for forms.
COLLECTION OF AMOUNT OWED TO HOSPITAL FOR HOSPITAL CARE
NRS 449.751 Definitions.
NRS 449.753 “Hospital
care” defined.
NRS 449.755 “Responsible
party” defined.
NRS 449.757 Limitations
on efforts of hospitals to collect; date for accrual of interest; rate of
interest; limitations on additional fees.
NRS 449.758 Limitations
on efforts of hospital to collect when hospital has contractual agreement with
third party that provides health coverage for care provided; exception.
NRS 449.759 Manner
of collection.
PREVENTING PERSONS FROM ENTERING OR EXITING HEALTH FACILITY
NRS 449.760 Unlawful
acts; exception; penalty.
USE OF AVERSIVE INTERVENTION OR FORMS OF RESTRAINT ON PATIENTS
WITH DISABILITIES
NRS 449.765 Definitions.
NRS 449.766 “Aversive
intervention” defined.
NRS 449.767 “Chemical
restraint” defined.
NRS 449.768 “Corporal
punishment” defined.
NRS 449.769 “Electric
shock” defined.
NRS 449.770 “Emergency”
defined.
NRS 449.771 “Facility”
defined.
NRS 449.772 “Mechanical
restraint” defined.
NRS 449.773 “Person
with a disability” defined.
NRS 449.774 “Physical
restraint” defined.
NRS 449.775 “Verbal
and mental abuse” defined.
NRS 449.776 Aversive
intervention: Prohibition on use.
NRS 449.777 Forms
of restraint: Restrictions on use.
NRS 449.778 Physical
restraint: Permissible use; report of use in emergency.
NRS 449.779 Mechanical
restraint: Permissible use; report of use in emergency.
NRS 449.780 Chemical
restraint: Permissible use; report of use.
NRS 449.781 Use
of forms of restraint by certain facilities.
NRS 449.782 Education
and training of members of staff of facility.
NRS 449.783 Violations:
Criminal penalties; ineligibility for employment; disciplinary action.
NRS 449.784 Violations:
Report required; development and review of and compliance with corrective plan.
NRS 449.785 Prohibition
on retaliation against person for reporting or providing information regarding
violation.
NRS 449.786 Entry
of denial of rights in patient’s record; notice and report of denial; action by
Division.
REGISTRY OF ADVANCE DIRECTIVES
FOR HEALTH CARE
NRS 449.900 Definitions.
NRS 449.905 “Advance
directive” defined.
NRS 449.910 “Registrant”
defined.
NRS 449.915 “Registry”
defined.
NRS 449.920 Establishment
and maintenance; information to be included in Registry.
NRS 449.925 Registration
of advance directive: Requirements; duties of Secretary of State.
NRS 449.930 Access
to advance directive.
NRS 449.935 Removal
of advance directive of deceased registrant.
NRS 449.940 Secretary
of State not required to determine accuracy of contents of advance directive or
validity of advance directive; effect of registration, failure to register and
failure to notify Secretary of State of revocation of advance directive.
NRS 449.945 Provider
of health care not required to inquire whether patient has registered advance
directive or access Registry; immunity of provider of health care from criminal
and civil liability.
NRS 449.950 Immunity
of Secretary of State and deputies, employees and attorneys of Secretary of
State.
NRS 449.955 Suspension
of components of Registry and duties of Secretary of State if sufficient money
not available; fees authorized; acceptance of gifts and grants.
NRS 449.960 Deposit,
accounting and use of money received; interest and income earned on money
received; payment of claims.
NRS 449.965 Regulations.
_________
_________
GENERAL PROVISIONS
NRS 449.001 Definitions. As
used in this chapter, unless the context otherwise requires, the words and
terms defined in NRS 449.0015 to 449.0195, inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1973, 1278; A 1975, 366, 897; 1977, 641; 1979, 160, 1113; 1983, 1657; 1985, 1736; 1989, 304, 1034, 1037; 1993, 2556; 1995, 1600; 1999, 248, 970; 2001, 1341, 2518; 2005, 485, 532, 1379, 1517, 2165, 2350; 2011, 1337;
2013, 3055)
NRS 449.0015 “Agency to provide nursing in the home” defined. “Agency to provide nursing in the home” means
any person or governmental organization which provides in the home, through its
employees or by contractual arrangement with other persons, skilled nursing and
assistance and training in health and housekeeping skills. The term does not
include a provider of supported living arrangement services during any period
in which the provider of supported living arrangement services is engaged in
providing supported living arrangement services.
(Added to NRS by 1979, 160; A 1985, 1737; 2005, 1379)
NRS 449.0021 “Agency to provide personal care services in the home” defined.
1. “Agency to provide personal care
services in the home” means any person, other than a natural person, which
provides in the home the services authorized pursuant to NRS 449.1935 to elderly persons or persons with
disabilities.
2. The term does not include:
(a) An independent contractor who provides
nonmedical services specified in NRS 449.1935
without the assistance of employees;
(b) An organized group of persons composed of the
family or friends of a person needing personal care services that employs or
contracts with persons to provide nonmedical services specified in NRS 449.1935 for the person if:
(1) The organization of the group of
persons is set forth in a written document that is made available for review by
the Division upon request; and
(2) The personal care services are
provided to only one person or one family who resides in the same residence; or
(c) An intermediary service organization.
3. As used in this section, “intermediary
service organization” has the meaning ascribed to it in NRS
449.4304.
(Added to NRS by 2005, 2164; A 2007, 1225; 2009, 2399;
2013, 134)
NRS 449.0025 “Board” defined. “Board”
means the State Board of Health.
(Added to NRS by 1985, 1735)
NRS 449.0031 “Community triage center” defined. “Community
triage center” means a facility that provides on a 24-hour basis medical
assessments of and short-term monitoring services for persons with mental
illness and abusers of alcohol or drugs in a manner which does not require that
the assessments and services be provided in a licensed hospital.
(Added to NRS by 2005, 532)
NRS 449.0032 “Division” defined. “Division”
means the Division of Public and Behavioral Health of the Department of Health
and Human Services.
(Added to NRS by 2013, 3055)
NRS 449.0033 “Facility for hospice care” defined. “Facility
for hospice care” means a facility which is operated to provide hospice care.
(Added to NRS by 1999, 248)
NRS 449.0038 “Facility for intermediate care” defined. “Facility for intermediate care” means an
establishment operated and maintained to provide 24-hour personal and medical
supervision, for a person who does not have illness, disease, injury or other
condition that would require the degree of care and treatment which a hospital
or facility for skilled nursing is designed to provide.
(Added to NRS by 1973, 1279; A 1985, 1737; 1991, 1974)
NRS 449.00385 “Facility for modified medical detoxification” defined. “Facility for modified medical detoxification”
means a facility that provides 24-hour medical monitoring of treatment and
detoxification in a manner which does not require that the service be provided
in a licensed hospital.
(Added to NRS by 1999, 969)
NRS 449.00387 “Facility for refractive surgery” defined.
1. “Facility for refractive surgery” means
a freestanding facility that provides limited medical services relating to
surgical treatments for patients with refractive errors of the eye, including
the preoperative care and evaluation of those patients, the surgical treatment
of those patients and the postoperative care and evaluation of those patients.
2. As used in this section:
(a) “Postoperative care” has the meaning ascribed
to it in NRS 449.24892.
(b) “Preoperative care” has the meaning ascribed
to it in NRS 449.24893.
(Added to NRS by 2001, 1339; A 2005, 2693; 2009, 452)
NRS 449.0039 “Facility for skilled nursing” defined.
1. “Facility for skilled nursing” means an
establishment which provides continuous skilled nursing and related care as
prescribed by a physician to a patient in the facility who is not in an acute
episode of illness and whose primary need is the availability of such care on a
continuous basis.
2. “Facility for skilled nursing” does not
include a facility which meets the requirements of a general or any other
special hospital.
(Added to NRS by 1973, 1279; A 1985, 1738)—(Substituted
in revision for NRS 449.018)
NRS 449.004 “Facility for the care of adults during the day” defined. “Facility for the care of adults during the
day” means an establishment operated and maintained to provide care during the
day on a temporary or permanent basis for aged or infirm persons. The term does
not include a halfway house for recovering alcohol and drug abusers.
(Added to NRS by 1983, 1657; A 1985, 1736; 2001, 2518)
NRS 449.0045 “Facility for the dependent” defined. “Facility
for the dependent” includes:
1. A facility for the treatment of abuse
of alcohol or drugs;
2. A halfway house for recovering alcohol
and drug abusers;
3. A facility for the care of adults during
the day;
4. A residential facility for groups;
5. An agency to provide personal care
services in the home;
6. A facility for transitional living for
released offenders; and
7. A home for individual residential care.
(Added to NRS by 1985, 1735; A 2001, 2518; 2005, 2165, 2350; 2011, 356)
NRS 449.00455 “Facility for the treatment of abuse of alcohol or drugs”
defined. “Facility for the
treatment of abuse of alcohol or drugs” means any public or private
establishment which provides residential treatment, including mental and
physical restoration, of abusers of alcohol or drugs and which is certified by
the Division pursuant to subsection 4 of NRS
458.025. It does not include a medical facility or services offered by
volunteers or voluntary organizations.
(Added to NRS by 1975, 366; A 1985, 1736; 1993, 1624; 1999, 1871; 2001, 417; 2005, 22nd
Special Session, 56; 2013, 3055)
NRS 449.0046 “Facility for the treatment of irreversible renal disease”
defined. “Facility for the
treatment of irreversible renal disease” means a facility that is not part of a
hospital and which provides peritoneal dialysis or hemodialysis or trains a
person with a permanent irreversible renal impairment to perform dialysis for
himself or herself.
(Added to NRS by 1985, 1735)
NRS 449.0055 “Facility for transitional living for released offenders”
defined.
1. “Facility for transitional living for
released offenders” means a residence that provides housing and a living
environment for persons who have been released from prison and who require
assistance with reintegration into the community, other than such a residence
that is operated or maintained by a state or local government or an agency
thereof. The term does not include a halfway house for recovering alcohol and
drug abusers or a facility for the treatment of abuse of alcohol or drugs.
2. As used in this section, “person who
has been released from prison” means:
(a) A parolee.
(b) A person who is participating in:
(1) A judicial program pursuant to NRS 209.4886 or 213.625; or
(2) A correctional program pursuant to NRS 209.4888 or 213.632.
(c) A person who is supervised by the Division of
Parole and Probation of the Department of Public Safety through residential
confinement pursuant to NRS 213.371 to 213.410, inclusive.
(d) A person who has been released from prison by
expiration of his or her term of sentence.
(Added to NRS by 2005, 2349)
NRS 449.008 “Halfway house for recovering alcohol and drug abusers” defined. “Halfway house for recovering alcohol and drug
abusers” means a residence that provides housing and a living environment for
recovering alcohol and drug abusers and is operated to facilitate their
reintegration into the community, but does not provide any treatment for
alcohol or drug abuse. The term does not include a facility for transitional living
for released offenders.
(Added to NRS by 2001, 2518; A 2005, 2350)
NRS 449.009 “Health Division” defined. Repealed.
(See chapter 489, Statutes of Nevada 2013, at page 3071.)
NRS 449.0105 “Home for individual residential care” defined. “Home for individual residential care” means a
home in which a natural person furnishes food, shelter, assistance and limited
supervision, for compensation, to not more than two persons with intellectual
disabilities or with physical disabilities or who are aged or infirm, unless
the persons receiving those services are related within the third degree of
consanguinity or affinity to the person providing those services. The term does
not include:
1. A halfway house for recovering alcohol
and drug abusers; or
2. A home in which supported living
arrangement services are provided by a provider of supported living arrangement
services during any period in which the provider of supported living
arrangement services is engaged in providing supported living arrangement
services.
(Added to NRS by 1993, 2556; A 2001, 2518; 2005, 1380; 2013, 696)
NRS 449.0115 “Hospice care” defined.
1. “Hospice care” means a centrally
administered program of palliative services and supportive services provided by
an interdisciplinary team directed by a physician. The program includes the
provision of physical, psychological, custodial and spiritual care for persons
who are terminally ill and their families. The care may be provided in the
home, at a residential facility or at a medical facility at any time of the day
or night. The term includes the supportive care and services provided to the
family after the patient dies.
2. As used in this section:
(a) “Family” includes the immediate family, the
person who primarily cared for the patient and other persons with significant
personal ties to the patient, whether or not related by blood.
(b) “Interdisciplinary team” means a group of
persons who work collectively to meet the special needs of terminally ill
patients and their families and includes such persons as a physician,
registered nurse, social worker, member of the clergy and trained volunteer.
(Added to NRS by 1979, 1112; A 1985, 1737; 1989, 1035; 2005, 485)
NRS 449.012 “Hospital” defined. “Hospital”
means an establishment for the diagnosis, care and treatment of human illness,
including care available 24 hours each day from persons licensed to practice
professional nursing who are under the direction of a physician, services of a
medical laboratory and medical, radiological, dietary and pharmaceutical
services.
(Added to NRS by 1973, 1279; A 1985, 1737)
NRS 449.013 “Independent center for emergency medical care” defined. “Independent center for emergency medical
care” means a facility, structurally separate and distinct from a hospital,
which provides limited services for the treatment of a medical emergency.
(Added to NRS by 1985, 1735)
NRS 449.0145 “Licensed practical nurse” defined. “Licensed
practical nurse” has the meaning ascribed to it in NRS 632.016.
(Added to NRS by 2005, 1517)
NRS 449.0151 “Medical facility” defined. “Medical
facility” includes:
1. A surgical center for ambulatory
patients;
2. An obstetric center;
3. An independent center for emergency
medical care;
4. An agency to provide nursing in the
home;
5. A facility for intermediate care;
6. A facility for skilled nursing;
7. A facility for hospice care;
8. A hospital;
9. A psychiatric hospital;
10. A facility for the treatment of
irreversible renal disease;
11. A rural clinic;
12. A nursing pool;
13. A facility for modified medical
detoxification;
14. A facility for refractive surgery;
15. A mobile unit; and
16. A community triage center.
(Added to NRS by 1973, 1279; A 1975, 366; 1979, 161, 887, 1113; 1983, 1657; 1985, 1736; 1989, 304, 1035, 1037; 1999, 248, 970; 2001, 1341; 2005, 532, 2693)
NRS 449.01513 “Medication aide - certified” defined. “Medication
aide - certified” has the meaning ascribed to it in NRS 632.0165.
(Added to NRS by 2011, 1337)
NRS 449.01515 “Mobile unit” defined.
1. Except as otherwise provided in
subsection 2, “mobile unit” means a motor vehicle that is specially designed,
constructed and equipped to provide any of the medical services provided by a
medical facility described in subsections 1 to 13, inclusive, of NRS 449.0151.
2. “Mobile unit” does not include:
(a) A motor vehicle that is operated by a medical
facility described in subsections 1 to 13, inclusive, of NRS 449.0151 which is accredited by the Joint
Commission on Accreditation of Healthcare Organizations or the American
Osteopathic Association;
(b) A motor vehicle that is operated by a health
center that is funded under section 330 of the Public Health Service Act, 42
U.S.C. § 254b, as amended; or
(c) A vehicle operated under the authority of a
permit issued pursuant to chapter 450B of
NRS.
(Added to NRS by 2001, 1339; A 2003, 421)
NRS 449.0152 “Nursing assistant” defined. “Nursing
assistant” has the meaning ascribed to it in NRS 632.0166.
(Added to NRS by 2005, 1517)
NRS 449.0153 “Nursing pool” defined. “Nursing
pool” means a person or agency which provides for compensation, through its
employees or by contractual arrangement with other persons, nursing services to
any natural person, medical facility or facility for the dependent. The term
does not include:
1. An independent contractor who provides
such services without the assistance of employees;
2. A nursing pool based in a medical
facility or facility for the dependent; or
3. A provider of supported living
arrangement services during any period in which the provider of supported
living arrangement services is engaged in providing supported living
arrangement services.
(Added to NRS by 1989, 303; A 2005, 1380)
NRS 449.0155 “Obstetric center” defined. “Obstetric
center” means a facility that is not part of a hospital and provides services
for normal, uncomplicated births.
(Added to NRS by 1985, 1735)
NRS 449.0156 “Palliative services” defined. “Palliative
services” means services and treatments directed toward the control of pain and
symptoms which provide the greatest degree of relief for the longest period
while minimizing any adverse effects of the services and treatments, including,
without limitation, any side effects of any medications given or administered.
(Added to NRS by 2005, 485)
NRS 449.0157 “Provider of health care” defined. “Provider
of health care” has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 1995, 1600)
NRS 449.0159 “Provider of supported living arrangement services” defined. “Provider of supported living arrangement
services” means a natural person who or a partnership, firm, corporation,
association, state or local government or agency thereof that has been issued a
certificate pursuant to NRS 435.3305
to 435.339, inclusive, and the
regulations adopted pursuant to NRS
435.3305 to 435.339, inclusive.
(Added to NRS by 2005, 1379)
NRS 449.0165 “Psychiatric hospital” defined. “Psychiatric
hospital” means a hospital for the diagnosis, care and treatment of mental
illness which provides 24-hour residential care.
(Added to NRS by 1985, 1735)
NRS 449.0167 “Registered nurse” defined. “Registered
nurse” has the meaning ascribed to it in NRS
632.019.
(Added to NRS by 2005, 1517)
NRS 449.017 “Residential facility for groups” defined.
1. Except as otherwise provided in
subsection 2, “residential facility for groups” means an establishment that
furnishes food, shelter, assistance and limited supervision to a person with an
intellectual disability or with a physical disability or a person who is aged
or infirm. The term includes, without limitation, an assisted living facility.
2. The term does not include:
(a) An establishment which provides care only
during the day;
(b) A natural person who provides care for no
more than two persons in his or her own home;
(c) A natural person who provides care for one or
more persons related to him or her within the third degree of consanguinity or
affinity;
(d) A halfway house for recovering alcohol and
drug abusers; or
(e) A facility funded by a division or program of
the Department of Health and Human Services.
(Added to NRS by 1973, 1278; A 1979, 212; 1983, 1657; 1985, 930, 1736; 1991, 1974; 1993, 1213; 1999, 114, 125; 2001, 57, 546, 2519, 2522; 2013, 696)
NRS 449.0175 “Rural clinic” defined. “Rural
clinic” means a facility located in an area that is not designated as an urban
area by the Bureau of the Census, where medical services are provided by a
physician assistant licensed pursuant to chapter
630 or 633 of NRS or an advanced practice
registered nurse licensed pursuant to NRS
632.237 who is under the supervision of a licensed physician.
(Added to NRS by 1985, 1735; A 2001, 782; 2007, 1862; 2013, 2082)
NRS 449.0177 “Rural hospital” defined. “Rural
hospital” means a hospital with 85 or fewer beds which is:
1. The sole institutional provider of
health care located within a county whose population is less than 100,000;
2. The sole institutional provider of
health care located within a city whose population is less than 25,000; or
3. Maintained and governed pursuant to NRS 450.550 to 450.750, inclusive.
(Added to NRS by 1995, 1600; A 2001, 1992)
NRS 449.0185 “Supported living arrangement services” defined. “Supported living arrangement services” has
the meaning ascribed to it in NRS 435.3315.
(Added to NRS by 2005, 1379)
NRS 449.019 “Surgical center for ambulatory patients” defined. “Surgical center for ambulatory patients”
means a facility with limited medical services available for diagnosis or
treatment of patients by surgery where the patients’ recovery, in the opinion
of the surgeon, will not require care as a patient in the facility for more
than 24 hours.
(Added to NRS by 1975, 366; A 1985, 1736; 1993, 207)
NRS 449.0195 “Terminally ill” defined. “Terminally
ill” means a medical diagnosis made by a physician that a person has an
anticipated life expectancy of not more than 12 months.
(Added to NRS by 2005, 485)
LICENSING AND REGULATION
General Provisions
NRS 449.030 License required to operate or maintain medical facility or
facility for the dependent and to operate program of hospice care.
1. No person, state or local government or
agency thereof may operate or maintain in this State any medical facility or
facility for the dependent without first obtaining a license therefor as provided
in NRS 449.030 to 449.2428,
inclusive.
2. Unless licensed as a facility for
hospice care, a person, state or local government or agency thereof shall not
operate a program of hospice care without first obtaining a license for the
program from the Board.
[Part 1:336:1951]—(NRS A 1971, 934; 1973, 1281; 1985, 1738; 1989, 1035; 1997, 444, 1484; 1999, 249, 3608; 2011, 704)
NRS 449.0301 Exemptions. The
provisions of NRS 449.030 to 449.2428, inclusive, do not apply to:
1. Any facility conducted by and for the
adherents of any church or religious denomination for the purpose of providing
facilities for the care and treatment of the sick who depend solely upon
spiritual means through prayer for healing in the practice of the religion of
the church or denomination, except that such a facility shall comply with all
regulations relative to sanitation and safety applicable to other facilities of
a similar category.
2. Foster homes as defined in NRS 424.014.
3. Any medical facility or facility for
the dependent operated and maintained by the United States Government or an
agency thereof.
[Part 3:336:1951] + [7:336:1951]—(NRS A 1971, 935;
1973, 1282; 1979,
887; 1985,
1740; 1993,
2724; 2003,
857; 2005,
2169; 2011,
356, 1064,
1358, 2253, 2396; 2013, 2145)—(Substituted
in revision for NRS 449.070)
NRS 449.0302 Board to adopt standards, qualifications and other regulations.
1. The Board shall adopt:
(a) Licensing standards for each class of medical
facility or facility for the dependent covered by NRS
449.030 to 449.2428, inclusive, and for
programs of hospice care.
(b) Regulations governing the licensing of such
facilities and programs.
(c) Regulations governing the procedure and
standards for granting an extension of the time for which a natural person may
provide certain care in his or her home without being considered a residential
facility for groups pursuant to NRS 449.017. The
regulations must require that such grants are effective only if made in writing.
(d) Regulations establishing a procedure for the
indemnification by the Division, from the amount of any surety bond or other
obligation filed or deposited by a facility for refractive surgery pursuant to NRS 449.068 or 449.069, of
a patient of the facility who has sustained any damages as a result of the
bankruptcy of or any breach of contract by the facility.
(e) Any other regulations as it deems necessary
or convenient to carry out the provisions of NRS
449.030 to 449.2428, inclusive.
2. The Board shall adopt separate
regulations governing the licensing and operation of:
(a) Facilities for the care of adults during the
day; and
(b) Residential facilities for groups,
Ê which
provide care to persons with Alzheimer’s disease.
3. The Board shall adopt separate
regulations for:
(a) The licensure of rural hospitals which take
into consideration the unique problems of operating such a facility in a rural
area.
(b) The licensure of facilities for refractive
surgery which take into consideration the unique factors of operating such a
facility.
(c) The licensure of mobile units which take into
consideration the unique factors of operating a facility that is not in a fixed
location.
4. The Board shall require that the
practices and policies of each medical facility or facility for the dependent
provide adequately for the protection of the health, safety and physical, moral
and mental well-being of each person accommodated in the facility.
5. In addition to the training
requirements prescribed pursuant to NRS 449.093,
the Board shall establish minimum qualifications for administrators and
employees of residential facilities for groups. In establishing the
qualifications, the Board shall consider the related standards set by
nationally recognized organizations which accredit such facilities.
6. The Board shall adopt separate
regulations regarding the assistance which may be given pursuant to NRS 453.375 and 454.213 to an ultimate user of controlled
substances or dangerous drugs by employees of residential facilities for
groups. The regulations must require at least the following conditions before
such assistance may be given:
(a) The ultimate user’s physical and mental
condition is stable and is following a predictable course.
(b) The amount of the medication prescribed is at
a maintenance level and does not require a daily assessment.
(c) A written plan of care by a physician or
registered nurse has been established that:
(1) Addresses possession and assistance in
the administration of the medication; and
(2) Includes a plan, which has been
prepared under the supervision of a registered nurse or licensed pharmacist,
for emergency intervention if an adverse condition results.
(d) The prescribed medication is not administered
by injection or intravenously.
(e) The employee has successfully completed
training and examination approved by the Division regarding the authorized
manner of assistance.
7. The Board shall adopt separate
regulations governing the licensing and operation of residential facilities for
groups which provide assisted living services. The Board shall not allow the
licensing of a facility as a residential facility for groups which provides assisted
living services and a residential facility for groups shall not claim that it
provides “assisted living services” unless:
(a) Before authorizing a person to move into the
facility, the facility makes a full written disclosure to the person regarding
what services of personalized care will be available to the person and the
amount that will be charged for those services throughout the resident’s stay
at the facility.
(b) The residents of the facility reside in their
own living units which:
(1) Except as otherwise provided in
subsection 8, contain toilet facilities;
(2) Contain a sleeping area or bedroom;
and
(3) Are shared with another occupant only
upon consent of both occupants.
(c) The facility provides personalized care to
the residents of the facility and the general approach to operating the
facility incorporates these core principles:
(1) The facility is designed to create a
residential environment that actively supports and promotes each resident’s
quality of life and right to privacy;
(2) The facility is committed to offering
high-quality supportive services that are developed by the facility in
collaboration with the resident to meet the resident’s individual needs;
(3) The facility provides a variety of
creative and innovative services that emphasize the particular needs of each
individual resident and the resident’s personal choice of lifestyle;
(4) The operation of the facility and its
interaction with its residents supports, to the maximum extent possible, each
resident’s need for autonomy and the right to make decisions regarding his or
her own life;
(5) The operation of the facility is
designed to foster a social climate that allows the resident to develop and
maintain personal relationships with fellow residents and with persons in the
general community;
(6) The facility is designed to minimize
and is operated in a manner which minimizes the need for its residents to move
out of the facility as their respective physical and mental conditions change
over time; and
(7) The facility is operated in such a
manner as to foster a culture that provides a high-quality environment for the
residents, their families, the staff, any volunteers and the community at
large.
8. The Division may grant an exception
from the requirement of subparagraph (1) of paragraph (b) of subsection 7 to a
facility which is licensed as a residential facility for groups on or before
July 1, 2005, and which is authorized to have 10 or fewer beds and was
originally constructed as a single-family dwelling if the Division finds that:
(a) Strict application of that requirement would
result in economic hardship to the facility requesting the exception; and
(b) The exception, if granted, would not:
(1) Cause substantial detriment to the
health or welfare of any resident of the facility;
(2) Result in more than two residents
sharing a toilet facility; or
(3) Otherwise impair substantially the
purpose of that requirement.
9. The Board shall, if it determines
necessary, adopt regulations and requirements to ensure that each residential
facility for groups and its staff are prepared to respond to an emergency,
including, without limitation:
(a) The adoption of plans to respond to a natural
disaster and other types of emergency situations, including, without
limitation, an emergency involving fire;
(b) The adoption of plans to provide for the
evacuation of a residential facility for groups in an emergency, including,
without limitation, plans to ensure that nonambulatory patients may be
evacuated;
(c) Educating the residents of residential
facilities for groups concerning the plans adopted pursuant to paragraphs (a)
and (b); and
(d) Posting the plans or a summary of the plans
adopted pursuant to paragraphs (a) and (b) in a conspicuous place in each
residential facility for groups.
10. The regulations governing the
licensing and operation of facilities for transitional living for released
offenders must provide for the licensure of at least three different types of
facilities, including, without limitation:
(a) Facilities that only provide a housing and
living environment;
(b) Facilities that provide or arrange for the
provision of supportive services for residents of the facility to assist the
residents with reintegration into the community, in addition to providing a
housing and living environment; and
(c) Facilities that provide or arrange for the
provision of alcohol and drug abuse programs, in addition to providing a
housing and living environment and providing or arranging for the provision of
other supportive services.
Ê The
regulations must provide that if a facility was originally constructed as a
single-family dwelling, the facility must not be authorized for more than eight
beds.
11. As used in this section, “living unit”
means an individual private accommodation designated for a resident within the
facility.
(Added to NRS by 1969, 946; A 1971, 934; 1973, 1281; 1985, 1738; 1987, 990; 1989, 1036, 2155, 2156; 1991, 1975; 1993, 1214; 1995, 1600; 1999, 3608; 2001, 1341; 2003, 1921; 2005, 2165, 2350, 2693; 2007, 1921; 2009, 1441;
2011, 2250)—(Substituted
in revision for NRS 449.037)
NRS 449.0303 Authority of Board to require licensing of other facilities. The Board may adopt regulations requiring the
licensing of a facility other than those required to be licensed pursuant to NRS 449.030 to 449.2428,
inclusive, if the:
1. Facility provides any type of medical
care or treatment; and
2. Regulation is necessary to protect the
health of the general public.
(Added to NRS by 1985, 1735)—(Substituted
in revision for NRS 449.038)
NRS 449.0305 Businesses that provide referrals to residential facilities for
groups: License required; standards and regulations; provision of referrals;
prohibited acts; civil penalties.
1. Except as otherwise provided in
subsection 5, a person must obtain a license from the Board to operate a business
that provides referrals to residential facilities for groups.
2. The Board shall adopt:
(a) Standards for the licensing of businesses
that provide referrals to residential facilities for groups;
(b) Standards relating to the fees charged by
such businesses;
(c) Regulations governing the licensing of such
businesses; and
(d) Regulations establishing requirements for
training the employees of such businesses.
3. A licensed nurse, social worker,
physician or hospital, or a provider of geriatric care who is licensed as a
nurse or social worker, may provide referrals to residential facilities for
groups through a business that is licensed pursuant to this section. The Board
may, by regulation, authorize a public guardian or any other person it determines
appropriate to provide referrals to residential facilities for groups through a
business that is licensed pursuant to this section.
4. A business that is licensed pursuant to
this section or an employee of such a business shall not:
(a) Refer a person to a residential facility for
groups that is not licensed.
(b) Refer a person to a residential facility for
groups if the business or its employee knows or reasonably should know that the
facility, or the services provided by the facility, are not appropriate for the
condition of the person being referred.
(c) Refer a person to a residential facility for
groups that is owned by the same person who owns the business.
Ê A person who
violates the provisions of this subsection is liable for a civil penalty to be
recovered by the Attorney General in the name of the Board for the first
offense of not more than $10,000 and for a second or subsequent offense of not
less than $10,000 nor more than $20,000. Unless otherwise required by federal
law, the Board shall deposit all civil penalties collected pursuant to this
section into a separate account in the State General Fund to be used to
administer and carry out the provisions of NRS 449.001
to 449.430, inclusive, and 449.435
to 449.965, inclusive, and to protect the health,
safety, well-being and property of the patients and residents of facilities in
accordance with applicable state and federal standards.
5. This section does not apply to a
medical facility that is licensed pursuant to NRS
449.030 to 449.2428, inclusive, on October 1,
1999.
(Added to NRS by 1999, 3606; A 2011, 705, 1805;
2013,135)
NRS 449.0306 Money received from licensing of facilities to be deposited in
State General Fund; expenditure of state or federal money.
1. Money received from licensing medical
facilities and facilities for the dependent must be forwarded to the State
Treasurer for deposit in the State General Fund.
2. The Division shall enforce the
provisions of NRS 449.030 to 449.245,
inclusive, and may incur any necessary expenses not in excess of money
appropriated for that purpose by the State or received from the Federal
Government.
[11:336:1951] + [13:336:1951]—(NRS A 1963, 960; 1971,
936; 1973, 1283; 1975, 898; 1979, 209; 1985, 1741; 2009, 1444;
2011, 2253,
2396; 2013, 3055)—(Substituted
in revision for NRS 449.140)
NRS 449.0307 Powers of Division. The
Division may:
1. Upon receipt of an application for a
license, conduct an investigation into the premises, facilities, qualifications
of personnel, methods of operation, policies and purposes of any person
proposing to engage in the operation of a medical facility or a facility for
the dependent. The facility is subject to inspection and approval as to
standards for safety from fire, on behalf of the Division, by the State Fire
Marshal.
2. Upon receipt of a complaint against a
medical facility or facility for the dependent, except for a complaint
concerning the cost of services, conduct an investigation into the premises,
facilities, qualifications of personnel, methods of operation, policies,
procedures and records of that facility or any other medical facility or
facility for the dependent which may have information pertinent to the
complaint.
3. Employ such professional, technical and
clerical assistance as it deems necessary to carry out the provisions of NRS 449.030 to 449.245,
inclusive.
[Part 6:336:1951]—(NRS A 1963, 960; 1969, 945; 1971,
936; 1973, 1284; 1975, 898; 1977, 642; 1985, 1220; 2013, 3055)—(Substituted
in revision for NRS 449.150)
NRS 449.0308 Authority of Division to collect actual cost of enforcing
provisions from unlicensed medical facility or facility for the dependent;
exception.
1. Except as otherwise provided in this
section, the Division may charge and collect from a medical facility or
facility for the dependent or a person who operates such a facility without a
license issued by the Division the actual costs incurred by the Division for
the enforcement of the provisions of NRS 449.030 to
449.2428, inclusive, including, without
limitation, the actual cost of conducting an inspection or investigation of the
facility.
2. The Division shall not charge and
collect the actual cost for enforcement pursuant to subsection 1 if the
enforcement activity is:
(a) Related to the issuance or renewal of a
license for which the Board charges a fee pursuant to NRS
449.050 or 449.089; or
(b) Conducted pursuant to an agreement with the
Federal Government which has appropriated money for that purpose.
3. Any money collected pursuant to
subsection 1 may be used by the Division to administer and carry out the
provisions of NRS 449.030 to 449.2428, inclusive, and the regulations adopted
pursuant thereto.
(Added to NRS by 2011, 355;
A 2013,
3055)
Licensing
NRS 449.040 Application for license: Filing; contents. Any person, state or local government or
agency thereof desiring a license under the provisions of NRS 449.030 to 449.2428,
inclusive, must file with the Division an application on a form prescribed,
prepared and furnished by the Division, containing:
1. The name of the applicant and, if a
natural person, whether the applicant has attained the age of 21 years.
2. The type of facility to be operated.
3. The location of the facility.
4. In specific terms, the nature of
services and type of care to be offered, as defined in the regulations.
5. The number of beds authorized by the
Director of the Department of Health and Human Services or, if such
authorization is not required, the number of beds the facility will contain.
6. The name of the person in charge of the
facility.
7. Such other information as may be
required by the Division for the proper administration and enforcement of NRS 449.030 to 449.2428,
inclusive.
8. Evidence satisfactory to the Division
that the applicant is of reputable and responsible character. If the applicant
is a firm, association, organization, partnership, business trust, corporation
or company, similar evidence must be submitted as to the members thereof and
the person in charge of the facility for which application is made. If the
applicant is a political subdivision of the State or other governmental agency,
similar evidence must be submitted as to the person in charge of the
institution for which application is made.
9. Evidence satisfactory to the Division
of the ability of the applicant to comply with the provisions of NRS 449.030 to 449.2428,
inclusive, and the standards and regulations adopted by the Board.
10. Evidence satisfactory to the Division
that the facility conforms to the zoning regulations of the local government
within which the facility will be operated or that the applicant has applied
for an appropriate reclassification, variance, permit for special use or other
exception for the facility.
[2:336:1951]—(NRS A 1963, 959; 1971, 934; 1973, 1281;
1975, 367; 1985,
1739; 1987,
776; 1991,
1078; 2007,
1133; 2009,
2025; 2013,
515, 2145,
3056)
NRS 449.050 Fees.
1. Each application for a license must be
accompanied by such fee as may be determined by regulation of the Board. The
Board may, by regulation, allow or require payment of a fee for a license in
installments and may fix the amount of each payment and the date that the
payment is due.
2. The fee imposed by the Board for a
facility for transitional living for released offenders must be based on the
type of facility that is being licensed and must be calculated to produce the
revenue estimated to cover the costs related to the license, but in no case may
a fee for a license exceed the actual cost to the Division of issuing or
renewing the license.
3. If an application for a license for a
facility for transitional living for released offenders is denied, any amount
of the fee paid pursuant to this section that exceeds the expenses and costs
incurred by the Division must be refunded to the applicant.
[Part 3:336:1951]—(NRS A 1971, 935; 1973, 1282; 1985, 1739; 1995, 501; 2003, 580; 2005, 2352; 2011, 356; 2013, 3056)
NRS 449.065 Surety bond for initial license and renewal of license to
operate facility for intermediate care, facility for skilled nursing,
residential facility for groups, home for individual residential care, agency
to provide personal care services in home and agency to provide nursing in
home; exemption; exception.
1. Except as otherwise provided in
subsections 6 and 7 and NRS 449.067, each facility
for intermediate care, facility for skilled nursing, residential facility for
groups, home for individual residential care, agency to provide personal care
services in the home and agency to provide nursing in the home shall, when
applying for a license or renewing a license, file with the Administrator of
the Division of Public and Behavioral Health a surety bond:
(a) If the facility, agency or home employs less
than 7 employees, in the amount of $5,000;
(b) If the facility, agency or home employs at
least 7 but not more than 25 employees, in the amount of $25,000; or
(c) If the facility, agency or home employs more than
25 employees, in the amount of $50,000.
2. A bond filed pursuant to this section
must be executed by the facility, agency or home as principal and by a surety
company as surety. The bond must be payable to the Aging and Disability
Services Division of the Department of Health and Human Services and must be
conditioned to provide indemnification to an older patient who the Specialist
for the Rights of Elderly Persons determines has suffered property damage as a
result of any act or failure to act by the facility, agency or home to protect
the property of the older patient.
3. Except when a surety is released, the
surety bond must cover the period of the initial license to operate or the
period of the renewal, as appropriate.
4. A surety on any bond filed pursuant to
this section may be released after the surety gives 30 days’ written notice to
the Administrator of the Division of Public and Behavioral Health, but the
release does not discharge or otherwise affect any claim filed by an older
patient for property damaged as a result of any act or failure to act by the
facility, agency or home to protect the property of the older patient alleged
to have occurred while the bond was in effect.
5. A license is suspended by operation of
law when the facility, agency or home is no longer covered by a surety bond as
required by this section or by a substitute for the surety bond pursuant to NRS 449.067. The Administrator of the Division of
Public and Behavioral Health shall give the facility, agency or home at least
20 days’ written notice before the release of the surety or the substitute for
the surety, to the effect that the license will be suspended by operation of
law until another surety bond or substitute for the surety bond is filed in the
same manner and amount as the bond or substitute being terminated.
6. The Administrator of the Division of
Public and Behavioral Health may exempt a residential facility for groups or a
home for individual residential care from the requirement of filing a surety
bond pursuant to this section if the Administrator determines that the
requirement would result in undue hardship to the residential facility for
groups or home for individual residential care.
7. The requirement of filing a surety bond
set forth in this section does not apply to a facility for intermediate care, facility
for skilled nursing, residential facility for groups, home for individual
residential care, agency to provide personal care services in the home or
agency to provide nursing in the home that is operated and maintained by the
State of Nevada or an agency thereof.
8. As used in this section, “older
patient” means a patient who is 60 years of age or older.
(Added to NRS by 1997, 1482; A 2003, 524; 2005, 2168; 2009, 502; 2013, 3057)
NRS 449.067 Substitute for surety required for facility for intermediate
care, facility for skilled nursing, residential facility for groups, home for
individual residential care, agency to provide personal care services in home
and agency to provide nursing in home.
1. As a substitute for the surety bond
required pursuant to NRS 449.065, a facility for
intermediate care, a facility for skilled nursing, a residential facility for
groups, a home for individual residential care, an agency to provide personal
care services in the home and an agency to provide nursing in the home may
deposit with any bank or trust company authorized to do business in this State,
upon approval from the Administrator of the Division of Public and Behavioral
Health:
(a) An obligation of a bank, savings and loan
association, thrift company or credit union licensed to do business in this
State;
(b) Bills, bonds, notes, debentures or other
obligations of the United States or any agency or instrumentality thereof, or
guaranteed by the United States; or
(c) Any obligation of this State or any city,
county, town, township, school district or other instrumentality of this State,
or guaranteed by this State, in an aggregate amount, based upon principal
amount or market value, whichever is lower.
2. The obligations of a bank, savings and
loan association, thrift company or credit union must be held to secure the
same obligation as would the surety bond required by NRS
449.065. With the approval of the Administrator of the Division of Public
and Behavioral Health, the depositor may substitute other suitable obligations
for those deposited, which must be assigned to the Aging and Disability
Services Division of the Department of Health and Human Services and are
negotiable only upon approval by the Administrator of the Aging and Disability
Services Division.
3. Any interest or dividends earned on the
deposit accrue to the account of the depositor.
4. The deposit must be an amount at least
equal to the surety bond required by NRS 449.065
and must state that the amount may not be withdrawn except by direct and sole
order of the Administrator of the Aging and Disability Services Division.
(Added to NRS by 1997, 1483; A 2003, 525; 2005, 2169; 2009, 503)
NRS 449.068 Surety bond required for initial license and renewal of license
to operate facility for refractive surgery.
1. Except as otherwise provided in NRS 449.069, each facility for refractive surgery
shall, when applying for a license or renewing a license, file with the
Administrator of the Division a surety bond:
(a) If the facility employs less than 7
employees, in the amount of $10,000;
(b) If the facility employs at least 7 but not
more than 25 employees, in the amount of $50,000; or
(c) If the facility employs more than 25
employees, in the amount of $100,000.
2. A bond filed pursuant to this section
must be executed by the facility as principal and by a surety company as
surety. The bond must be payable to the Division and must be conditioned to
provide indemnification to a patient of the facility who the Administrator of
the Division or the Administrator’s designee determines has sustained any
damages as a result of the bankruptcy of or any breach of contract by the
facility.
3. Except when a surety is released, the
surety bond must cover the period of the initial license to operate or the
period of the renewal, as appropriate.
4. A surety on any bond filed pursuant to
this section may be released after the surety gives 30 days’ written notice to
the Administrator of the Division, but the release does not discharge or
otherwise affect any claim filed by a patient for any damages sustained as a
result of the bankruptcy of or any breach of contract by the facility while the
bond was in effect.
5. The license of a facility for
refractive surgery is suspended by operation of law when the facility is no
longer covered by a surety bond as required by this section or by a substitute
for the surety bond pursuant to NRS 449.069. The
Administrator of the Division shall give the facility at least 20 days’ written
notice before the release of the surety or the substitute for the surety, to
the effect that the license will be suspended by operation of law until another
surety bond is filed or substitute for the surety bond is deposited in the same
manner and amount as the bond or substitute being terminated.
(Added to NRS by 2001, 1340; A 2005, 2696)
NRS 449.069 Substitute for surety bond required for facility for refractive
surgery.
1. As a substitute for the surety bond
required pursuant to NRS 449.068, a facility for
refractive surgery may deposit with any bank or trust company authorized to do
business in this State, upon approval of the Administrator of the Division:
(a) An obligation of a bank, savings and loan
association, thrift company or credit union licensed to do business in this
State;
(b) Bills, bonds, notes, debentures or other
obligations of the United States or any agency or instrumentality thereof, or
guaranteed by the United States; or
(c) Any obligation of this State or any city,
county, town, township, school district or other instrumentality of this State,
or guaranteed by this State, in an aggregate amount, based upon principal
amount or market value, whichever is lower.
2. The obligations of a bank, savings and
loan association, thrift company or credit union must be held to secure the
same obligation as would the surety bond required by NRS
449.068. With the approval of the Administrator of the Division, the
facility may substitute other suitable obligations for those deposited, which
must be assigned to the Division and are negotiable only upon approval of the
Administrator of the Division.
3. Any interest or dividends earned on the
deposit accrue to the account of the facility.
4. The deposit must be an amount at least
equal to the surety bond required by NRS 449.068
and must state that the amount may not be withdrawn except by the direct and
sole order of the Administrator of the Division.
(Added to NRS by 2001, 1340; A 2005, 2696)
NRS 449.080 Issuance, validity and transferability of license.
1. If, after investigation, the Division
finds that the:
(a) Applicant is in full compliance with the
provisions of NRS 449.030 to 449.2428, inclusive;
(b) Applicant is in substantial compliance with
the standards and regulations adopted by the Board;
(c) Applicant, if he or she has undertaken a
project for which approval is required pursuant to NRS 439A.100, has obtained the approval
of the Director of the Department of Health and Human Services; and
(d) Facility conforms to the applicable zoning
regulations,
Ê the Division
shall issue the license to the applicant.
2. A license applies only to the person to
whom it is issued, is valid only for the premises described in the license and
is not transferable.
[Part 3:336:1951]—(NRS A 1963, 959; 1971, 935; 1973,
1283; 1985,
1740; 1987,
777; 1991,
1078; 2011,
1064)
NRS 449.085 Form and contents of license. Each
license issued by the Division shall be in the form prescribed by the Division
and shall contain:
1. The name of the person or persons
authorized to operate such licensed facility;
2. The location of such licensed facility;
and
3. The number of beds authorized in such
licensed facility, the nature of services offered and the service delivery
capacity.
(Added to NRS by 1973, 1279; A 1975, 367)
NRS 449.087 Amendment of license required for addition of certain services;
requirements for approval of amendment; revocation of approval; standards.
1. A licensee must obtain the approval of
the Division to amend his or her license to operate a facility before the
addition of any of the following services:
(a) The intensive care of newborn babies.
(b) The treatment of burns.
(c) The transplant of organs.
(d) The performance of open-heart surgery.
(e) A center for the treatment of trauma.
2. The Division shall approve an
application to amend a license to allow a facility to provide any of the
services described in subsection 1 if:
(a) The applicant satisfies the requirements
contained in NRS 449.080;
(b) The Division determines on the basis of the
standards adopted by the Board pursuant to subsection 4 that there are an
adequate number of cases in the community to be served to support amending the
license to add the service; and
(c) The Division determines that the applicant
satisfies any other standards adopted by the Board pursuant to subsection 4.
3. The Division may revoke its approval if
the licensee fails to maintain substantial compliance with the standards
adopted by the Board pursuant to subsection 4 for the provision of such
services, or with any conditions included in the written approval of the
Director issued pursuant to the provisions of NRS 439A.100.
4. The Board shall:
(a) Adopt standards which have been adopted by
appropriate national organizations to be used by the Division in determining
whether there are an adequate number of cases in the community to be served to
support amending the license of a licensee to add a service pursuant to this
section; and
(b) Adopt such other standards as it deems
necessary for determining whether to approve the provision of services pursuant
to this section.
(Added to NRS by 1987, 876; A 1989, 1948; 2011, 741)
NRS 449.089 Expiration and renewal of license.
1. Each license issued pursuant to NRS 449.030 to 449.2428,
inclusive, expires on December 31 following its issuance and is renewable for 1
year upon reapplication and payment of all fees required pursuant to NRS 449.050 unless the Division finds, after an
investigation, that the facility has not:
(a) Satisfactorily complied with the provisions
of NRS 449.030 to 449.2428,
inclusive, or the standards and regulations adopted by the Board;
(b) Obtained the approval of the Director of the
Department of Health and Human Services before undertaking a project, if such
approval is required by NRS 439A.100;
or
(c) Conformed to all applicable local zoning
regulations.
2. Each reapplication for an agency to
provide personal care services in the home, an agency to provide nursing in the
home, a facility for intermediate care, a facility for skilled nursing, a hospital
described in 42 U.S.C. § 1395ww(d)(1)(B)(iv) which accepts payment through
Medicare, a residential facility for groups, a program of hospice care, a home
for individual residential care, a facility for the care of adults during the
day, a facility for hospice care, a nursing pool, the distinct part of a
hospital which meets the requirements of a skilled nursing facility or nursing
facility pursuant to 42 C.F.R. § 483.5(b)(2), a hospital that provides
swing-bed services as described in 42 C.F.R. § 482.66 or, if residential
services are provided to children, a medical facility or facility for the
treatment of abuse of alcohol or drugs must include, without limitation, a
statement that the facility, hospital, agency, program or home is in compliance
with the provisions of NRS 449.119 to 449.125, inclusive, and 449.174.
3. Each reapplication for an agency to
provide personal care services in the home, a facility for intermediate care, a
facility for skilled nursing, a facility for the care of adults during the day,
a residential facility for groups or a home for individual residential care
must include, without limitation, a statement that the holder of the license to
operate, and the administrator or other person in charge and employees of, the
facility, agency or home are in compliance with the provisions of NRS 449.093.
[Part 3:336:1951]—(NRS A 1963, 959; 1971, 935; 1973,
1282; 1985,
1739; 1987,
777; 1991,
1078; 1995,
1490; 1997,
445; 2003,
580; 2005,
2167; 2009,
502; 2011,
2252; 2013,
2146, 2889)—(Substituted
in revision for NRS 449.060)
NRS 449.091 Provisional license.
1. The Division may cancel the license of
a medical facility or facility for the dependent and issue a provisional
license, effective for a period determined by the Division, to such a facility
if it:
(a) Is in operation at the time of the adoption
of standards and regulations pursuant to the provisions of NRS 449.030 to 449.2428,
inclusive, and the Division determines that the facility requires a reasonable
time under the particular circumstances within which to comply with the
standards and regulations; or
(b) Has failed to comply with the standards or
regulations and the Division determines that the facility is in the process of
making the necessary changes or has agreed to make the changes within a
reasonable time.
2. The provisions of subsection 1 do not require
the issuance of a license or prevent the Division from refusing to renew or
from revoking or suspending any license where the Division deems such action
necessary for the health and safety of the occupants of any facility.
(Added to NRS by 1973, 1279; A 1985, 1740; 2011, 1064)
NRS 449.092 Applicant for issuance or renewal of license for home for
individual residential care to attest to knowledge of and compliance with
certain guidelines concerning safe and appropriate injection practices. The Division shall not issue or renew a
license for a home for individual residential care unless the applicant for
issuance or renewal of the license attests to knowledge of and compliance with
the guidelines of the Centers for Disease Control and Prevention concerning the
prevention of transmission of infectious agents through safe and appropriate
injection practices.
(Added to NRS by 2011, 2053)
NRS 449.093 Training to recognize and prevent abuse of older persons:
Persons required to receive; frequency; topics; costs; actions for failure to
complete.
1. An applicant for a license to operate a
facility for intermediate care, facility for skilled nursing, agency to provide
personal care services in the home, facility for the care of adults during the
day, residential facility for groups or home for individual residential care
must receive training to recognize and prevent the abuse of older persons
before a license to operate such a facility, agency or home is issued to the
applicant. If an applicant has completed such training within the year
preceding the date of the application for a license and the application
includes evidence of the training, the applicant shall be deemed to have
complied with the requirements of this subsection.
2. A licensee who holds a license to
operate a facility for intermediate care, facility for skilled nursing, agency
to provide personal care services in the home, facility for the care of adults
during the day, residential facility for groups or home for individual
residential care must annually receive training to recognize and prevent the
abuse of older persons before the license to operate such a facility, agency or
home may be renewed.
3. If an applicant or licensee who is
required by this section to obtain training is not a natural person, the person
in charge of the facility, agency or home must receive the training required by
this section.
4. An administrator or other person in
charge of a facility for intermediate care, facility for skilled nursing,
agency to provide personal care services in the home, facility for the care of
adults during the day, residential facility for groups or home for individual
residential care must receive training to recognize and prevent the abuse of
older persons before the facility, agency or home provides care to a person and
annually thereafter.
5. An employee who will provide care to a
person in a facility for intermediate care, facility for skilled nursing,
agency to provide personal care services in the home, facility for the care of
adults during the day, residential facility for groups or home for individual
residential care must receive training to recognize and prevent the abuse of
older persons before the employee provides care to a person in the facility,
agency or home and annually thereafter.
6. The topics of instruction that must be
included in the training required by this section must include, without
limitation:
(a) Recognizing the abuse of older persons,
including sexual abuse and violations of NRS
200.5091 to 200.50995, inclusive;
(b) Responding to reports of the alleged abuse of
older persons, including sexual abuse and violations of NRS 200.5091 to 200.50995, inclusive; and
(c) Instruction concerning the federal, state and
local laws, and any changes to those laws, relating to:
(1) The abuse of older persons; and
(2) Facilities for intermediate care,
facilities for skilled nursing, agencies to provide personal care services in
the home, facilities for the care of adults during the day, residential
facilities for groups or homes for individual residential care, as applicable
for the person receiving the training.
7. The facility for intermediate care,
facility for skilled nursing, agency to provide personal care services in the
home, facility for the care of adults during the day, residential facility for
groups or home for individual residential care is responsible for the costs
related to the training required by this section.
8. The administrator of a facility for
intermediate care, facility for skilled nursing or residential facility for
groups who is licensed pursuant to chapter 654
of NRS shall ensure that each employee of the facility who provides care to
residents has obtained the training required by this section. If an
administrator or employee of a facility or home does not obtain the training
required by this section, the Division shall notify the Board of Examiners for
Long-Term Care Administrators that the administrator is in violation of this
section.
9. The holder of a license to operate a
facility for intermediate care, facility for skilled nursing, agency to provide
personal care services in the home, facility for the care of adults during the
day, residential facility for groups or home for individual residential care
shall ensure that each person who is required to comply with the requirements
for training pursuant to this section complies with such requirements. The
Division may, for any violation of this section, take disciplinary action
against a facility, agency or home pursuant to NRS
449.160 and 449.163.
(Added to NRS by 2011, 2248)
NRS 449.094 Continuing education requirements concerning care of persons
with dementia for certain employees of facilities for skilled nursing, facilities
for intermediate care and residential facilities for groups.
1. The Board shall establish minimum
continuing education requirements concerning the care of persons with any form
of dementia, including, without limitation, dementia caused by Alzheimer’s
disease, for each person who is:
(a) Employed by a facility for skilled nursing,
facility for intermediate care or residential facility for groups which
provides care to persons with any form of dementia; and
(b) Licensed or certified by an occupational
licensing board.
2. In establishing continuing education
requirements pursuant to subsection 1, the Board shall consider any other
educational requirements imposed on such employees to ensure that the
continuing education requirements established by the Board do not duplicate or
conflict with the existing educational requirements imposed on those employees.
3. The administrator of a facility for
skilled nursing, facility for intermediate care or residential facility for
groups which provides care to persons with any form of dementia, including,
without limitation, dementia caused by Alzheimer’s disease, shall ensure that
each employee of the facility who is required to comply with the requirements
for continuing education established by the Board pursuant to this section
complies with such requirements.
(Added to NRS by 2003, 856)—(Substituted
in revision for NRS 449.0357)
Background Investigations
NRS 449.119 “Facility, hospital, agency, program or home” defined. As used in NRS 449.119
to 449.125, inclusive, “facility, hospital, agency,
program or home” means an agency to provide personal care services in the home,
an agency to provide nursing in the home, a facility for intermediate care, a
facility for skilled nursing, a hospital described in 42 U.S.C. §
1395ww(d)(1)(B)(iv) which accepts payment through Medicare, a residential
facility for groups, a program of hospice care, a home for individual
residential care, a facility for the care of adults during the day, a facility
for hospice care, a nursing pool, the distinct part of a hospital which meets
the requirements of a skilled nursing facility or nursing facility pursuant to
42 C.F.R. § 483.5(b)(2), a hospital that provides swing-bed services as
described in 42 C.F.R. § 482.66 or, if residential services are provided to
children, a medical facility or facility for the treatment of abuse of alcohol
or drugs.
(Added to NRS by 2013, 2889)
NRS 449.121 Exemption for facility for the treatment of abuse of alcohol or
drugs; exception.
1. Except as otherwise provided in
subsection 2, the provisions of NRS 449.119 to 449.125, inclusive, and 449.174
do not apply to any facility for the treatment of abuse of alcohol or drugs.
2. A facility for the treatment of abuse
of alcohol or drugs must comply with the requirements of NRS
449.119 to 449.125, inclusive, and 449.174 if the facility for the treatment of abuse of
alcohol or drugs provides residential services to children.
(Added to NRS by 1997, 442; A 2011, 3556;
2013, 2890)—(Substituted
in revision for NRS 449.173)
NRS 449.122 Investigation of applicant for license to operate facility,
hospital, agency, program or home.
1. Each applicant for a license to operate
a facility, hospital, agency, program or home shall submit to the Central
Repository for Nevada Records of Criminal History one complete set of
fingerprints for submission to the Federal Bureau of Investigation for its
report.
2. The Central Repository for Nevada
Records of Criminal History shall determine whether the applicant has been
convicted of a crime listed in paragraph (a) of subsection 1 of NRS 449.174 and immediately inform the administrator
of the facility, hospital, agency, program or home, if any, and the Division of
whether the applicant has been convicted of such a crime.
3. A person who holds a license to operate
a facility, hospital, agency, program or home which provides residential
services to children shall submit to the Central Repository for Nevada Records
of Criminal History one complete set of fingerprints for a report required by
this section at least once every 5 years after the initial investigation.
(Added to NRS by 1997, 442; A 2009, 504; 2011, 3556;
2013, 2890)—(Substituted
in revision for NRS 449.176)
NRS 449.123 Initial and periodic investigations of employee, employee of
temporary employment service or independent contractor of facility, hospital,
agency, program or home; penalty.
1. Except as otherwise provided in
subsections 2 and 3, within 10 days after hiring an employee, accepting an
employee of a temporary employment service or entering into a contract with an
independent contractor, the administrator of, or the person licensed to operate
a facility, hospital, agency, program or home shall:
(a) Obtain a written statement from the employee,
employee of the temporary employment service or independent contractor stating
whether he or she has been convicted of any crime listed in NRS 449.174;
(b) Obtain an oral and written confirmation of
the information contained in the written statement obtained pursuant to
paragraph (a);
(c) Obtain proof that the employee, employee of
the temporary employment service or independent contractor holds any required
license, permit or certificate;
(d) Obtain from the employee, employee of the
temporary employment service or independent contractor one set of fingerprints
and a written authorization to forward the fingerprints to the Central
Repository for Nevada Records of Criminal History for submission to the Federal
Bureau of Investigation for its report;
(e) Submit to the Central Repository for Nevada
Records of Criminal History the fingerprints obtained pursuant to paragraph (d)
to obtain information on the background and personal history of each employee,
employee of a temporary employment service or independent contractor to
determine whether the person has been convicted of any crime listed in NRS 449.174; and
(f) If an Internet website has been established
pursuant to NRS 439.942:
(1) Screen the employee, employee of the
temporary employment service or independent contractor using the Internet website.
Upon request of the Division, proof that the employee, temporary employee or
independent contractor was screened pursuant to this subparagraph must be
provided to the Division.
(2) Enter on the Internet website
information to be maintained on the website concerning the employee, employee
of the temporary employment service or independent contractor.
2. The administrator of, or the person
licensed to operate, a facility, hospital, agency, program or home is not
required to obtain the information described in subsection 1 from an employee,
employee of a temporary employment service or independent contractor if his or
her fingerprints have been submitted to the Central Repository for Nevada
Records of Criminal History for submission to the Federal Bureau of
Investigation for its report within the immediately preceding 6 months and the
report of the Federal Bureau of Investigation indicated that the employee,
employee of the temporary employment service or independent contractor has not
been convicted of any crime set forth in NRS 449.174.
3. The administrator of, or the person
licensed to operate, a facility, hospital, agency, program or home is not
required to obtain the information described in subsection 1, other than the
information described in paragraph (c) of subsection 1, from an employee,
employee of a temporary employment service or independent contractor if:
(a) The employee, employee of the temporary
employment service or independent contractor agrees to allow the administrator
of, or the person licensed to operate, a facility, hospital, agency, program or
home to receive notice from the Central Repository for Nevada Records of
Criminal History regarding any conviction and subsequent conviction of the
employee, employee of the temporary employment service or independent
contractor of a crime listed in NRS 449.174;
(b) An agency, board or commission that regulates
an occupation or profession pursuant to title 54 of NRS or temporary employment
service has, within the immediately preceding 5 years, submitted the
fingerprints of the employee, employee of the temporary employment service or
independent contractor to the Central Repository for Nevada Records of Criminal
History for submission to the Federal Bureau of Investigation for its report;
and
(c) The report of the Federal Bureau of
Investigation indicated that the employee, employee of the temporary employment
service or independent contractor has not been convicted of any crime set forth
in NRS 449.174.
4. The administrator of, or the person
licensed to operate, a facility, hospital, agency, program or home shall ensure
that the information concerning the background and personal history of each
employee, employee of a temporary employment service or independent contractor
who works at the facility, hospital, agency, program or home:
(a) Except as otherwise provided in subsection 2,
is completed as soon as practicable, and if residential services are provided
to children, before the employee, employee of the temporary employment service
or independent contractor provides any care or services to a child in the facility,
hospital, agency, program or home without supervision; and
(b) At least once every 5 years after the date of
the initial investigation.
5. The administrator or person shall, when
required:
(a) Obtain one set of fingerprints from the
employee, employee of the temporary employment service or independent
contractor;
(b) Obtain written authorization from the
employee, employee of the temporary employment service or independent
contractor to forward the fingerprints obtained pursuant to paragraph (a) to
the Central Repository for Nevada Records of Criminal History for submission to
the Federal Bureau of Investigation for its report; and
(c) Submit the fingerprints to the Central
Repository for Nevada Records of Criminal History or, if the fingerprints were
submitted electronically, obtain proof of electronic submission of the
fingerprints to the Central Repository for Nevada Records of Criminal History.
6. Upon receiving fingerprints submitted
pursuant to this section, the Central Repository for Nevada Records of Criminal
History shall determine whether the employee, employee of the temporary
employment service or independent contractor has been convicted of a crime
listed in NRS 449.174 and immediately inform the
Division and the administrator of, or the person licensed to operate, the facility,
hospital, agency, program or home at which the person works whether the
employee, employee of the temporary employment service or independent
contractor has been convicted of such a crime.
7. The Central Repository for Nevada
Records of Criminal History may impose a fee upon a facility, hospital, agency,
program or home that submits fingerprints pursuant to this section for the
reasonable cost of the investigation. The facility, hospital, agency, program
or home may recover from the employee or independent contractor whose
fingerprints are submitted not more than one-half of the fee imposed by the
Central Repository. If the facility, hospital, agency, program or home requires
the employee or independent contractor to pay for any part of the fee imposed
by the Central Repository, it shall allow the employee or independent
contractor to pay the amount through periodic payments. The facility, hospital,
agency, program or home may require a temporary employment service which
employs a temporary employee whose fingerprints are submitted to pay the fee
imposed by the Central Repository. A facility, hospital, agency, program or home
shall notify a temporary employment service if a person employed by the
temporary employment service is determined to be ineligible to provide services
at the facility, hospital, agency, program or home based upon the results of an
investigation conducted pursuant to this section.
8. Unless a greater penalty is provided by
law, a person who willfully provides a false statement or information in
connection with an investigation of the background and personal history of the
person pursuant to this section that would disqualify the person from
employment, including, without limitation, a conviction of a crime listed in NRS 449.174, is guilty of a misdemeanor.
(Added to NRS by 1997, 442; A 1999, 1946; 2005, 2170; 2009, 504; 2011, 3556;
2013, 2890)—(Substituted
in revision for NRS 449.179)
NRS 449.1235 Temporary employment service prohibited from sending ineligible
employee to facility, hospital, agency, program or home; temporary employment
service to provide certain information regarding its employees.
1. A temporary employment service shall
not send an employee to provide services to a facility, hospital, agency,
program or home if the temporary employment service has received notice from a
facility, hospital, agency, program or home that the employee of the temporary
employment service is ineligible to provide such services.
2. A facility, hospital, agency, program
or home that enters into an agreement with a temporary employment service to
provide services for the facility, hospital, agency, program or home on a
temporary basis must require the temporary employment service to:
(a) Provide proof that each employee of the
temporary employment service whom it may send to provide services to the
facility, hospital, agency, program or home has been continuously employed by
the temporary employment service since the last investigation conducted of the
employee pursuant to NRS 449.123; and
(b) Notify the facility, hospital, agency,
program or home if the investigation conducted of an employee of the temporary
employment service pursuant to NRS 449.123 has not
been conducted within the immediately preceding 5 years.
(Added to NRS by 2013, 2889)
NRS 449.124 Maintenance and availability of certain records regarding
employee, employee of temporary employment service or independent contractor of
facility, hospital, agency, program or home.
1. Each facility, hospital, agency,
program or home shall maintain records of the information concerning its employees,
employees of a temporary employment service and independent contractors
collected pursuant to NRS 449.123, including,
without limitation:
(a) A copy of the fingerprints that were
submitted to the Central Repository for Nevada Records of Criminal History or
proof of electronic fingerprint submission and a copy of the written
authorization that was provided by the employee, employee of the temporary
employment service or independent contractor;
(b) Proof that the fingerprints of the employee,
employee of the temporary employment service or independent contractor were
submitted to the Central Repository; and
(c) Any other documentation of the information
collected pursuant to NRS 449.123.
2. The records maintained pursuant to
subsection 1 must be:
(a) Maintained for the period of the employment
of the person with the facility, hospital, agency, program or home; and
(b) Made available for inspection by the Division
at any reasonable time, and copies thereof must be furnished to the Division
upon request.
3. If an Internet website has been
established pursuant to NRS 439.942, a facility,
hospital, agency, program or home shall maintain a current list of its
employees, employees of a temporary employment service and independent
contractors on the Internet website.
4. The Central Repository for Nevada
Records of Criminal History may maintain an electronic image of fingerprints
submitted pursuant to NRS 449.122 and 449.123 to notify a facility, hospital, agency,
program or home and the Division of any subsequent conviction of a person who
is required to submit to an investigation pursuant to NRS
449.122 or 449.123.
(Added to NRS by 1997, 443; A 1999, 1947; 2005, 2171; 2009, 505; 2011, 3558;
2013, 2893)—(Substituted
in revision for NRS 449.182)
NRS 449.125 Termination of employment or contract of employee, employee of
temporary employment service or independent contractor of facility, hospital,
agency, program or home who has been convicted of certain crime; period in
which to correct information regarding conviction; liability of facility,
hospital, agency, program or home.
1. Upon receiving information from the
Central Repository for Nevada Records of Criminal History pursuant to NRS 449.123, or evidence from any other source, that
an employee, employee of a temporary employment service or independent
contractor of a facility, hospital, agency, program or home:
(a) Has been convicted of a crime listed in
paragraph (a) of subsection 1 of NRS 449.174; or
(b) Has had a substantiated report of abuse or
neglect made against him or her, if he or she is employed at a facility,
hospital, agency, program or home that provides residential services to
children,
Ê the
administrator of, or the person licensed to operate, the facility, hospital,
agency, program or home shall terminate the employment or contract of that
person or notify the temporary employment service that its employee is
prohibited from providing services for the facility, hospital, agency, program
or home after allowing the person time to correct the information as required
pursuant to subsection 2.
2. If an employee, employee of a temporary
employment service or independent contractor believes that the information
provided by the Central Repository is incorrect, the employee, employee of the
temporary employment service or independent contractor may immediately inform
the facility, hospital, agency, program or home or temporary employment
service. The facility, hospital, agency, program, home or temporary employment
service that is so informed shall give the employee, employee of the temporary
employment service or independent contractor a reasonable amount of time of not
less than 30 days to correct the information received from the Central
Repository before terminating the employment or contract of the person pursuant
to subsection 1.
3. A facility, hospital, agency, program
or home that has complied with NRS 449.123 may not
be held civilly or criminally liable based solely upon the ground that the
facility, hospital, agency, program or home allowed an employee, employee of a
temporary employment service or independent contractor to work:
(a) Before it received the information concerning
the employee, employee of the temporary employment service or independent
contractor from the Central Repository, except that an employee, employee of
the temporary employment service or independent contractor shall not have
contact with a child without supervision before such information is received;
(b) During the period required pursuant to
subsection 2 to allow the employee, employee of the temporary employment
service or independent contractor to correct that information, except that an
employee, employee of the temporary employment service or independent
contractor shall not have contact with a child without supervision during such
period;
(c) Based on the information received from the
Central Repository, if the information received from the Central Repository was
inaccurate; or
(d) Any combination thereof.
Ê A facility,
hospital, agency, program or home may be held liable for any other conduct
determined to be negligent or unlawful.
(Added to NRS by 1997, 443; A 1999, 1948; 2005, 2171; 2009, 505; 2011, 3558;
2013, 2894)—(Substituted
in revision for NRS 449.185)
Inspections
NRS 449.131 Entry and inspection of building and premises by Division, State
Fire Marshal and Chief Medical Officer.
1. Any authorized member or employee of
the Division may enter and inspect any building or premises at any time to
secure compliance with or prevent a violation of any provision of NRS 449.030 to 449.245,
inclusive.
2. The State Fire Marshal or a designee of
the State Fire Marshal shall, upon receiving a request from the Division or a
written complaint concerning compliance with the plans and requirements to
respond to an emergency adopted pursuant to subsection 9 of NRS 449.0302:
(a) Enter and inspect a residential facility for
groups; and
(b) Make recommendations regarding the adoption
of plans and requirements pursuant to subsection 9 of NRS
449.0302,
Ê to ensure the
safety of the residents of the facility in an emergency.
3. The Chief Medical Officer or a designee
of the Chief Medical Officer shall enter and inspect at least annually each
building or the premises of a residential facility for groups to ensure compliance
with standards for health and sanitation.
4. An authorized member or employee of the
Division shall enter and inspect any building or premises operated by a
residential facility for groups within 72 hours after the Division is notified
that a residential facility for groups is operating without a license.
[Part 4:336:1951]—(NRS A 1963, 962; 1971, 937; 1973,
1286; 1975, 898; 1985,
1742; 1999,
3610; 2001,
1343; 2003,
421, 1923;
2005, 2172;
2009, 1446;
2011, 1067,
2255, 2398)—(Substituted
in revision for NRS 449.230)
NRS 449.132 Inspection of medical facility and facility for dependent by
Division of Public and Behavioral Health and Aging and Disability Services
Division. Every medical facility
or facility for the dependent may be inspected at any time, with or without
notice, as often as is necessary by:
1. The Division of Public and Behavioral
Health to ensure compliance with all applicable regulations and standards; and
2. Any person designated by the Aging and
Disability Services Division of the Department of Health and Human Services to
investigate complaints made against the facility.
(Added to NRS by 1977, 642; A 1985, 1742; 1991, 1975; 2001, 1343; 2003, 422)—(Substituted
in revision for NRS 449.235)
NRS 449.133 Report of results of inspections of medical facilities and
facilities for dependent by Division; disclosure of results of inspections of
facilities for skilled nursing, facilities for intermediate care and
residential facilities for groups. The
Division shall:
1. Prepare a report of the results of its
inspections of medical facilities and facilities for the dependent regarding
compliance with applicable regulations and standards. The report must be
provided to the facility and include, without limitation, a recommendation of
the Division for correcting any deficiencies and, if a deficiency is discovered
as a result of an investigation by a county, district or city board of health
or health officer, the recommendations of the board or health officer.
2. Upon request, disclose to any person or
governmental entity the results of its inspections of facilities for skilled
nursing, facilities for intermediate care and residential facilities for groups
regarding their compliance with applicable regulations and standards.
[14:336:1951]—(NRS A 1963, 961; 1971, 936; 1973,
1285; 1987,
1054; 2009,
559)—(Substituted in revision for NRS 449.200)
NRS 449.134 Facility for intermediate care, facility for skilled nursing,
residential facility for groups or home for individual residential care to
provide immediate notification of certain deficiencies to certain persons. A facility for intermediate care, facility for
skilled nursing, residential facility for groups or home for individual
residential care shall immediately provide notice of a deficiency affecting the
health and safety of a patient discovered during the course of an inspection of
the facility for intermediate care, facility for skilled nursing, residential
facility for groups or home for individual residential care conducted by the
Division to:
1. A person receiving care at the facility
or home;
2. The parent or legal guardian of the
person receiving care at the facility or home; or
3. Any other natural person designated to
receive such notice by the person receiving care at the facility or home or the
parent or guardian of the person.
(Added to NRS by 2011, 2396)
Disciplinary Action
NRS 449.160 Grounds for denial, suspension or revocation of license;
revocation of license in connection with certain nuisance activity; log of
complaints; information concerning complaint, investigation and disciplinary
action to be provided to facility for the care of adults during the day;
written report of complaints and disciplinary actions.
1. The Division may deny an application
for a license or may suspend or revoke any license issued under the provisions
of NRS 449.030 to 449.2428,
inclusive, upon any of the following grounds:
(a) Violation by the applicant or the licensee of
any of the provisions of NRS 439B.410
or 449.030 to 449.245,
inclusive, or of any other law of this State or of the standards, rules and
regulations adopted thereunder.
(b) Aiding, abetting or permitting the commission
of any illegal act.
(c) Conduct inimical to the public health,
morals, welfare and safety of the people of the State of Nevada in the
maintenance and operation of the premises for which a license is issued.
(d) Conduct or practice detrimental to the health
or safety of the occupants or employees of the facility.
(e) Failure of the applicant to obtain written
approval from the Director of the Department of Health and Human Services as
required by NRS 439A.100 or as
provided in any regulation adopted pursuant to NRS
449.001 to 449.430, inclusive, and 449.435 to 449.965,
inclusive, if such approval is required.
(f) Failure to comply with the provisions of NRS 449.2486.
2. In addition to the provisions of
subsection 1, the Division may revoke a license to operate a facility for the
dependent if, with respect to that facility, the licensee that operates the
facility, or an agent or employee of the licensee:
(a) Is convicted of violating any of the
provisions of NRS 202.470;
(b) Is ordered to but fails to abate a nuisance
pursuant to NRS 244.360, 244.3603 or 268.4124; or
(c) Is ordered by the appropriate governmental
agency to correct a violation of a building, safety or health code or
regulation but fails to correct the violation.
3. The Division shall maintain a log of
any complaints that it receives relating to activities for which the Division
may revoke the license to operate a facility for the dependent pursuant to
subsection 2. The Division shall provide to a facility for the care of adults
during the day:
(a) A summary of a complaint against the facility
if the investigation of the complaint by the Division either substantiates the
complaint or is inconclusive;
(b) A report of any investigation conducted with
respect to the complaint; and
(c) A report of any disciplinary action taken
against the facility.
Ê The facility
shall make the information available to the public pursuant to NRS 449.2486.
4. On or before February 1 of each
odd-numbered year, the Division shall submit to the Director of the Legislative
Counsel Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained
by the Division pursuant to subsection 3; and
(b) Any disciplinary actions taken by the
Division pursuant to subsection 2.
[Part 6:336:1951] + [Part 8:336:1951]—(NRS A 1963,
960; 1971, 936; 1973, 1284; 1975, 898; 1977, 257; 1981, 1220; 1987, 1783; 1989, 1662; 1991, 1079; 2001, 1350; 2003, 47, 857; 2007, 271; 2009, 1444;
2011, 357,
1065, 1358, 2253, 2396; 2013, 136, 2147, 3058)
NRS 449.163 Administrative sanctions: Imposition by Division; disposition of
money collected.
1. In addition to the payment of the
amount required by NRS 449.0308, if a medical
facility or facility for the dependent violates any provision related to its
licensure, including any provision of NRS
439B.410 or 449.030 to 449.2428,
inclusive, or any condition, standard or regulation adopted by the Board, the
Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:
(a) Prohibit the facility from admitting any
patient until it determines that the facility has corrected the violation;
(b) Limit the occupancy of the facility to the
number of beds occupied when the violation occurred, until it determines that
the facility has corrected the violation;
(c) If the license of the facility limits the
occupancy of the facility and the facility has exceeded the approved occupancy,
require the facility, at its own expense, to move patients to another facility
that is licensed;
(d) Impose an administrative penalty of not more
than $1,000 per day for each violation, together with interest thereon at a
rate not to exceed 10 percent per annum; and
(e) Appoint temporary management to oversee the
operation of the facility and to ensure the health and safety of the patients
of the facility, until:
(1) It determines that the facility has
corrected the violation and has management which is capable of ensuring
continued compliance with the applicable statutes, conditions, standards and
regulations; or
(2) Improvements are made to correct the
violation.
2. If a violation by a medical facility or
facility for the dependent relates to the health or safety of a patient, an
administrative penalty imposed pursuant to paragraph (d) of subsection 1 must
be in a total amount of not less than $1,000 and not more than $10,000 for each
patient who was harmed or at risk of harm as a result of the violation.
3. If the facility fails to pay any
administrative penalty imposed pursuant to paragraph (d) of subsection 1, the
Division may:
(a) Suspend the license of the facility until the
administrative penalty is paid; and
(b) Collect court costs, reasonable attorney’s
fees and other costs incurred to collect the administrative penalty.
4. The Division may require any facility
that violates any provision of NRS
439B.410 or 449.030 to 449.2428,
inclusive, or any condition, standard or regulation adopted by the Board to
make any improvements necessary to correct the violation.
5. Any money collected as administrative
penalties pursuant to paragraph (d) of subsection 1 must be accounted for
separately and used to administer and carry out the provisions of NRS 449.001 to 449.430,
inclusive, and 449.435 to 449.965,
inclusive, and to protect the health, safety, well-being and property of the
patients and residents of facilities in accordance with applicable state and
federal standards.
(Added to NRS by 1989, 863; A 1989, 1663; 2003, 858; 2009, 558, 1445; 2011, 358, 1066, 1359, 1806, 2254, 2397; 2013, 137, 2148, 3059)
NRS 449.165 Administrative sanctions: Regulations of Board. The Board shall adopt regulations establishing
the criteria for the imposition of each sanction prescribed by NRS 449.163. These regulations must:
1. Prescribe the circumstances and manner
in which each sanction applies;
2. Minimize the time between
identification of a violation and the imposition of a sanction;
3. Provide for the imposition of
incrementally more severe sanctions for repeated or uncorrected violations; and
4. Provide for less severe sanctions for
lesser violations of applicable state statutes, conditions, standards or
regulations.
(Added to NRS by 1989, 864)
NRS 449.170 Denial, suspension or revocation of license or imposition of
sanctions: Notice; appeal; adoption of regulations.
1. When the Division intends to deny,
suspend or revoke a license, or impose any sanction prescribed by NRS 449.163, it shall give reasonable notice to all
parties by certified mail. The notice must contain the legal authority, jurisdiction
and reasons for the action to be taken. Notice is not required if the Division
finds that the public health requires immediate action. In that case, it may
order a summary suspension of a license pursuant to this section and NRS 233B.127 or impose any sanction
prescribed by NRS 449.163, pending proceedings for
revocation or other action.
2. If a person wants to contest the action
of the Division, the person must file an appeal pursuant to regulations adopted
by the Board.
3. Upon receiving notice of an appeal, the
Division shall hold a hearing pursuant to regulations adopted by the Board.
4. The Board shall adopt such regulations
as are necessary to carry out the provisions of this section.
[Part 8:336:1951]—(NRS A 1963, 960; 1969, 95; 1973,
1284; 1977, 70;
1985, 1741;
1989, 864; 1995, 1585; 2009, 558)
NRS 449.171 Authority of Division to take control over medical records of
medical facility or facility for dependent upon suspension of license or
cessation of operation; confidentiality; sharing of records with appropriate
authorities.
1. If the Division suspends the license of
a medical facility or a facility for the dependent pursuant to the provisions
of this chapter, or if a facility otherwise ceases to operate, including,
without limitation, pursuant to an action or order of a health authority pursuant
to chapter 441A of NRS, the Division may,
if deemed necessary by the Administrator of the Division, take control of and
ensure the safety of the medical records of the facility.
2. Subject to the provisions of the Health
Insurance Portability and Accountability Act of 1996, Public Law 104-191, the
Division shall:
(a) Maintain the confidentiality of the medical
records obtained pursuant to subsection 1.
(b) Share medical records obtained pursuant to
subsection 1 with law enforcement agencies in this State and other governmental
entities which have authority to license the facility or to license the owners
or employees of the facility.
(c) Release a medical record obtained pursuant to
subsection 1 to the patient or legal guardian of the patient who is the subject
of the medical record.
3. The Board shall adopt regulations to
carry out the provisions of this section, including, without limitation,
regulations for contracting with a person to maintain any medical records under
the control of the Division pursuant to subsection 1 and for payment by the
facility of the cost of maintaining medical records.
(Added to NRS by 2009, 557)
NRS 449.172 Residential facility for groups: Duties of Division and operator
upon suspension or revocation of license for abuse, neglect or isolation of
occupants. If the Division
suspends or revokes the license of a person who operates a residential facility
for groups for abuse, neglect or isolation of the occupants of the facility,
the Division shall suspend or revoke the license of all residential facilities
for groups operated by that person. The person who operates the facility shall
move all of the persons who are receiving services in the residential
facilities for groups to other licensed residential facilities for groups at
his or her own expense.
(Added to NRS by 1999, 3607)
NRS 449.174 Additional grounds for denial, suspension or revocation of
license to operate certain facility, hospital, agency, program or home.
1. In addition to the grounds listed in NRS 449.160, the Division may deny a license to
operate a facility, hospital, agency, program or home to an applicant or may
suspend or revoke the license of a licensee to operate such a facility, hospital,
agency, program or home if:
(a) The applicant or licensee has been convicted
of:
(1) Murder, voluntary manslaughter or
mayhem;
(2) Assault or battery with intent to kill
or to commit sexual assault or mayhem;
(3) Sexual assault, statutory sexual
seduction, incest, lewdness or indecent exposure, or any other sexually related
crime that is punished as a felony;
(4) Prostitution, solicitation, lewdness
or indecent exposure, or any other sexually related crime that is punished as a
misdemeanor, within the immediately preceding 7 years;
(5) A crime involving domestic violence
that is punished as a felony;
(6) A crime involving domestic violence
that is punished as a misdemeanor, within the immediately preceding 7 years;
(7) Abuse or neglect of a child or
contributory delinquency;
(8) A violation of any federal or state
law regulating the possession, distribution or use of any controlled substance
or any dangerous drug as defined in chapter 454
of NRS, within the immediately preceding 7 years;
(9) Abuse, neglect, exploitation or
isolation of older persons or vulnerable persons, including, without
limitation, a violation of any provision of NRS
200.5091 to 200.50995, inclusive,
or a law of any other jurisdiction that prohibits the same or similar conduct;
(10) A violation of any provision of law
relating to the State Plan for Medicaid or a law of any other jurisdiction that
prohibits the same or similar conduct, within the immediately preceding 7
years;
(11) A violation of any provision of NRS 422.450 to 422.590, inclusive;
(12) A criminal offense under the laws
governing Medicaid or Medicare, within the immediately preceding 7 years;
(13) Any offense involving fraud, theft,
embezzlement, burglary, robbery, fraudulent conversion or misappropriation of
property, within the immediately preceding 7 years;
(14) Any other felony involving the use or
threatened use of force or violence against the victim or the use of a firearm
or other deadly weapon; or
(15) An attempt or conspiracy to commit
any of the offenses listed in this paragraph, within the immediately preceding
7 years;
(b) The licensee has, in violation of NRS 449.125, continued to employ a person who has been
convicted of a crime listed in paragraph (a); or
(c) The applicant or licensee has had a
substantiated report of child abuse or neglect made against him or her and if
the facility, hospital, agency, program or home provides residential services
to children.
2. In addition to the grounds listed in NRS 449.160, the Division may suspend or revoke the
license of a licensee to operate an agency to provide personal care services in
the home or an agency to provide nursing in the home if the licensee has, in
violation of NRS 449.125, continued to employ a
person who has been convicted of a crime listed in paragraph (a) of subsection
1.
3. As used in this section:
(a) “Domestic violence” means an act described in
NRS 33.018.
(b) “Facility, hospital, agency, program or home”
has the meaning ascribed to it in NRS 449.119.
(c) “Medicaid” has the meaning ascribed to it in NRS 439B.120.
(d) “Medicare” has the meaning ascribed to it in NRS 439B.130.
(Added to NRS by 1997, 444; A 1999, 1948; 2005, 2171; 2007, 652, 2401; 2009, 506; 2013, 2895)—(Substituted
in revision for NRS 449.188)
Miscellaneous Provisions
NRS 449.181 Medical facility that has custody of child pursuant to court
order to adopt policy relating to medical care and medications for child;
employees to receive copy of policy.
1. Except as otherwise provided in this
section, a medical facility that has custody of a child pursuant to the order
of a court shall adopt a policy concerning the manner in which to:
(a) Document the orders of the treating physician
of a child;
(b) Administer medication to a child;
(c) Store, handle and dispose of medication;
(d) Document the administration of medication and
any errors in the administration of medication;
(e) Minimize errors in the administration of
medication; and
(f) Address errors in the administration of
medication.
2. Such a medical facility shall ensure
that each employee of the medical facility who will administer medication to
such a child receives a copy of and understands the policy adopted pursuant to
subsection 1.
(Added to NRS by 2011, 1357)
NRS 449.183 Facility for intermediate care, facility for skilled nursing and
residential facility for groups to adopt written policy concerning readmission
after temporary transfer of patient or resident.
1. A facility for intermediate care,
facility for skilled nursing and residential facility for groups shall adopt a
written policy that establishes:
(a) The number of days the facility will hold the
bed of a patient or resident for his or her return if the patient or resident
is transferred temporarily to a hospital or other facility for medical reasons;
and
(b) That a patient or resident who is so
transferred for a period that exceeds the period of the hold established
pursuant to paragraph (a) will be allowed to resume his or her residency as
soon as a bed becomes available, if the facility is suitable for properly
caring for the patient upon his or her return.
2. Upon admission of a patient or resident
to a facility for intermediate care, facility for skilled nursing or
residential facility for groups, the facility shall provide to the patient or
resident and, if applicable, to the legal representative of the patient or
resident, a copy of the policy established pursuant to subsection 1.
(Added to NRS by 2011, 1063)
NRS 449.184 Operator of residential facility for groups, facility for
intermediate care or facility for skilled nursing to post certain information
in conspicuous place.
1. A person who operates a residential
facility for groups shall:
(a) Post his or her license to operate the
residential facility for groups;
(b) Post the rates for services provided by the
residential facility for groups; and
(c) Post contact information for the
administrator and the designated representative of the owner or operator of the
facility,
Ê in a
conspicuous place in the residential facility for groups.
2. A person who operates a facility for
intermediate care or facility for skilled nursing shall:
(a) Post his or her license to operate the
facility;
(b) Post the organizational structure of the
management of the facility; and
(c) Post contact information for the
administrator and the designated representative of the owner or operator of the
facility,
Ê in a
conspicuous place in the facility for intermediate care or facility for skilled
nursing.
(Added to NRS by 1999, 3606; A 2011, 1064)—(Substituted
in revision for NRS 449.095)
NRS 449.186 Supervision of residential facility for groups. A residential facility for groups must not be
operated except under the supervision of an administrator of a residential
facility for groups licensed pursuant to the provisions of chapter 654 of NRS.
(Added to NRS by 1993, 2144)—(Substituted
in revision for NRS 449.0355)
NRS 449.187 Supervision of facility for skilled nursing or facility for
intermediate care.
1. Except as otherwise provided in
subsection 2, a facility for skilled nursing or facility for intermediate care
licensed pursuant to the provisions of NRS 449.030
to 449.2428, inclusive, may not be operated except
under the supervision of a nursing facility administrator who is at the facility
and licensed under the provisions of chapter 654
of NRS.
2. The provisions of subsection 1 do not
apply to a facility for intermediate care which limits its care and treatment
to those persons with intellectual disabilities or conditions related to
intellectual disabilities.
(Added to NRS by 1969, 672; A 1971, 934; 1973, 1281; 1977, 1031; 1985, 1738; 1993, 1214; 2013, 697)
NRS 449.189 Physician and nurse required to operate independent center to
provide emergency medical care. An
independent center to provide emergency medical care shall not be operated
unless a physician and registered nurse are on the premises.
(Added to NRS by 1985, 1735)—(Substituted
in revision for NRS 449.034)
NRS 449.191 Medical facility not required to allow abortions.
1. A hospital or other medical facility
licensed under the provisions of this chapter which is not operated by the
State or a local government or an agency of either is not required to permit the
use of its facilities for the induction or performance of an abortion, except
in a medical emergency.
2. Such refusal does not give rise to a
cause of action in favor of any person.
(Added to NRS by 1973, 897; A 1985, 1742)
NRS 449.192 Admission of dentist to membership on medical staff of hospital. No dentist may be:
1. Automatically admitted to membership on
the medical staff of a hospital solely because he or she is licensed as a
dentist in this state or is authorized pursuant to NRS 631.267 to perform certain functions;
or
2. Denied admission to membership on the
medical staff of a hospital merely because he or she is licensed as a dentist
and not as a physician.
(Added to NRS by 1985, 2097)—(Substituted
in revision for NRS 449.032)
NRS 449.193 Facility for intermediate care, facility for skilled nursing,
residential facility for groups or home for individual residential care to
provide itemized statement of charges upon request to certain persons.
1. Subject to the provisions of the Health
Insurance Portability and Accountability Act of 1996, Public Law 104-191, a
facility for intermediate care, facility for skilled nursing, residential
facility for groups or home for individual residential care shall, upon
request, provide an itemized statement of charges to:
(a) The person who received care in the facility
or home;
(b) The parent or guardian of the person who
received care in the facility or home; or
(c) Any other natural person designated by the
person receiving care at the facility or home.
2. An itemized statement of charges
provided by a facility for intermediate care, facility for skilled nursing,
residential facility for groups or home for individual residential care
pursuant to subsection 1 must, without limitation:
(a) Itemize the charges for services, care, food,
medicine and other supplies provided to the person receiving care at the
facility or home;
(b) Identify the amount of payment allocated to
each charge;
(c) Be provided in a manner that is
understandable to an ordinary person;
(d) Be provided at no additional cost; and
(e) Be provided in a timely manner.
(Added to NRS by 2011, 2395)
NRS 449.1935 Agency to provide personal care services in the home authorized
to provide certain services to certain persons. An
agency to provide personal care services in the home that is licensed pursuant
to this section and NRS 449.030 to 449.2428, inclusive, may, through its employees or by
contractual arrangement with other persons, provide:
1. To persons with disabilities, any
medical services authorized pursuant to NRS
629.091; and
2. Nonmedical services related to personal
care to elderly persons or persons with disabilities to assist those persons
with activities of daily living, including, without limitation:
(a) The elimination of wastes from the body;
(b) Dressing and undressing;
(c) Bathing;
(d) Grooming;
(e) The preparation and eating of meals;
(f) Laundry;
(g) Shopping;
(h) Cleaning;
(i) Transportation; and
(j) Any other minor needs related to the
maintenance of personal hygiene.
(Added to NRS by 2013, 134)
NRS 449.194 Certain employees of agency to provide personal care services in
the home immune from civil liability resulting from rendering emergency care or
assistance. Any person who is
employed by an agency to provide personal care services in the home who:
1. Has successfully completed a course in
cardiopulmonary resuscitation according to the guidelines of the American
National Red Cross or American Heart Association;
2. Has successfully completed the training
requirements of a course in basic emergency care of a person in cardiac arrest
conducted in accordance with the standards of the American Heart Association;
or
3. Has successfully completed the training
requirements of a course in the use and administration of first aid, including
cardiopulmonary resuscitation,
Ê and who in
good faith renders emergency care or assistance in accordance with the person’s
training, in the course of his or her regular employment or profession, to an
elderly person or a person with a disability, is not liable for any civil damages
as a result of any act or omission, not amounting to gross negligence, by that
person in rendering that care.
(Added to NRS by 2013, 434)
NRS 449.195 Waiver of deductible or copayment; conditions. A medical facility shall not waive a
deductible or copayment if:
1. The medical facility is not a preferred
provider of health care; and
2. The waiver would reduce the financial
effect of a preferred provider’s incentive or disincentive to its insureds.
(Added to NRS by 1987, 1783; A 1995, 1602)
NRS 449.196 Requirements for program of hospice care. No person, state or local government or agency
may represent that it provides “hospice care” unless the program of care,
either directly or indirectly:
1. Has a medical director whose
responsibilities are appropriate to the needs of the program and who:
(a) Is a physician, currently licensed to
practice;
(b) On the basis of training, experience and
interest, is knowledgeable about the psychosocial and medical aspects of
hospice; and
(c) Acts as a medical resource to the
interdisciplinary team which provides the hospice care;
2. Is provided to the patient, as needed,
in the patient’s home, at a residential facility and at a medical facility, at
any time of the day or night;
3. Includes medical, nursing,
psychological and pastoral care and social services at the level required by
the patient’s condition;
4. Provides supportive services for the
patient’s immediate family and other persons with significant personal ties to
the patient, whether or not related by blood, including:
(a) Care for the patient which provides a respite
from the stresses and responsibilities that result from the daily care of the
patient; and
(b) Emotional support and other care after the
patient dies; and
5. Includes the services of trained
volunteers.
(Added to NRS by 1989, 1034)—(Substituted
in revision for NRS 449.031)
NRS 449.197 Provision of care by facility for hospice care.
1. A licensed facility for hospice care
may provide any of the following levels of care for terminally ill patients:
(a) Medical care for a patient who is in an acute
episode of illness;
(b) Skilled nursing care;
(c) Intermediate care;
(d) Custodial care; and
(e) Palliative services.
2. A licensed facility for hospice care
may provide direct supportive services to a patient’s family and persons who
provide care for the patient, including services which provide care for the
patient during the day and other services which provide a respite from the
stresses and responsibilities that result from the daily care of the patient.
(Added to NRS by 1989, 1034; A 1999, 249; 2005, 485)—(Substituted
in revision for NRS 449.0315)
NRS 449.198 Requirements for obstetric center. An
obstetric center must:
1. Provide sufficient space for members of
the family of the pregnant woman and other persons chosen by the woman to
assist her with the birth; and
2. Have obstetrical services available to
meet the needs of an acute patient.
(Added to NRS by 1985, 1735)—(Substituted
in revision for NRS 449.036)
NRS 449.199 Residential facility for groups and homes for individual
residential care prohibited from providing accommodations to persons not
meeting requirements for admission; exception.
1. Except as otherwise provided in
subsection 2, a residential facility for groups which is authorized to have 10
or fewer beds or a home for individual residential care shall not provide
accommodations for a person who does not meet the requirements for admission to
the facility or home.
2. A residential facility for groups which
is authorized to have 10 or fewer beds or a home for individual residential
care may provide accommodations for a person who is related within the third
degree of consanguinity to a resident of the facility or home regardless of
whether the person meets the requirements for admission to the facility or
home.
(Added to NRS by 2009, 1441)—(Substituted
in revision for NRS 449.03555)
NRS 449.201 Certification required for alcohol and drug abuse programs
operated or provided by facility for transitional living for released
offenders. Each alcohol and drug
abuse program operated or provided by a facility for transitional living for released
offenders must be certified by the Division in accordance with the requirements
set forth in chapter 458 of NRS and any
regulations adopted pursuant thereto. As used in this section, “alcohol and
drug abuse program” has the meaning ascribed to it in NRS 458.010.
(Added to NRS by 2005, 2350; A 2013, 3060)—(Substituted
in revision for NRS 449.0356)
NRS 449.202 Classification of hospitals.
1. A hospital which provides only one or
two of the following categories of service:
(a) Medical;
(b) Surgical;
(c) Obstetrical; or
(d) Psychiatric,
Ê shall be
designated a medical hospital, surgical hospital, obstetrical hospital or
psychiatric hospital or combined-categories hospital, as the case may be.
2. When a hospital offers services in
medical, surgical and obstetrical categories, as a minimum, it shall be
designated a general hospital.
(Added to NRS by 1971, 933; A 1973,
1280)—(Substituted in revision for NRS 449.021)
NRS 449.203 Designation of hospital as primary stroke center; Division to
maintain list of hospitals so designated; regulations.
1. A hospital licensed pursuant to NRS 449.030 to 449.2428,
inclusive, may submit to the Division proof that the hospital is certified as a
primary stroke center by the Joint Commission, its successor organization or an
equivalent organization approved by the Division. Upon receiving proof that a
hospital is certified as a primary stroke center, the Division shall include
the hospital on the list established pursuant to subsection 2.
2. On or before July 1 of each year, the
Division shall post a list of the hospitals designated as primary stroke
centers on an Internet website maintained by the Division.
3. If a hospital wishes to be included as
a primary stroke center on the list established pursuant to subsection 2, the
hospital must annually resubmit the proof required pursuant to this section.
4. The Division may remove a hospital from
the list established pursuant to subsection 2 if the certificate recognizing
the hospital as a primary stroke center issued by the Joint Commission, its
successor organization or an equivalent organization, as applicable, is
suspended or revoked.
5. A hospital that is not included on the
list established pursuant to subsection 2 as a primary stroke center shall not
represent, advertise or imply that the hospital is designated as a primary
stroke center.
6. The provisions of this section do not
prohibit a hospital that is licensed pursuant to NRS
449.030 to 449.2428, inclusive, from providing
care to a victim of stroke if the hospital does not have a designation as a
primary stroke center.
7. The Board may adopt regulations to
carry out the provisions of this section and to designate hospitals with
similar certifications which are recognized by the Joint Commission, its
successor organization or an equivalent organization.
(Added to NRS by 2011, 1363)
NRS 449.2035 Designation of hospital as STEMI receiving center; Division to
maintain list of hospitals so designated; regulations.
1. A hospital licensed pursuant to NRS 449.030 to 449.2428,
inclusive, may submit to the Division proof that the hospital is accredited as
a STEMI receiving center. Upon receiving proof that a hospital is accredited as
a STEMI receiving center, the Division shall include the hospital on the list
established pursuant to subsection 2.
2. On or before July 1 of each year, the
Division shall post a list of all hospitals designated as STEMI receiving
centers on an Internet website maintained by the Division.
3. If a hospital wishes to be included as
a STEMI receiving center on the list established pursuant to subsection 2, the
hospital must annually resubmit the proof required pursuant to this section.
4. The Division may remove a hospital from
the list established pursuant to subsection 2 if the accreditation recognizing
the hospital as a STEMI receiving center is suspended or revoked.
5. A hospital that is not included on the
list established pursuant to subsection 2 shall not represent, advertise or
imply that the hospital is designated as a STEMI receiving center.
6. The provisions of this section do not
prohibit a hospital that is licensed pursuant to NRS
449.030 to 449.2428, inclusive, from providing
care to a victim of a heart attack if the hospital does not have a designation
as a STEMI receiving center.
7. The Board may adopt regulations to
carry out the provisions of this section and to designate hospitals with
accreditations similar to those required for designation as a STEMI receiving
center.
8. As used in this section:
(a) “STEMI” means a myocardial infarction as
indicated by an abnormal elevation of the ST segment of an electrocardiogram
that is administered to a patient.
(b) “STEMI receiving center” means a hospital
that is accredited by the Society of Cardiovascular Patient Care, in
conjunction with the initiative developed by the American Heart Association
known as the “Mission: Lifeline initiative,” or an equivalent organization
approved by the Division, as having met specific standards of performance in
the receipt and treatment of a patient with STEMI.
(Added to NRS by 2013, 507)
NRS 449.204 Misleading name or other designation of facility prohibited. The name, sign, listing or other designation
of a medical facility or facility for the dependent must not contain any terms
misleading to the public with regard to the services offered.
(Added to NRS by 1973, 1279; A 1975, 367; 1985, 1738)—(Substituted
in revision for NRS 449.026)
Prohibited Acts; Penalties
NRS 449.205 Retaliation or discrimination against employees and certain
other persons: Prohibition under certain circumstances; medical facility
prohibited from restricting right to make report or take certain other actions.
1. A medical facility or any agent or
employee thereof shall not retaliate or discriminate unfairly against:
(a) An employee of the medical facility or a
person acting on behalf of the employee who in good faith:
(1) Reports to the Board of Medical
Examiners or the State Board of Osteopathic Medicine, as applicable,
information relating to the conduct of a physician which may constitute grounds
for initiating disciplinary action against the physician or which otherwise
raises a reasonable question regarding the competence of the physician to
practice medicine with reasonable skill and safety to patients;
(2) Reports a sentinel event to the
Division pursuant to NRS 439.835; or
(3) Cooperates or otherwise participates
in an investigation or proceeding conducted by the Board of Medical Examiners,
the State Board of Osteopathic Medicine or another governmental entity relating
to conduct described in subparagraph (1) or (2); or
(b) A registered nurse, licensed practical nurse,
nursing assistant or medication aide - certified who is employed by or contracts
to provide nursing services for the medical facility and who:
(1) In accordance with the policy, if any,
established by the medical facility:
(I) Reports to his or her immediate
supervisor, in writing, that he or she does not possess the knowledge, skill or
experience to comply with an assignment to provide nursing services to a
patient; and
(II) Refuses to provide to a patient
nursing services for which, as verified by documentation in the personnel file
of the registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified concerning his or her competence to provide various
nursing services, he or she does not possess the knowledge, skill or experience
to comply with the assignment to provide nursing services to the patient,
unless the refusal constitutes unprofessional conduct as set forth in chapter 632 of NRS or any regulations adopted
pursuant thereto;
(2) In accordance with a policy adopted
pursuant to NRS 449.2423, requests to be relieved
of, refuses or objects to a work assignment;
(3) In good faith, reports to the medical
facility, the Board of Medical Examiners, the State Board of Osteopathic
Medicine, the State Board of Nursing, the Legislature or any committee thereof
or any other governmental entity:
(I) Any information concerning the
willful conduct of another registered nurse, licensed practical nurse, nursing
assistant or medication aide - certified which violates any provision of chapter 632 of NRS or which is required to be
reported to the State Board of Nursing;
(II) Any concerns regarding patients
who may be exposed to a substantial risk of harm as a result of the failure of
the medical facility or any agent or employee thereof to comply with minimum
professional or accreditation standards or applicable statutory or regulatory
requirements; or
(III) Any other concerns regarding
the medical facility, the agents and employees thereof or any situation that
reasonably could result in harm to patients; or
(4) Refuses to engage in conduct that
would violate the duty of the registered nurse, licensed practical nurse,
nursing assistant or medication aide - certified to protect patients from
actual or potential harm, conduct which would violate any provision of chapter 632 of NRS or conduct which would
subject the registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified to disciplinary action by the State Board of
Nursing.
2. A medical facility or any agent or
employee thereof shall not retaliate or discriminate unfairly against an
employee of the medical facility or a registered nurse, licensed practical
nurse, nursing assistant or medication aide - certified who is employed by or
contracts to provide nursing services for the medical facility because the
employee, registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified has taken an action described in subsection 1.
3. A medical facility or any agent or
employee thereof shall not prohibit, restrict or attempt to prohibit or
restrict by contract, policy, procedure or any other manner the right of an
employee of the medical facility or a registered nurse, licensed practical
nurse, nursing assistant or medication aide - certified who is employed by or
contracts to provide nursing services for the medical facility to take an
action described in subsection 1.
4. As used in this section:
(a) “Good faith” means honesty in fact in the
reporting of the information or in the cooperation in the investigation
concerned.
(b) “Physician” means a person licensed to
practice medicine pursuant to chapter 630 or 633 of NRS.
(c) “Retaliate or discriminate”:
(1) Includes, without limitation, any of
the following actions if taken solely because the employee, registered nurse,
licensed practical nurse, nursing assistant or medication aide - certified took
an action described in subsection 1:
(I) Frequent or undesirable changes
in the location where the person works;
(II) Frequent or undesirable transfers
or reassignments;
(III) The issuance of letters of
reprimand, letters of admonition or evaluations of poor performance;
(IV) A demotion;
(V) A reduction in pay;
(VI) The denial of a promotion;
(VII) A suspension;
(VIII) A dismissal;
(IX) A transfer; or
(X) Frequent changes in working
hours or workdays.
(2) Does not include an action described
in sub-subparagraphs (I) to (X), inclusive, of subparagraph (1) if the action
is taken in the normal course of employment or as a form of discipline.
(Added to NRS by 2002
Special Session, 16; A 2005, 1517; 2009, 1418;
2011, 1338;
2013, 2148)
NRS 449.207 Retaliation or discrimination against employees and certain
other persons: Violation; civil action for certain acts of retaliation or
discrimination; damages; equitable relief; rebuttable presumption; civil
penalty; time limit for bringing action.
1. An employee of
a medical facility or a registered nurse, licensed practical nurse, nursing
assistant or medication aide - certified who is employed by or contracts to
provide nursing services for the medical facility and who believes that he or she
has been retaliated or discriminated against in violation of NRS 449.205 may file an action in a court of competent
jurisdiction.
2. If a court determines that a violation
of NRS 449.205 has occurred, the court may award
such damages as it determines to have resulted from the violation, including,
without limitation:
(a) Compensatory damages;
(b) Reimbursement of any wages, salary,
employment benefits or other compensation denied to or lost by the employee,
registered nurse, licensed practical nurse, nursing assistant or medication
aide - certified as a result of the violation;
(c) Attorney’s fees and costs, including, without
limitation, fees for expert witnesses; and
(d) Punitive damages, if the facts warrant.
3. The court shall award interest on the
amount of damages at a rate determined pursuant to NRS 17.130.
4. The court may grant any equitable
relief it considers appropriate, including, without limitation, reinstatement
of the employee, registered nurse, licensed practical nurse, nursing assistant
or medication aide - certified and any temporary, preliminary or permanent
injunctive relief.
5. If any action to retaliate or
discriminate is taken against an employee, registered nurse, licensed practical
nurse, nursing assistant or medication aide - certified within 60 days after
the employee, registered nurse, licensed practical nurse, nursing assistant or
medication aide - certified takes any action described in subsection 1 of NRS 449.205, there is a rebuttable presumption that
the action taken against the employee, registered nurse, licensed practical
nurse, nursing assistant or medication aide - certified constitutes retaliation
or discrimination in violation of NRS 449.205.
6. A medical facility or any agent or
employee thereof that violates the provisions of NRS
449.205 is subject to a civil penalty of not more than $10,000 for each
violation. The Attorney General or any district attorney of this State may
recover the penalty in a civil action brought in the name of the State of
Nevada in any court of competent jurisdiction.
7. Any action under this section must be
brought not later than 2 years after the date of the last event constituting
the alleged violation for which the action is brought.
8. As used in this section, “retaliate or
discriminate” has the meaning ascribed to it in NRS
449.205.
(Added to NRS by 2002
Special Session, 17; A 2005, 1518; 2009, 1420;
2011, 1339)
NRS 449.208 Retaliation or discrimination against employees or certain other
persons: Written notice regarding protections and legal remedies for certain
acts of retaliation or discrimination; posting of notice; inclusion of notice
in employee handbook.
1. A medical facility shall prepare a
written notice for the employees of the medical facility and for the nurses,
nursing assistants and medication aides - certified who contract with the
medical facility regarding the protections provided for actions taken pursuant
to subsection 1 of NRS 449.205 and the legal remedy
provided pursuant to NRS 449.207. The notice must
include the process by which an employee, nurse, nursing assistant or
medication aide - certified may make a report pursuant to subsection 1 of NRS 449.205.
2. A medical facility shall:
(a) Post in one or more conspicuous places at the
medical facility the notice prepared pursuant to subsection 1; and
(b) Include the text of the written notice in any
manual or handbook that the medical facility provides to employees, nurses,
nursing assistants and medication aides - certified who contract with the
medical facility concerning employment practices at the medical facility.
(Added to NRS by 2009, 557;
A 2011,
1340)
NRS 449.209 Prohibition against medical facility or employee of medical
facility making certain referrals to residential facilities for groups; civil
penalties; system to track violations.
1. In addition to the requirements and
prohibitions set forth in NRS 449.0305, and
notwithstanding any exceptions set forth in that section, a licensed medical
facility or an employee of such a medical facility shall not:
(a) Refer a person to a residential facility for
groups that is not licensed by the Division; or
(b) Refer a person to a residential facility for
groups if the licensed medical facility or its employee knows or reasonably
should know that the residential facility for groups, or the services provided
by the residential facility for groups, are not appropriate for the condition
of the person being referred.
2. If a licensed medical facility or an
employee of such a medical facility violates the provisions of subsection 1,
the licensed medical facility is liable for a civil penalty to be recovered by
the Attorney General in the name of the Board for the first offense of not more
than $10,000 and for a second or subsequent offense of not less than $10,000 or
more than $20,000. Unless otherwise required by federal law, the Board shall
deposit all civil penalties collected pursuant to this section into a separate
account in the State General Fund to be used for the enforcement of this
section and the protection of the health, safety, well-being and property of
residents of residential facilities for groups.
3. The Board shall:
(a) Establish and maintain a system to track
violations of this section and NRS 449.0305.
Except as otherwise provided in this paragraph, records created by or for the
system are public records and are available for public inspection. The
following information is confidential:
(1) Any personally identifying information
relating to a person who is referred to a residential facility for groups.
(2) Information which may not be disclosed
under federal law.
(b) Educate the public regarding the requirements
and prohibitions set forth in this section and NRS
449.0305.
4. As used in this section, “licensed
medical facility” means:
(a) A medical facility that is required to be
licensed pursuant to this section and NRS 449.030
to 449.2428, inclusive.
(b) A facility for the dependent that is required
to be licensed pursuant to this section and NRS 449.030
to 449.2428, inclusive.
(c) A facility that provides medical care or
treatment and is required by regulation of the Board to be licensed pursuant to
NRS 449.0303.
(Added to NRS by 2011, 704)
NRS 449.210 Penalties for unlicensed operation: Medical facility or facility
for dependent; residential facility for groups or home for individual
residential care.
1. In addition to the payment of the
amount required by NRS 449.0308, except as
otherwise provided in subsection 2 and NRS 449.24897,
a person who operates a medical facility or facility for the dependent without
a license issued by the Division is guilty of a misdemeanor.
2. In addition to the payment of the
amount required by NRS 449.0308, if a person
operates a residential facility for groups or a home for individual residential
care without a license issued by the Division, the Division shall:
(a) Impose a civil penalty on the operator in the
following amount:
(1) For a first offense, $10,000.
(2) For a second offense, $25,000.
(3) For a third or subsequent offense,
$50,000.
(b) Order the operator, at the operator’s own
expense, to move all of the persons who are receiving services in the
residential facility for groups or home for individual residential care to a
residential facility for groups or home for individual residential care, as
applicable, that is licensed.
(c) Prohibit the operator from applying for a
license to operate a residential facility for groups or home for individual
residential care, as applicable. The duration of the period of prohibition must
be:
(1) For 6 months if the operator is
punished pursuant to subparagraph (1) of paragraph (a).
(2) For 1 year if the operator is punished
pursuant to subparagraph (2) of paragraph (a).
(3) Permanent if the operator is punished
pursuant to subparagraph (3) of paragraph (a).
3. Before the Division imposes an
administrative sanction pursuant to subsection 2, the Division shall provide
the operator of a residential facility for groups with reasonable notice. The
notice must contain the legal authority, jurisdiction and reasons for the
action to be taken. If the operator of a residential facility for groups wants
to contest the action, the operator may file an appeal pursuant to the
regulations of the State Board of Health adopted pursuant to NRS 449.165 and 449.170.
Upon receiving notice of an appeal, the Division shall hold a hearing in
accordance with those regulations. For the purpose of this subsection, it is no
defense to the violation of operating a residential facility for groups without
a license that the operator thereof subsequently licensed the facility in
accordance with law.
4. Unless otherwise required by federal
law, the Division shall deposit all civil penalties collected pursuant to
paragraph (a) of subsection 2 into a separate account in the State General Fund
to be used to administer and carry out the provisions of NRS
449.001 to 449.430, inclusive, and 449.935 to 449.965,
inclusive, and to protect the health, safety, well-being and property of the
patients and residents of facilities and homes for individual residential care
in accordance with applicable state and federal standards.
[10:336:1951]—(NRS A 1967, 581; 1971, 936; 1973,
1285; 1985,
1742; 1999,
3609; 2009,
452; 2011,
358, 700,
1806; 2013, 137, 3060)
NRS 449.220 Action to enjoin violations.
1. The Division may bring an action in the
name of the State to enjoin any person, state or local government unit or
agency thereof from operating or maintaining any facility within the meaning of
NRS 449.030 to 449.2428,
inclusive:
(a) Without first obtaining a license therefor;
or
(b) After his or her license has been revoked or
suspended by the Division.
2. It is sufficient in such action to
allege that the defendant did, on a certain date and in a certain place,
operate and maintain such a facility without a license.
[Part 6:336:1951]—(NRS A 1963, 961; 1971, 937; 1973,
1285; 2009,
1446; 2011,
359, 1067,
1360, 2255, 2398)
NRS 449.240 Institution and conduct of prosecutions. The district attorney of the county in which
the facility is located shall, upon application by the Division, institute and
conduct the prosecution of any action for violation of any provisions of NRS 449.030 to 449.245,
inclusive.
[Part 8:336:1951]—(NRS A 1963, 962; 1971, 937; 1973,
1286; 1975, 899; 2009, 1446;
2011, 359,
1360, 2256, 2399)
REQUIREMENTS RELATING TO STAFFING
NRS 449.241 Definitions. As
used in NRS 449.241 to 449.2428,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.2413 to 449.2418,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2009, 2024;
A 2013,
2150)
NRS 449.2413 “Certified nursing assistant” defined. “Certified
nursing assistant” means a person who has been certified by the State Board of
Nursing pursuant to NRS 632.2852 to
practice as a nursing assistant in this State.
(Added to NRS by 2013, 2143)
NRS 449.2414 “Health care facility” defined. “Health
care facility” means:
1. A hospital;
2. An independent center for emergency
medical care;
3. A psychiatric hospital; and
4. A surgical center for ambulatory
patients.
(Added to NRS by 2009, 2024)
NRS 449.2416 “Licensed nurse” defined. “Licensed
nurse” means a person licensed pursuant to chapter
632 of NRS to practice nursing, including, without limitation, a licensed
practical nurse. The term does not include a certified nursing assistant or a
medication aide - certified.
(Added to NRS by 2009, 2024;
A 2011,
1341; 2013,
2150)
NRS 449.2418 “Unit” defined. “Unit”
means a component within a health care facility for providing patient care.
(Added to NRS by 2009, 2024)
NRS 449.242 Establishment of staffing committee by certain hospitals in
larger counties; membership; duty to develop documented staffing plan; duty to
consider certain requests; quarterly meetings; reporting to Legislature.
1. Each hospital located in a county whose
population is 100,000 or more and which is licensed to have more than 70 beds
shall establish a staffing committee to develop a written policy as required
pursuant to NRS 449.2423 and a documented staffing
plan as required pursuant to NRS 449.2421. The
staffing committee must consist of:
(a) Not less than one-half of the total members
of the staffing committee from the licensed nursing staff and certified nursing
assistants who are providing direct patient care at the hospital; and
(b) Not less than one-half of the total members
of the staffing committee appointed by the administration of the hospital.
2. In developing the written policy and
the staffing plan, the staffing committee shall consider, without limitation,
the information received pursuant to paragraph (b) of subsection 5 of NRS 449.2423 regarding requests to be relieved of a
work assignment, refusals of a work assignment and objections to a work
assignment.
3. The staffing committee of a hospital
shall meet at least quarterly.
4. Each hospital that is required to
establish a staffing committee pursuant to this section shall prepare a written
report concerning the establishment of the staffing committee, the activities
and progress of the staffing committee and a determination of the efficacy of
the staffing committee. The hospital shall submit the report on or before
December 31 of each:
(a) Even-numbered year to the Director of the
Legislative Counsel Bureau for transmission to the next regular session of the
Legislature.
(b) Odd-numbered year to the Legislative
Committee on Health Care.
(Added to NRS by 2009, 2024;
A 2013,
2151)
NRS 449.2421 Certain health care facilities in larger counties required to
make available to Division written policy that allows refusal of or objection
to work assignments and documented staffing plan; requirements of staffing plan
and flexibility for adjustments.
1. As a condition of licensing, a health
care facility located in a county whose population is 100,000 or more and which
is licensed to have more than 70 beds shall make available to the Division a
written policy adopted pursuant to NRS 449.2423, a
documented staffing plan and a written certification that the written policy
and the documented staffing plan are adequate to meet the needs of the patients
of the health care facility. The documented staffing plan must include, without
limitation:
(a) A detailed written plan setting forth:
(1) The number, skill mix and
classification of licensed nurses required in each unit in the health care
facility, which must take into account the experience of the clinical and
nonclinical support staff with whom the licensed nurses collaborate, supervise
or otherwise delegate assignments; and
(2) The number of certified nursing
assistants required in each unit in the health care facility;
(b) A description of the types of patients who
are treated in each unit, including, without limitation, the type of care
required by the patients;
(c) A description of the activities in each unit,
including, without limitation, discharges, transfers and admissions;
(d) A description of the size and geography of
each unit;
(e) A description of any specialized equipment
and technology available for each unit;
(f) Any foreseeable changes in the size or
function of each unit; and
(g) Protocols for adequately staffing the health
care facility:
(1) In the event of an emergency,
including, without limitation, mass casualties and a significant change in the
acuity or number of patients;
(2) If applicable, in circumstances when a
significant number of patients are diverted from another facility; and
(3) If a licensed nurse or certified
nursing assistant is absent or refuses a work assignment pursuant to NRS 449.2423.
2. A documented staffing plan must provide
sufficient flexibility to allow for adjustments based upon changes in a unit of
the health care facility.
3. The health care facility shall ensure
that it is staffed in accordance with the documented staffing plan.
(Added to NRS by 2009, 2025;
A 2013,
2151)
NRS 449.2423 Certain health care facilities in larger counties to adopt
written policy to allow nurse or certified nursing assistant to refuse or
object to work assignments; requirements of policy; maintenance of records of
refusals of and objections to work assignments.
1. As a condition of licensure, a health
care facility which is located in a county whose population is 100,000 or more
and which is licensed to have more than 70 beds must adopt and disseminate to
each licensed nurse and certified nursing assistant employed by the health care
facility a written policy that sets forth the circumstances under which a
licensed nurse or certified nursing assistant may refuse or object to a work
assignment.
2. The written policy concerning work
assignments must, at a minimum, allow a licensed nurse or certified nursing assistant
to:
(a) Refuse a work assignment for any reason for
refusal set forth in paragraph (b) of subsection 1 of NRS
449.205; and
(b) File an objection to a work assignment if the
work assignment violates any provision of NRS 449.241
to 449.2428, inclusive.
3. For the purposes of refusing a work
assignment pursuant to paragraph (a) of subsection 2, the written policy
concerning work assignments must contain:
(a) Reasonable requirements for prior notice to
the supervisor of the licensed nurse or certified nursing assistant of the
request by the licensed nurse or certified nursing assistant to be relieved of
the work assignment, including, without limitation, the reasons supporting the
request;
(b) Reasonable requirements which provide, if
feasible, an opportunity for the supervisor to review a request by the licensed
nurse or certified nursing assistant to be relieved of the work assignment,
including any specific conditions supporting the request, and based upon that
review:
(1) Relieve the licensed nurse or
certified nursing assistant of the work assignment as requested; or
(2) Deny the request; and
(c) A process pursuant to which a licensed nurse
or certified nursing assistant may exercise his or her right to refuse a work
assignment if the supervisor does not approve the request to be relieved of the
work assignment if:
(1) The supervisor failed to approve the
request without proposing a remedy or, if a remedy is proposed, the proposed
remedy would be inadequate or untimely;
(2) The process for filing a complaint
with the Division or any other appropriate regulatory entity, including any
investigation that would be required, would be untimely to address the concerns
of the licensed nurse or certified nursing assistant in refusing a work
assignment; and
(3) The licensed nurse or certified
nursing assistant in good faith believes that the work assignment meets the
conditions established in the written policy justifying refusal.
4. For the purposes of objecting to a work
assignment pursuant to paragraph (b) of subsection 2, the written policy
concerning work assignments must contain:
(a) A process for a licensed nurse or certified
nursing assistant to file an objection with the health care facility, but still
accept the work assignment despite the objection; and
(b) A requirement that the health care facility
respond to the objection as soon as practicable, but not later than 45 days
after receiving the objection.
5. The health care facility shall:
(a) Maintain records for at least 2 years of each
request to be relieved of a work assignment, each refusal of a work assignment
and each objection to a work assignment that is filed with the health care
facility pursuant to the written policy adopted pursuant to this section;
(b) If the health care facility has established a
staffing committee pursuant to NRS 449.242, provide
to the staffing committee:
(1) The number of requests to be relieved
of a work assignment and refusals of a work assignment made by a licensed nurse
or a certified nursing assistant at the health care facility pursuant to this
section;
(2) The number of objections to a work
assignment filed by a licensed nurse or a certified nursing assistant at the
health care facility pursuant to this section; and
(3) An explanation of how the health care
facility addressed the requests, refusals and objections; and
(c) Ensure that the health care facility complies
with the written policy adopted pursuant to this section.
(Added to NRS by 2013, 2143)
NRS 449.2428 Division required to ensure that certain health care facilities
comply with provisions; regulations. For
each health care facility which is located in a county whose population is
100,000 or more and which is licensed to have more than 70 beds, the Division
shall:
1. Ensure the general compliance of the
health care facility with the provisions of NRS 449.241
to 449.2428, inclusive, including, without
limitation, those provisions relating to documented staffing plans and written
policies adopted pursuant to NRS 449.2423; and
2. Adopt such regulations as are necessary
or appropriate to carry out the provisions of this section.
(Added to NRS by 2013, 2145)
MISCELLANEOUS PROVISIONS
NRS 449.243 Itemized list of charges required; use of Uniform Billing and
Claims Forms authorized; contracted rates; summary of charges. Every hospital licensed pursuant to the
provisions of NRS 449.030 to 449.2428, inclusive:
1. May, except as otherwise provided in
subsection 2, utilize the Uniform Billing and Claims Forms established by the
American Hospital Association.
2. Shall, except as otherwise provided in
this section, on its billings to patients, itemize, on a daily basis, all
charges for services, and charges for equipment used and the supplies and
medicines provided incident to the provision of those services with specificity
and in language that is understandable to an ordinary lay person. This itemized
list must be timely provided after the patient is discharged at no additional
cost.
3. Except as otherwise provided in this
subsection, if a patient is charged a rate, pursuant to a contract or other
agreement, that is different than the billed charges, shall provide to the
patient either:
(a) A copy of the billing prepared pursuant to
subsection 2;
(b) A statement specifying the agreed rate for
the services; or
(c) If the patient is not obligated to pay any
portion of the bill, a statement of the total charges.
Ê In any case,
the hospital shall include on the billing or statement any copayment or
deductible for which the patient is responsible. The hospital shall answer any
questions regarding the bill.
4. If the hospital is paid by the insurer
of a patient a rate that is based on the number of persons treated and not on
the services actually rendered, shall, upon the discharge of the patient,
advise the patient of the status of any copayment or deductible for which the
patient is responsible.
5. Shall prepare a summary of charges for
common services for patients admitted to the hospital and make it available to
the public.
6. Shall provide to any patient upon
request a copy of the billing prepared pursuant to subsection 2.
(Added to NRS by 1975, 897; A 1983, 649; 1985, 905; 1993, 2427; 1995, 1856)
NRS 449.244 Certain costs for examination or treatment of victims of sexual
offenses to be charged to county. Repealed.
(See chapter 142, Statutes of Nevada 2013, at page 487.)
NRS 449.245 Release of child from hospital; provision of authorization for
release and other information to Division of Child and Family Services;
disclosure of information; penalty.
1. No hospital licensed under the
provisions of NRS 449.030 to 449.2428, inclusive, may release from the hospital or
otherwise surrender physical custody of any child under 6 months of age, whose
living parent or guardian is known to the hospital, to any person other than a
parent, guardian or relative by blood or marriage of that child, without a
written authorization signed by a living parent, who must be the mother if
unwed, or guardian specifying the particular person or agency to whom the child
may be released and the permanent address of that person or agency.
2. Upon the release or other surrender of
physical custody of the child, the hospital shall require from the person to
whom the child is released such reasonable proof of identity as the hospital
may deem necessary for compliance with the provisions of this section. The
hospital shall furnish a true copy of the written authorization to the Division
of Child and Family Services of the Department of Health and Human Services
before the release or other surrender by it of physical custody of the child.
The copy must be furnished to the Division immediately upon receipt by the
hospital.
3. Any person to whom any such child is
released who thereafter surrenders physical custody of that child to any other
person or agency shall, upon demand by the Division of Child and Family
Services, disclose to the Division the name and permanent address of the person
or agency to whom physical custody of the child was delivered.
4. Except as otherwise provided in NRS 239.0115, all information received by
the Division of Child and Family Services pursuant to the provisions of this
section is confidential and must be protected from disclosure in the same
manner that information is protected under NRS
432.035.
5. Compliance with the provisions of this
section is not a substitute for compliance with NRS 127.220 to 127.310, inclusive, governing placements
for adoption and permanent free care.
6. A violation of any provision of this
section is a misdemeanor.
(Added to NRS by 1957, 251; A 1961, 739; 1963, 962;
1967, 1172; 1973, 1286, 1406; 1981, 721; 1993, 2724; 2007, 2109)
NRS 449.2455 Authority of hospital to enter into agreement with Armed Forces
of United States for provision of medical care by certain medical officers.
1. A hospital may enter into an agreement
with the Armed Forces of the United States to authorize a medical officer to
provide medical care in the hospital if:
(a) The medical officer holds a valid license in
good standing to provide such medical care in the District of Columbia or any
state or territory of the United States;
(b) The medical care is provided as part of a
training or educational program designed to further the employment of the
medical officer; and
(c) The agreement complies with the provisions of
10 U.S.C. § 1094 and any regulations or guidelines adopted pursuant thereto.
2. As used in this section, “medical
officer” includes any physician, nurse, dentist or other health care
professional who is employed by the Armed Forces of the United States or a
reserve component thereof.
(Added to NRS by 2009, 818)
NRS 449.246 Hospital or obstetric center to provide information relating to
voluntary acknowledgment or establishment of paternity before discharging
unmarried woman who has borne child; regulations.
1. Before discharging an unmarried woman
who has borne a child, a hospital or obstetric center shall provide to the
child’s mother and father:
(a) The opportunity to sign, in the hospital, a
declaration for the voluntary acknowledgment of paternity developed pursuant to
NRS 440.283;
(b) Written materials about establishing
paternity;
(c) The forms necessary to acknowledge paternity
voluntarily;
(d) A written description of the rights and
responsibilities of acknowledging paternity; and
(e) The opportunity to speak by telephone with
personnel of the program for enforcement of child support who are trained to
clarify information and answer questions about the establishment of paternity.
2. The Administrator of the Division of
Welfare and Supportive Services of the Department of Health and Human Services
shall adopt the regulations necessary to ensure that the services provided by a
hospital or obstetric center pursuant to this section are in compliance with
the regulations adopted by the Secretary of Health and Human Services pursuant
to 42 U.S.C. § 666(a)(5)(C).
(Added to NRS by 1995, 2426; A 1997, 2341; 2007, 1529)
NRS 449.2465 Persons entitled to results of tests performed at laboratory
regarding patient of rural hospital. The
following persons are entitled to access the results of tests performed at a
licensed laboratory regarding a patient of a rural hospital:
1. The patient;
2. The physician who ordered the tests;
and
3. A provider of health care who is
currently treating or providing assistance in the treatment of the patient.
(Added to NRS by 1995, 1600)
NRS 449.247 Powers and duties of Division and State Board of Nursing with
respect to nursing assistants and medication aides - certified and training of
nursing assistants and medication aides - certified; provision of information
to State Board of Nursing.
1. The Division may review the personnel
files of a medical facility or facility for the dependent to determine that
each nursing assistant or medication aide - certified employed by the facility
has a current certificate.
2. The Division shall review the
qualifications of instructors of nursing assistants or medication aides -
certified for each program of which the Division is notified pursuant to NRS 632.127.
3. The Division may conduct the review of
training programs for nursing assistants or medication aides - certified in
facilities for long-term care.
4. The Division and any other state agency
which regulates medical facilities and facilities for the dependent shall
provide to the State Board of Nursing any information it discovers concerning:
(a) Programs and instructors for training nursing
assistants or medication aides - certified which do not comply with the
requirements established by the State Board of Nursing.
(b) The failure of a nursing assistant or
medication aide - certified to perform consistently at a safe level.
(c) The results of any investigation of a
facility if the investigation concerns a nursing assistant, medication aide -
certified or instructor or training program for nursing assistants or
medication aides - certified.
5. The State Board of Nursing shall
investigate any report submitted pursuant to subsection 4 and may revoke
approval of a program or instructor if the allegations of the report are true.
(Added to NRS by 1989, 2017; A 2011, 1341)
NRS 449.2475 Unlicensed insurer not allowed to make payment directly to
person who received services in certain circumstances; limitation on civil and
criminal liability.
1. An insurer that is not licensed in this
State pursuant to title 57 of NRS and that is obligated to pay benefits for
services provided to a person by a hospital or other provider of health care,
or to reimburse a person for the costs of such services, shall not make the
payment directly to the person if an itemized statement for the services is
submitted to the insurer which clearly indicates that the right of the person
to those benefits has been assigned to the hospital or other provider of health
care.
2. The provisions of this section do not
create grounds for civil or criminal liability.
(Added to NRS by 2007, 734)
NRS 449.248 Additional services to be provided by agency to provide nursing
in home. An agency to provide
nursing in the home shall, in addition to skilled nursing, provide at least one
of the following services:
1. Speech or occupational therapy;
2. Guidance regarding nutrition or
vocations;
3. Physical therapy;
4. Pharmaceutical services; or
5. Other social or medical services.
(Added to NRS by 1979, 160; A 1985, 1742)
NRS 449.2485 Return to dispensing pharmacy of unused prescription drug
dispensed to patient of facility for skilled nursing or facility for
intermediate care for purpose of reissuing drug or transferring drug.
1. A facility for skilled nursing or a
facility for intermediate care may return a prescription drug that is dispensed
to a patient of the facility, but will not be used by that patient, to the
dispensing pharmacy for the purpose of reissuing the drug to fill other
prescriptions for patients in that facility or for the purpose of transferring
the drug to a nonprofit pharmacy designated by the State Board of Pharmacy
pursuant to NRS 639.2676 if:
(a) The drug is not a controlled substance;
(b) The drug is dispensed in a unit dose, in
individually sealed doses or in a bottle sealed by the manufacturer of the
drug;
(c) The drug is returned unopened and sealed in
the original manufacturer’s packaging or bottle;
(d) The usefulness of the drug has not expired;
(e) The packaging or bottle contains the
expiration date of the usefulness of the drug; and
(f) The name of the patient for whom the drug was
originally prescribed, the prescription number and any other identifying marks
are obliterated from the packaging or bottle before the return of the drug.
2. A dispensing pharmacy to which a drug
is returned pursuant to this section may:
(a) Reissue the drug to fill other prescriptions
for patients in the same facility if the registered pharmacist of the pharmacy
determines that the drug is suitable for that purpose in accordance with
standards adopted by the State Board of Pharmacy pursuant to subsection 5; or
(b) Transfer the drug to a nonprofit pharmacy
designated by the State Board of Pharmacy pursuant to NRS 639.2676.
3. No drug that is returned to a
dispensing pharmacy pursuant to this section may be used to fill other
prescriptions more than one time.
4. A facility for skilled nursing or
facility for intermediate care shall adopt written procedures for returning
drugs to a dispensing pharmacy pursuant to this section. The procedures must:
(a) Provide appropriate safeguards for ensuring
that the drugs are not compromised or illegally diverted during their return.
(b) Require the maintenance and retention of such
records relating to the return of drugs to dispensing pharmacies as are
required by the State Board of Pharmacy.
(c) Be approved by the State Board of Pharmacy.
5. The State Board of Pharmacy shall adopt
such regulations as are necessary to carry out the provisions of this section,
including, without limitation, requirements for:
(a) Returning and reissuing such drugs pursuant
to the provisions of this section.
(b) Transferring drugs to a nonprofit pharmacy
pursuant to the provisions of this section and NRS 639.2676.
(c) Maintaining records relating to the return
and the use of such drugs to fill other prescriptions.
(Added to NRS by 2003, 1372; A 2009, 1087)
NRS 449.2486 Facility for care of adults during the day to maintain and
provide certain information; form in which information to be provided.
1. A facility for the care of adults
during the day shall maintain a copy of:
(a) The license issued to the facility pursuant
to NRS 449.030 to 449.2428,
inclusive;
(b) Any summaries of complaints provided to the
facility pursuant to subsection 3 of NRS 449.160;
(c) The report of any investigation conducted
with respect to the complaints; and
(d) The report of any disciplinary action taken
against the facility pursuant to NRS 449.160 or 449.163.
2. The information maintained pursuant to
subsection 1 must be provided in the form prescribed pursuant to subsection 3:
(a) To each patient or the patient’s legal
representative, at or before the time of admission.
(b) To a prospective patient or the prospective
patient’s legal representative, upon request, who is considering admission of
the patient to the facility.
(c) In the case of disciplinary action taken
pursuant to NRS 449.160 or 449.163,
to all patients admitted to the facility and their legal representatives.
Notice of disciplinary action must be provided to the legal representatives of
all patients admitted to the facility within 3 working days after receipt by
the facility.
3. The Division shall develop a standard
form for reporting the information required to be provided pursuant to
subsection 2. The information reported on the form must include all required
information for the 12-month period ending on the last day of the month
immediately preceding the month in which the information is provided.
4. The Division shall inform persons
seeking information concerning facilities for the care of adults during the day
of their right to information pursuant to this section.
(Added to NRS by 2007, 270)
NRS 449.2487 Notice to be provided by certain facilities which offer
independent living.
1. A facility for the dependent, a medical
facility or an entity affiliated with such a facility which offers housing to
persons that does not include the provision of care or services which require
licensure pursuant to this chapter shall conspicuously post in the facility and
shall include in any contracts of sale or agreements for occupancy a notice
that includes the following information:
(a) That the specific area of the facility is
intended for independent living and does not directly provide or coordinate the
oversight of services to meet the scheduled and unscheduled needs of its
residents, including, without limitation, the provision of personal care,
supportive services and health-related services.
(b) The other levels of care that are available
to persons who require personal care, supportive services or health-related
services, including, without limitation, residential facilities for groups,
facilities for intermediate care and facilities for skilled nursing. The notice
must describe the facilities and levels of care in language that is easy to
understand.
(c) A statement that encourages residents to
reassess on a regular basis the type of housing and care that is most
appropriate for them.
2. The Aging and Disability Services
Division of the Department of Health and Human Services shall develop the
language for the notice required by subsection 1 in consultation with
nationally recognized advocacy groups for older persons and housing
organizations.
3. For the purposes of this section, an
entity is affiliated with a facility described in subsection 1 if:
(a) It is under common or shared ownership;
(b) It is under common or shared management; or
(c) It receives promotional or marketing support
from the facility.
(Added to NRS by 2007, 2466; A 2011, 359)
NRS 449.2488 Department to develop brochure and website to assist persons who
are 55 years of age or older in determining appropriate level of care and type
of housing; information to be included in brochure and website.
1. The Department of Health and Human
Services shall develop a brochure and website to assist persons who are 55
years of age or older in determining the appropriate level of care and type of
housing that they require to meet their individual needs. The brochure and
website must include, without limitation:
(a) The various types of housing and levels of
care that are available to persons who are 55 years of age or older, including,
without limitation, residential facilities for groups, facilities for
intermediate care and facilities for skilled nursing, distinguishing the
varying degree of services that are offered by the different types of facilities;
(b) Whether individual facilities accept payment
through Medicaid or Medicare for the level of care and type of housing that the
facilities provide;
(c) The manner in which a person may obtain
information concerning whether the facility has ever been found to have
violated the provisions of this chapter; and
(d) Such other information as the Department
deems to be beneficial to persons who are 55 years of age or older in
determining the appropriate level of care and type of housing that they require
to meet their individual needs.
2. As used in this section:
(a) “Medicaid” has the meaning ascribed to it in NRS 439B.120.
(b) “Medicare” has the meaning ascribed to it in NRS 439B.130.
(Added to NRS by 2007, 2467)
FACILITIES FOR REFRACTIVE SURGERY
NRS 449.2489 Definitions. As
used in NRS 449.2489 to 449.24898,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.24891 to 449.24894,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2009, 450)
NRS 449.24891 “Ophthalmologist” defined. “Ophthalmologist”
means a physician who is qualified to perform laser surgery or intense pulsed
light therapy on the globe of the eye pursuant to NRS 630.371 or 633.693.
(Added to NRS by 2009, 450)
NRS 449.24892 “Postoperative care” defined. “Postoperative
care” means assessing, monitoring or treating a patient while the patient is
recovering or healing from a surgical treatment for a refractive error of the
eye.
(Added to NRS by 2009, 451)
NRS 449.24893 “Preoperative care” defined. “Preoperative
care” means assessing or treating a patient in preparation for a surgical
treatment for a refractive error of the eye.
(Added to NRS by 2009, 451)
NRS 449.24894 “Surgical treatment for a refractive error of the eye” defined. “Surgical treatment for a refractive error of
the eye” means the surgical treatment of a patient with a refractive error of
the eye by:
1. Photorefractive keratectomy;
2. Laser in situ keratomileusis;
3. Conductive keratoplasty;
4. Implantation of an intraocular lens; or
5. Any other available technology,
technique or procedure which surgically treats refractive errors of the eye and
which has been approved by the United States Food and Drug Administration.
(Added to NRS by 2009, 451)
NRS 449.24895 Certain persons not required to obtain license to operate and
maintain facility; filing of affidavit with Division required. A person is not required to obtain a license
to operate and maintain a facility for refractive surgery pursuant to the
provisions of this chapter if the person:
1. Is an ophthalmologist;
2. Provides surgical procedures to
patients at the facility in addition to preoperative care, postoperative care
and surgical treatments for refractive errors of the eye; and
3. Files with the Division an affidavit
attesting that the person provides surgical procedures at the facility in
addition to preoperative care, postoperative care and surgical treatments for
refractive errors of the eye.
(Added to NRS by 2009, 451)
NRS 449.24896 Surgical treatments at facility must be performed by licensed
ophthalmologist; availability of ophthalmologist. A
facility for refractive surgery shall ensure that:
1. All surgical treatments for refractive
errors of the eye performed at the facility are performed only by an
ophthalmologist.
2. The ophthalmologist who performs a
surgical treatment for refractive errors of the eye at the facility:
(a) Is available in person for postoperative care
if the medical needs of a patient necessitate the services of an
ophthalmologist; or
(b) Enters into an agreement with another
ophthalmologist to be available in person for postoperative care if the medical
needs of the patient necessitate the services of an ophthalmologist.
(Added to NRS by 2009, 451)
NRS 449.24897 Order to cease and desist operation for failure to obtain
license; injunction; penalties.
1. If the Division believes that a person
who is required to obtain a license pursuant to this chapter is operating a
facility for refractive surgery without such a license, the Division may issue
an order to cease and desist the operation of the facility. The order must be
served upon the person directly or by certified or registered mail, return
receipt requested. The order becomes effective upon service.
2. An order issued pursuant to subsection
1 expires 30 days after the date of service unless the Division institutes an
action in a court of competent jurisdiction seeking an injunction.
3. Upon a showing by the Division that a
person is operating a facility for refractive surgery without a license issued
pursuant to this chapter, a court of competent jurisdiction may:
(a) Enjoin the person from operating the
facility.
(b) Impose a civil penalty to be recovered by the
Division of not more than $10,000 for the first offense and of not less than
$10,000 or more than $20,000 for a second or subsequent offense.
4. A person enjoined or penalized pursuant
to subsection 3 may not apply for a license to operate a facility for
refractive surgery for a period of 6 months after the date on which the court
issues the injunction or penalty.
(Added to NRS by 2009, 451)
NRS 449.24898 Collaboration between ophthalmologist and optometrist authorized
pursuant to NRS 636.374. The provisions of NRS
449.2489 to 449.24898, inclusive, do not
prohibit an ophthalmologist from collaborating with an optometrist to provide
care to a patient if the collaboration complies with the requirements of NRS 636.374.
(Added to NRS by 2009, 452)
NEVADA HEALTH FACILITIES ASSISTANCE ACT
NRS 449.250 Short title. NRS 449.250 to 449.430,
inclusive, may be cited as the Nevada Health Facilities Assistance Act.
[1:219:1949; 1943 NCL § 5285.01]—(NRS A 1965, 983; 2011, 3575)
NRS 449.260 Definitions. As
used in NRS 449.250 to 449.430,
inclusive:
1. “Community mental health center” means
a facility providing services for the prevention or diagnosis of mental
illness, or care and treatment of patients with mental illness, or
rehabilitation of such persons, which services are provided principally for
persons residing in a particular community in or near which the facility is
situated.
2. “Construction” includes the
construction of new buildings, modernization, expansion, remodeling and
alteration of existing buildings, and initial equipment of such buildings,
including medical transportation facilities, and includes architects’ fees, but
excludes the cost of off-site improvements and, except with respect to public
health centers, the cost of the acquisition of the land.
3. “Facility for persons with intellectual
disabilities” means a facility specially designed for the diagnosis, treatment,
education, training or custodial care of persons with intellectual
disabilities, including facilities for training specialists and sheltered
workshops for persons with intellectual disabilities, but only if such
workshops are part of facilities which provide or will provide comprehensive
services for persons with intellectual disabilities.
4. “Federal Act” means 42 U.S.C. §§ 291 to
291o-l, inclusive, and 300k to 300t, inclusive, and any other federal law
providing for or applicable to the provision of assistance for health
facilities.
5. “Federal agency” means the federal
department, agency or official designated by law, regulation or delegation of
authority to administer the Federal Act.
6. “Health facility” includes a public
health center, hospital, facility for hospice care, facility for persons with
intellectual disabilities, community mental health center, and other facility
to provide diagnosis, treatment, care, rehabilitation, training or related
services to persons with physical or mental impairments, including diagnostic
or diagnostic and treatment centers, rehabilitation facilities and nursing
homes, as those terms are defined in the Federal Act, and such other facilities
for which federal aid may be authorized under the Federal Act, but, except for
facilities for persons with intellectual disabilities, does not include any
facility furnishing primarily domiciliary care.
7. “Nonprofit health facility” means any
health facility owned and operated by a corporation or association, no part of
the net earnings of which inures or may lawfully inure to the benefit of any
private shareholder or natural person.
8. “Public health center” means a publicly
owned facility for the provision of public health services, including related
facilities such as laboratories, clinics and administrative offices operated in
connection with public health centers.
9. “State Department” means the Department
of Health and Human Services, acting through its appropriate divisions.
[2:219:1949; A 1956, 47]—(NRS A 1963, 962; 1965, 983;
1967, 1173; 1973, 1406; 1975, 909; 1977, 258; 1979, 1113; 1985, 1743; 1989, 1036; 1999, 249; 2011, 3575;
2013, 697)
NRS 449.270 State Department to constitute sole agency of State for certain
purposes. The State Department
shall constitute the sole agency of the State for the purpose of:
1. Inventorying existing health
facilities, surveying the need for construction of health facilities, and
developing programs of health facilities construction as provided in NRS 449.250 to 449.430,
inclusive.
2. Developing and administering state
plans for the construction of public and other nonprofit health facilities as
provided in NRS 449.250 to 449.430,
inclusive.
3. Developing and administering any other
plan or program providing assistance to health facilities for which funds may
be available to this state under the Federal Act.
[3:219:1949; 1943 NCL § 5285.03]—(NRS A 1965, 985)
NRS 449.280 Duties of State Department. In
carrying out the purposes of NRS 449.250 to 449.430, inclusive, the State Department is authorized
and directed:
1. To require such reports, make such
inspections and investigations, and prescribe such regulations as it deems
necessary.
2. To provide such methods of
administration, appoint all necessary officers and other personnel and take
such other action as may be necessary to comply with the requirements of NRS 449.250 to 449.430,
inclusive, the Federal Act and the regulations thereunder.
3. To procure in its discretion the
temporary or intermittent services of experts or consultants, by contract, when
such services are to be performed on a part-time or fee-for-service basis and
do not involve the performance of administrative duties.
4. To the extent that it considers
desirable to effectuate the purposes of NRS 449.250
to 449.430, inclusive, to enter into agreements for
the utilization of the facilities and services of other departments, agencies
and institutions, public or private.
5. To accept on behalf of the State and to
deposit with the State Treasurer in appropriate accounts in the Department of
Health and Human Services’ Gift Fund any grant, gift or contribution made to
assist in meeting the cost of carrying out the purposes of NRS 449.250 to 449.430,
inclusive, and to expend the same for such purposes.
6. To do all other things on behalf of the
State necessary or advisable to obtain the maximum benefits available under the
Federal Act.
7. All claims must be approved by the
Health Officer before they are paid.
[4:219:1949; 1943 NCL § 5285.04]—(NRS A 1965, 985;
1969, 945; 1981,
79)
NRS 449.300 Inventory of existing health facilities; development of program
for construction of facilities. The
State Department is authorized and directed to inventory existing health
facilities, including public, nonprofit, and proprietary health facilities, to
survey the need for construction of health facilities, and, on the basis of
such inventory and survey, to develop programs for the construction of such
public and other nonprofit health facilities as will, in conjunction with
existing facilities, afford the necessary physical facilities for furnishing
adequate health facility services to all the people of the State.
[7:219:1949; 1943 NCL § 5285.07]—(NRS A 1965, 986)
NRS 449.310 Requirements of program for construction of health facilities. The construction programs must provide, in
accordance with NRS 449.250 to 449.430, inclusive, and the regulations thereunder,
for adequate health facilities for the people residing in this State, and,
insofar as possible, must provide for their distribution throughout the State
in such manner as to make the services of all types of health facilities
reasonably accessible to all persons in the State.
[9:219:1949; 1943 NCL § 5285.09]—(NRS A 1965, 986; 1981, 1901)
NRS 449.320 Application for federal money; deposit of money.
1. The State Department may apply to the
federal agency for federal money to assist in carrying out the surveys,
planning and construction activities provided for in NRS
449.250 to 449.430, inclusive.
2. The money must be deposited in the
State Treasury and must be available to the State Department for expenditure
for carrying out the purposes of NRS 449.250 to 449.430, inclusive.
[8:219:1949; 1943 NCL § 5285.08]—(NRS A 1965, 987; 1981, 1901)
NRS 449.340 State Department to prescribe minimum standards; standards to
supersede local ordinances and regulations; penalty.
1. The State Department may, by
regulation, establish standards for the maintenance and operation of health
facilities, which supersede all local ordinances and regulations inconsistent
therewith.
2. A copy of the regulations, giving the
date that they take effect, must be issued in pamphlet form.
3. Any health facility that applies for
and accepts federal aid for construction under a state plan does so on the
condition that the health facility qualify under the minimum standards for
maintenance and operation adopted and enforced by the State Department.
4. Any person, partnership, association or
corporation establishing, conducting, managing or operating any health facility
within the meaning of NRS 449.250 to 449.430, inclusive, who violates any of the provisions
of this section or regulations lawfully adopted thereunder is guilty of a
misdemeanor.
[11:219:1949; 1943 NCL § 5285.11] + [12:219:1949;
1943 NCL § 5285.12]—(NRS A 1963, 963; 1965, 987; 1971, 937; 1985, 369)
NRS 449.345 Restriction on adoption of regulations concerning construction,
maintenance, operation or safety of building, structure or other property. Before the State Department may adopt any
regulation concerning the construction, maintenance, operation or safety of a
building, structure or other property in this State, the State Department shall
consult with the Deputy Administrator of the Public Works - Compliance and Code
Enforcement Section for the purposes of subsection 9 of NRS 341.100.
(Added to NRS by 2011, 3574;
A 2013, 397)
NRS 449.360 Application for construction of health facility: Filing;
compliance with federal and state requirements.
1. Applications for health facility
construction projects for which federal funds are required must be submitted to
the appropriate health systems agency and the State Department. They may be
submitted by the State or any political subdivision thereof or by any public or
nonprofit agency authorized to construct and operate a health facility.
2. Each application for a construction
project must conform to federal and state requirements and must be submitted in
the manner and form prescribed by the State Department.
[14:219:1949; 1943 NCL § 5285.14]—(NRS A 1965, 988; 1979, 969)
NRS 449.370 Application for construction of health facility: Notice and
hearing; approval and forwarding.
1. The State Department shall afford to
every applicant for assistance for a construction project an opportunity for a
fair hearing before the State Department upon 10 days’ written notice to the
applicant.
2. If the State Department, after
affording reasonable opportunity for development and presentation of
applications in the order of relative need, finds that an application is in
conformity with the state plan, the State Department shall approve the
application and shall recommend and forward it to the federal agency.
3. The State Department shall consider and
forward applications in the order of relative need set forth in the state plan.
[15:219:1949; 1943 NCL § 5285.15]—(NRS A 1965, 988; 1981, 856; 1985, 1362)
NRS 449.380 Inspection of construction of health facility; certification by
State Department. From time to
time, the State Department shall inspect each construction project approved by
the federal agency and, if the inspection so warrants, the State Department
shall certify to the federal agency that work has been performed upon the
project, or that purchases have been made, in accordance with the approved
plans and specifications, and that payment of an installment of federal funds
is due to the applicant.
[16:219:1949; 1943 NCL § 5285.16]—(NRS A 1965, 988)
NRS 449.390 Authority to receive and distribute federal money; Health Facilities
Assistance Fund; deposits, use and controls.
1. The State Department is hereby
authorized to receive federal funds in behalf of, and transmit them to,
applicants.
2. There is hereby established a
nonreverting trust fund designated as the Health Facilities Assistance Fund.
Money received from the Federal Government for a construction project approved
by the federal agency shall be transmitted to the State Treasurer to be
deposited in the State Treasury to the credit of the Health Facilities Assistance
Fund, and shall be used solely for payments due applicants for work performed,
purchases made or other approved expenditures in carrying out approved projects
or plans, except that any moneys in such Fund which become available under the
Federal Act and regulations for expenditure in administering an approved state
plan may be expended for that purpose.
3. The State Department shall establish
and maintain such accounts and fiscal controls of moneys deposited in and
disbursed from the Health Facilities Assistance Fund as may be required by the
Federal Act and regulations promulgated thereunder.
[17:219:1949; 1943 NCL § 5285.17]—(NRS A 1965, 988;
1975, 259)
NRS 449.400 State Public Health Facilities Construction Assistance Fund:
Creation; administration.
1. In order to provide state assistance
for construction projects for publicly owned general hospitals, hospitals for
the chronically ill and impaired, facilities for persons with intellectual
disabilities, community mental health facilities, diagnostic or diagnostic and
treatment centers, rehabilitation facilities, nursing homes and other
facilities financed in part by federal funds in accordance with NRS 449.250 to 449.430,
inclusive, and to promote maximum utilization of federal funds available for
such projects, there is hereby created in the State Treasury a nonreverting
trust fund to be known as the State Public Health Facilities Construction
Assistance Fund. Money for the Fund may be provided from time to time by
legislative appropriation.
2. The State Public Health Facilities
Construction Assistance Fund must be administered by the State Department in
accordance with the purposes and provisions of NRS
449.250 to 449.430, inclusive.
[17.1:219:1949; added 1956, 47]—(NRS A 1965, 989; 1985, 1744; 2013, 698)
NRS 449.410 State assistance for construction of certain projects;
eligibility of project for assistance.
1. Money in the State Public Health
Facilities Construction Assistance Fund must be used to supplement money from
the Federal Government and money provided by the sponsor of a project for
approved projects for the construction of publicly owned general hospitals,
hospitals for the chronically ill or impaired, facilities for persons with
intellectual disabilities, community mental health facilities, diagnostic or
diagnostic and treatment centers, rehabilitation facilities, nursing homes and
other facilities financed in part by federal funds pursuant to NRS 449.250 to 449.430,
inclusive, and for no other purpose or purposes.
2. Applications for state assistance for
construction projects must be submitted to the State Department for consideration
in the manner prescribed in NRS 449.250 to 449.430, inclusive, for applications for federal
assistance.
3. No project is entitled to receive state
assistance unless it is entitled to receive federal assistance.
[17.2:219:1949; added 1956, 47]—(NRS A 1965, 989; 1985, 1744; 2013, 698)
NRS 449.420 Amount of state assistance: Allocations; payments. Money in the State Public Health Facilities
Construction Assistance Fund must be allocated and paid to construction
projects on the basis of relative need in accordance with the need identified
in the state health plan and in accordance with a ratio between state money and
federal money determined by the State Department. In no event may the amount of
state assistance made available or paid out for a project exceed the amount
supplied by the sponsor of the project.
[17.3:219:1949; added 1956, 47]—(NRS A 1965, 989; 1981, 856, 1901)
NRS 449.430 Money from State Public Health Facilities Construction
Assistance Fund to be paid in installments. Moneys
in the State Public Health Facilities Construction Assistance Fund allocated to
a particular approved project shall be paid out in installments at the same
times and in the same manner as installments of federal funds are paid out from
the Health Facilities Assistance Fund pursuant to NRS 449.390.
[17.4:219:1949; added 1956, 47]—(NRS A 1965, 990)
INTERMEDIARY SERVICE ORGANIZATIONS
General Provisions
NRS 449.4304 “Intermediary service organization” defined. As used in NRS 449.4304
to 449.4339, inclusive, unless the context
otherwise requires, “intermediary service organization” means a nongovernmental
entity that provides services authorized pursuant to NRS
449.4308 for a person with a disability or other responsible person.
(Added to NRS by 2013, 126)
NRS 449.4308 Authority to provide services.
1. An intermediary service organization
that is certified pursuant to NRS 449.4304 to 449.4339, inclusive, may provide services for a
person with a disability or other responsible person relating to personal
assistance received by the person with a disability. The services that may be
provided by an intermediary service organization include, without limitation:
(a) Obtaining a criminal background check of a
personal assistant selected by the person with a disability or other
responsible person to provide nonmedical services and any medical services
authorized pursuant to NRS 629.091;
(b) Providing payroll services to pay the
personal assistant and determine any tax liability;
(c) Providing services relating to financial
management; and
(d) Providing any other services relating to the
employment of a personal assistant and any other financial assistance relating
to the personal assistance for the person with a disability.
2. As used in this section:
(a) “Other responsible person” means:
(1) A parent or guardian of, or any other
person legally responsible for, a person with a disability who is under the age
of 18 years; or
(2) A parent, spouse, guardian or adult
child of a person with a disability who suffers from a cognitive impairment.
(b) “Personal assistance” means the provision of
any goods or services to help a person with a disability maintain his or her
independence, personal hygiene and safety, including, without limitation, the
provision of services by a personal assistant.
(c) “Personal assistant” means a person who, for
compensation and under the direction of a person with a disability or other
responsible person, performs services for a person with a disability to help
the person maintain his or her independence, personal hygiene and safety.
(Added to NRS by 2013, 126)
Certification
NRS 449.431 Certificate required; exception; penalty.
1. Except as otherwise provided in
subsection 2, a person shall not operate or maintain in this State an
intermediary service organization without first obtaining a certificate to
operate an intermediary service organization as provided in NRS 449.4304 to 449.4339,
inclusive.
2. A person who is licensed to operate an
agency to provide personal care services in the home pursuant to this chapter
is not required to obtain a certificate to operate an intermediary service
organization as described in this section.
3. A person who violates the provisions of
this section is guilty of a misdemeanor.
(Added to NRS by 2013, 126)
NRS 449.4311 Application for certificate: Contents. Any
person wishing to obtain a certificate to operate an intermediary service
organization pursuant to the provisions of NRS
449.4304 to 449.4339, inclusive, must file
with the Division an application on a form prescribed, prepared and furnished
by the Division, containing:
1. The name of the applicant and, if a
natural person, whether the applicant has attained the age of 21 years.
2. The location of the intermediary
service organization.
3. The name of the person in charge of the
intermediary service organization.
4. Such other information as may be
required by the Division for the proper administration and enforcement of NRS 449.4304 to 449.4339,
inclusive.
5. Evidence satisfactory to the Division
that the applicant is of reputable and responsible character. If the applicant
is a firm, association, organization, partnership, business trust, corporation
or company, similar evidence must be submitted as to the members thereof, and
the person in charge of the intermediary service organization for which
application is made.
6. Evidence satisfactory to the Division
of the ability of the applicant to comply with the provisions of NRS 449.4304 to 449.4339,
inclusive, and the standards and regulations adopted by the Board.
(Added to NRS by 2013, 127)
NRS 449.4312 Application for certificate: Social security number required.
[Effective until the date of the repeal of 42 U.S.C. § 666, the federal law
requiring each state to establish procedures for withholding, suspending and
restricting the professional, occupational and recreational licenses for child
support arrearages and for noncompliance with certain processes relating to
paternity or child support proceedings.] An
application for the issuance of a certificate to operate an intermediary
service organization pursuant to NRS 449.4311 must
include the social security number of the applicant.
(Added to NRS by 2013, 127)
NRS 449.4313 Application for certificate: Statement regarding obligation of
child support; grounds for denial; duty of Division. [Effective until the date
of the repeal of 42 U.S.C. § 666, the federal law requiring each state to
establish procedures for withholding, suspending and restricting the
professional, occupational and recreational licenses for child support
arrearages and for noncompliance with certain processes relating to paternity
or child support proceedings.]
1. An applicant for the issuance or
renewal of a certificate to operate an intermediary service organization must
submit to the Division the statement prescribed by the Division of Welfare and
Supportive Services of the Department pursuant to NRS 425.520. The statement must be
completed and signed by the applicant.
2. The Division shall include the
statement required pursuant to subsection 1 in:
(a) The application or any other forms that must
be submitted for the issuance or renewal of the certificate; or
(b) A separate form prescribed by the Division.
3. A certificate as an intermediary
service organization may not be issued or renewed by the Division if the applicant:
(a) Fails to submit the statement required
pursuant to subsection 1; or
(b) Indicates on the statement submitted pursuant
to subsection 1 that the applicant is subject to a court order for the support
of a child and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the repayment
of the amount owed pursuant to the order.
4. If an applicant indicates on the
statement submitted pursuant to subsection 1 that the applicant is subject to a
court order for the support of a child and is not in compliance with the order
or a plan approved by the district attorney or other public agency enforcing
the order for the repayment of the amount owed pursuant to the order, the
Division shall advise the applicant to contact the district attorney or other
public agency enforcing the order to determine the actions that the applicant
may take to satisfy the arrearage.
(Added to NRS by 2013, 127)
NRS 449.4314 Application for certificate: Fee. Each
application for a certificate to operate an intermediary service organization
must be accompanied by such fee as may be determined by regulation of the
Board. The Board may, by regulation, allow or require payment of a fee for a
certificate in installments and may fix the amount of each payment and the date
on which the payment is due.
(Added to NRS by 2013, 128)
NRS 449.4317 Issuance of certificate; nontransferability.
1. The Division shall issue the
certificate to operate an intermediary service organization to the applicant
if, after investigation, the Division finds that the:
(a) Applicant is in full compliance with the
provisions of NRS 449.4304 to 449.4339, inclusive; and
(b) Applicant is in substantial compliance with
the standards and regulations adopted by the Board.
2. A certificate applies only to the
person to whom it is issued and is not transferable.
(Added to NRS by 2013, 128)
NRS 449.4318 Form and contents of certificate. Each
certificate to operate an intermediary service organization issued by the
Division pursuant to NRS 449.4304 to 449.4339, inclusive, must be in the form prescribed
by the Division and must contain:
1. The name of the person or persons
authorized to operate the intermediary service organization;
2. The location of the intermediary
service organization; and
3. The services offered by the intermediary
service organization.
(Added to NRS by 2013, 128)
NRS 449.4319 Expiration and renewal of certificate.
1. Each certificate to operate an
intermediary service organization issued pursuant to NRS
449.4304 to 449.4339, inclusive, expires on
December 31 following its issuance and is renewable for 1 year upon
reapplication and payment of all fees required pursuant to NRS 449.4314 unless the Division finds, after an investigation,
that the intermediary service organization has not satisfactorily complied with
the provisions of NRS 449.4304 to 449.4339, inclusive, or the standards and regulations
adopted by the Board.
2. Each reapplication for an intermediary
service organization must include, without limitation, a statement that the
organization is in compliance with the provisions of NRS
449.4329 to 449.4332, inclusive.
(Added to NRS by 2013, 128)
NRS 449.432 Application for renewal of certificate: Information concerning
business license required; conditions which require denial.
1. In addition to any other requirements
set forth in NRS 449.4304 to 449.4339, inclusive, an applicant for the renewal of
a certificate as an intermediary service organization must indicate in the
application submitted to the Division whether the applicant has a state
business license. If the applicant has a state business license, the applicant
must include in the application the state business license number assigned by
the Secretary of State upon compliance with the provisions of chapter 76 of NRS.
2. A certificate as an intermediary
service organization may not be renewed by the Division if:
(a) The applicant fails to submit the information
required by subsection 1; or
(b) The State Controller has informed the
Division pursuant to subsection 5 of NRS
353C.1965 that the applicant owes a debt to an agency that has been
assigned to the State Controller for collection and the applicant has not:
(1) Satisfied the debt;
(2) Entered into an agreement for the
payment of the debt pursuant to NRS
353C.130; or
(3) Demonstrated that the debt is not
valid.
3. As used in this section:
(a) “Agency” has the meaning ascribed to it in NRS 353C.020.
(b) “Debt” has the meaning ascribed to it in NRS 353C.040.
(Added to NRS by 2013, 2730)
NRS 449.4321 Grounds for denial, suspension or revocation of certificate. The Division may deny an application for a
certificate to operate an intermediary service organization or may suspend or
revoke any certificate issued under the provisions of NRS
449.4304 to 449.4339, inclusive, upon any of
the following grounds:
1. Violation by the applicant or the
holder of a certificate of any of the provisions of NRS
449.4304 to 449.4339, inclusive, or of any
other law of this State or of the standards, rules and regulations adopted
thereunder.
2. Aiding, abetting or permitting the
commission of any illegal act.
3. Conduct inimical to the public health,
morals, welfare and safety of the people of the State of Nevada in the
operation of an intermediary service organization.
4. Conduct or practice detrimental to the
health or safety of a person under contract with or employees of the
intermediary service organization.
(Added to NRS by 2013, 128)
NRS 449.4322 Suspension of certificate for failure to pay child support or
comply with certain subpoenas or warrants; reinstatement of certificate.
[Effective until the date of the repeal of 42 U.S.C. § 666, the federal law
requiring each state to establish procedures for withholding, suspending and
restricting the professional, occupational and recreational licenses for child
support arrearages and for noncompliance with certain processes relating to
paternity or child support proceedings.]
1. If the Division receives a copy of a
court order issued pursuant to NRS 425.540
that provides for the suspension of all professional, occupational and
recreational licenses, certificates and permits issued to a person who is the
holder of a certificate to operate an intermediary service organization, the
Division shall deem the certificate issued to that person to be suspended at
the end of the 30th day after the date on which the court order was issued
unless the Division receives a letter issued to the holder of the certificate
by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the
certificate has complied with the subpoena or warrant or has satisfied the
arrearage pursuant to NRS 425.560.
2. The Division shall reinstate a
certificate to operate an intermediary service organization that has been
suspended by a district court pursuant to NRS
425.540 if the Division receives a letter issued by the district attorney
or other public agency pursuant to NRS
425.550 to the person whose certificate was suspended stating that the
person whose certificate was suspended has complied with the subpoena or
warrant or has satisfied the arrearage pursuant to NRS 425.560.
(Added to NRS by 2013, 128)
NRS 449.4324 Provisional certificate.
1. The Division may cancel a certificate
to operate an intermediary service organization and issue a provisional
certificate, effective for a period determined by the Division, to the
intermediary service organization if the intermediary service organization:
(a) Is in operation at the time of the adoption
of standards and regulations pursuant to the provisions of NRS 449.4304 to 449.4339,
inclusive, and the Division determines that the intermediary service
organization requires a reasonable time under the particular circumstances
within which to comply with the standards and regulations; or
(b) Has failed to comply with the standards or
regulations and the Division determines that the intermediary service
organization is in the process of making the necessary changes or has agreed to
make the changes within a reasonable time.
2. The provisions of subsection 1 do not
require the issuance of a certificate or prevent the Division from refusing to
renew or from revoking or suspending any certificate if the Division deems such
action necessary for the health and safety of a person for whom the
intermediary service organization provides services.
(Added to NRS by 2013, 129)
NRS 449.4325 Deposit of money received; expenses of Division to enforce
provisions.
1. Money received from the certification
of intermediary service organizations:
(a) Must be forwarded to the State Treasurer for
deposit in the State Treasury;
(b) Must be accounted for separately in the State
General Fund; and
(c) May only be used to carry out the provisions
of NRS 449.4304 to 449.4339,
inclusive.
2. The Division shall enforce the
provisions of NRS 449.4304 to 449.4339, inclusive, and may incur any necessary
expenses not in excess of money appropriated for that purpose by the State or
received from the Federal Government.
(Added to NRS by 2013, 129)
NRS 449.4327 Regulations; powers of Division.
1. The Board shall adopt regulations
governing the certification of intermediary service organizations and such
other regulations as it deems necessary to carry out the provisions of NRS 449.4304 to 449.4339,
inclusive.
2. The Division may:
(a) Upon receipt of an application for a
certificate to operate an intermediary service organization, conduct an
investigation into the qualifications of personnel, methods of operation and
policies and purposes of any person proposing to engage in the operation of an
intermediary service organization.
(b) Upon receipt of a complaint against an
intermediary service organization, except for a complaint concerning the cost
of services, conduct an investigation into the qualifications of personnel,
methods of operation and policies, procedures and records of that intermediary
service organization or any other intermediary service organization which may
have information pertinent to the complaint.
(c) Employ such professional, technical and
clerical assistance as it deems necessary to carry out the provisions of NRS 449.4304 to 449.4339,
inclusive.
(Added to NRS by 2013, 129)
Background Investigations
NRS 449.4329 Initial and periodic investigations of employee, employee of
temporary employment service or independent contractor; penalty.
1. Except as otherwise provided in
subsections 2 and 3, within 10 days after hiring an employee, accepting an
employee of a temporary employment service or entering into a contract with an
independent contractor, the holder of a certificate to operate an intermediary
service organization shall:
(a) Obtain a written statement from the employee,
employee of the temporary employment service or independent contractor stating
whether he or she has been convicted of any crime listed in subsection 1 of NRS 449.4332;
(b) Obtain an oral and written confirmation of
the information contained in the written statement obtained pursuant to
paragraph (a);
(c) Obtain proof that the employee, employee of
the temporary employment service or independent contractor holds any required
license, permit or certificate;
(d) Obtain from the employee, employee of the
temporary employment service or independent contractor one set of fingerprints
and a written authorization to forward the fingerprints to the Central
Repository for Nevada Records of Criminal History for submission to the Federal
Bureau of Investigation for its report;
(e) Submit to the Central Repository for Nevada
Records of Criminal History the fingerprints obtained pursuant to paragraph (d)
to obtain information on the background and personal history of each employee,
employee of a temporary employment service or independent contractor to
determine whether the person has been convicted of any crime listed in
subsection 1 of NRS 449.4332; and
(f) If an Internet website has been established
pursuant to NRS 439.942:
(1) Screen the employee, employee of the
temporary employment service or independent contractor using the Internet
website. Upon request of the Division, proof that the employee, temporary
employee or independent contractor was screened pursuant to this subparagraph
must be provided to the Division.
(2) Enter on the Internet website
information to be maintained on the website concerning the employee, employee
of the temporary employment service or independent contractor.
2. The holder of a certificate to operate
an intermediary service organization is not required to obtain the information
described in subsection 1 from an employee, employee of a temporary employment
service or independent contractor if his or her fingerprints have been
submitted to the Central Repository for Nevada Records of Criminal History for
submission to the Federal Bureau of Investigation for its report within the
immediately preceding 6 months and the report of the Federal Bureau of
Investigation indicated that the employee, employee of the temporary employment
service or independent contractor has not been convicted of any crime set forth
in subsection 1 of NRS 449.4332.
3. The holder of a certificate to operate
an intermediary service organization is not required to obtain the information
described in subsection 1, other than the information described in paragraph
(c) of subsection 1, from an employee, employee of a temporary employment
service or independent contractor if:
(a) The employee, employee of the temporary
employment service or independent contractor agrees to allow the holder of a
certificate to operate an intermediary service organization to receive notice
from the Central Repository for Nevada Records of Criminal History regarding
any conviction and subsequent conviction of the employee, employee of the
temporary employment service or independent contractor of a crime listed in
subsection 1 of NRS 449.4332;
(b) An agency, board or commission that regulates
an occupation or profession pursuant to title 54 of NRS or temporary employment
service has, within the immediately preceding 5 years, submitted the
fingerprints of the employee, employee of the temporary employment service or
independent contractor to the Central Repository for Nevada Records of Criminal
History for submission to the Federal Bureau of Investigation for its report;
and
(c) The report of the Federal Bureau of
Investigation indicated that the employee, employee of the temporary employment
service or independent contractor has not been convicted of any crime set forth
in subsection 1 of NRS 449.4332.
4. The holder of a certificate to operate
an intermediary service organization shall ensure that the information
concerning the background and personal history of each employee, employee of a
temporary employment service or independent contractor who works at or for the
intermediary service organization is investigated is completed as soon as
practicable and at least once every 5 years after the date of the initial
investigation. The holder of the certificate shall, when required:
(a) Obtain one set of fingerprints from the
employee, employee of the temporary employment service or independent
contractor;
(b) Obtain written authorization from the
employee, employee of the temporary employment service or independent
contractor to forward the fingerprints obtained pursuant to paragraph (a) to
the Central Repository for Nevada Records of Criminal History for submission to
the Federal Bureau of Investigation for its report; and
(c) Submit the fingerprints to the Central
Repository for Nevada Records of Criminal History or, if the fingerprints were
submitted electronically, obtain proof of electronic submission of the
fingerprints to the Central Repository for Nevada Records of Criminal History.
5. Upon receiving fingerprints submitted
pursuant to this section, the Central Repository for Nevada Records of Criminal
History shall determine whether the employee, employee of the temporary
employment service or independent contractor has been convicted of a crime
listed in subsection 1 of NRS 449.4332 and
immediately inform the Division and the holder of the certificate to operate an
intermediary service organization for which the person works whether the
employee, employee of the temporary employment service or independent
contractor has been convicted of such a crime.
6. The Central Repository for Nevada
Records of Criminal History may impose a fee upon an intermediary service
organization that submits fingerprints pursuant to this section for the
reasonable cost of the investigation. The intermediary service organization may
recover from the employee or independent contractor whose fingerprints are
submitted not more than one-half of the fee imposed by the Central Repository.
If the intermediary service organization requires the employee or independent
contractor to pay for any part of the fee imposed by the Central Repository, it
shall allow the employee or independent contractor to pay the amount through
periodic payments. The intermediary service organization may require a
temporary employment service which employs a temporary employee whose
fingerprints are submitted to pay the fee imposed by the Central Repository. An
intermediary service organization shall notify a temporary employment service
if a person employed by the temporary employment service is determined to be
ineligible to provide services to the intermediary service organization based
upon the results of an investigation conducted pursuant to this section.
7. Unless a greater penalty is provided by
law, a person who willfully provides a false statement or information in
connection with an investigation of the background and personal history of the
person pursuant to this section that would disqualify the person from
employment, including, without limitation, a conviction of a crime listed in
subsection 1 of NRS 449.4332, is guilty of a misdemeanor.
(Added to NRS by 2013, 131)
NRS 449.43295 Temporary employment service prohibited from sending ineligible
employee to organization; temporary employment service to provide certain
information regarding its employees.
1. A temporary employment service shall
not send an employee to provide services to an intermediary service
organization if the temporary employment service has received notice from a
holder of a certificate to operate an intermediary service organization that
the employee of the temporary employment service is ineligible to provide such
services.
2. A holder of a certificate to operate an
intermediary service organization who enters into an agreement with a temporary
employment service to provide services to the intermediary service organization
on a temporary basis must require the temporary employment service to:
(a) Provide proof that each employee of the
temporary employment service whom it may send to provide services to the
intermediary service organization has been continuously employed by the
temporary employment service since the last investigation conducted of the
employee pursuant to NRS 449.4329; and
(b) Notify the intermediary service organization
if the investigation conducted of an employee of the temporary employment
service pursuant to NRS 449.4329 has not been
conducted within the immediately preceding 5 years.
(Added to NRS by 2013, 2889)
NRS 449.433 Maintenance and availability of certain records regarding
employee, employee of temporary employment service or independent contractor of
organization.
1. Each intermediary service organization
shall maintain accurate records of the information concerning its employees,
employees of a temporary employment service and independent contractors
collected pursuant to NRS 449.4329, including,
without limitation:
(a) A copy of the fingerprints submitted to the
Central Repository for Nevada Records of Criminal History or proof of
electronic fingerprint submission and a copy of the written authorization that
was provided by the employee, employee of the temporary employment service or
independent contractor;
(b) Proof that the fingerprints of the employee,
employee of the temporary employment service or independent contractor were
submitted to the Central Repository; and
(c) Any other documentation of the information
collected pursuant to NRS 449.4329.
2. The records maintained pursuant to
subsection 1 must be:
(a) Maintained for the period of the employment
of the person with the intermediary service organization; and
(b) Made available for inspection by the Division
at any reasonable time, and copies thereof must be furnished to the Division
upon request.
3. If an Internet website has been
established pursuant to NRS 439.942, an
intermediary service organization shall maintain a current list of its
employees, employees of a temporary employment service and independent
contractors on the Internet website.
4. The Central Repository for Nevada
Records of Criminal History may maintain an electronic image of fingerprints
submitted pursuant to NRS 449.4329 to notify an
intermediary service organization and the Division of any subsequent conviction
of a person who is required to submit to an investigation pursuant to NRS 449.4329.
(Added to NRS by 2013, 132)
NRS 449.4331 Termination of employment or contract of employee, employee of
temporary employment service or independent contractor who has been convicted of
certain crime; period in which to correct information regarding conviction;
liability of organization.
1. Upon receiving information from the
Central Repository for Nevada Records of Criminal History pursuant to NRS 449.4329, or evidence from any other source, that
an employee, employee of a temporary employment service or independent
contractor of an intermediary service organization has been convicted of a
crime listed in subsection 1 of NRS 449.4332, the
holder of the certificate to operate the intermediary service organization
shall terminate the employment or contract of that person or notify the
temporary employment service that its employee is prohibited from providing
services for the intermediary service organization after allowing the person
time to correct the information as required pursuant to subsection 2.
2. If an employee, employee of a temporary
employment service or independent contractor believes that the information
provided by the Central Repository is incorrect, the employee, employee of the
temporary employment service or independent contractor may immediately inform
the intermediary service organization. The intermediary service organization
that is so informed shall give the employee, employee of the temporary
employment service or independent contractor a reasonable amount of time of not
less than 30 days to correct the information received from the Central
Repository before terminating the employment or contract of the person pursuant
to subsection 1.
3. An intermediary service organization
that has complied with NRS 449.4329 may not be
held civilly or criminally liable based solely upon the ground that the
intermediary service organization allowed an employee, employee of a temporary
employment service or independent contractor to work:
(a) Before it received the information concerning
the employee, employee of the temporary employment service or independent
contractor from the Central Repository;
(b) During the period required pursuant to
subsection 2 to allow the employee, employee of the temporary employment
service or independent contractor to correct that information;
(c) Based on the information received from the
Central Repository, if the information received from the Central Repository was
inaccurate; or
(d) Any combination thereof.
Ê An
intermediary service organization may be held liable for any other conduct
determined to be negligent or unlawful.
(Added to NRS by 2013, 132)
NRS 449.4332 Additional grounds for denial, suspension or revocation of
certificate. In addition to the
grounds listed in NRS 449.4321, the Division may
deny a certificate to operate an intermediary service organization to an
applicant or may suspend or revoke a certificate of a holder of a certificate
to operate an intermediary service organization if:
1. The applicant for or holder of the
certificate has been convicted of:
(a) Murder, voluntary manslaughter or mayhem;
(b) Assault with intent to kill or to commit
sexual assault or mayhem;
(c) Sexual assault, statutory sexual seduction,
incest, lewdness or indecent exposure, or any other sexually related crime that
is punished as a felony;
(d) Prostitution, solicitation, lewdness or
indecent exposure, or any other sexually related crime that is punished as a
misdemeanor, if the conviction occurred within the immediately preceding 7
years;
(e) Abuse or neglect of a child or contributory
delinquency;
(f) A violation of any federal or state law
regulating the possession, distribution or use of any controlled substance or
any dangerous drug as defined in chapter 454
of NRS, within the past 7 years;
(g) A violation of any provision of NRS 200.5099 or 200.50995;
(h) Any offense involving fraud, theft, embezzlement,
burglary, robbery, fraudulent conversion or misappropriation of property,
within the immediately preceding 7 years; or
(i) Any other felony involving the use of a
firearm or other deadly weapon, within the immediately preceding 7 years; or
2. The holder of a certificate has
continued to employ a person who has been convicted of a crime listed in
subsection 1.
(Added to NRS by 2013, 133)
Disciplinary Action; Enforcement
NRS 449.4335 Administrative sanctions: Imposition by Division; consequences
of failure to pay; use of money collected.
1. If an intermediary service organization
violates any provision related to its certification, including, without
limitation, any provision of NRS 449.4304 to 449.4339, inclusive, or any condition, standard or
regulation adopted by the Board, the Division, in accordance with the
regulations adopted pursuant to NRS 449.4336, may,
as it deems appropriate:
(a) Prohibit the intermediary service
organization from providing services pursuant to NRS
449.4308 until it determines that the intermediary service organization has
corrected the violation;
(b) Impose an administrative penalty of not more
than $1,000 per day for each violation, together with interest thereon at a
rate not to exceed 10 percent per annum; and
(c) Appoint temporary management to oversee the
operation of the intermediary service organization and to ensure the health and
safety of the persons for whom the intermediary service organization performs
services, until:
(1) It determines that the intermediary
service organization has corrected the violation and has management which is
capable of ensuring continued compliance with the applicable statutes,
conditions, standards and regulations; or
(2) Improvements are made to correct the
violation.
2. If the intermediary service
organization fails to pay any administrative penalty imposed pursuant to paragraph
(b) of subsection 1, the Division may:
(a) Suspend the certificate to operate an
intermediary service organization which is held by the intermediary service
organization until the administrative penalty is paid; and
(b) Collect court costs, reasonable attorney’s
fees and other costs incurred to collect the administrative penalty.
3. The Division may require any
intermediary service organization that violates any provision of NRS 449.4304 to 449.4339,
inclusive, or any condition, standard or regulation adopted by the Board, to
make any improvements necessary to correct the violation.
4. Any money collected as administrative
penalties pursuant to this section must be accounted for separately and used to
protect the health or property of the persons for whom the intermediary service
organization performs services in accordance with applicable federal standards.
(Added to NRS by 2013, 130)
NRS 449.4336 Administrative sanctions: Regulations. The
Board shall adopt regulations establishing the criteria for the imposition of
each sanction prescribed by NRS 449.4335. These
regulations must:
1. Prescribe the circumstances and manner
in which each sanction applies;
2. Minimize the time between
identification of a violation and the imposition of a sanction;
3. Provide for the imposition of
incrementally more severe sanctions for repeated or uncorrected violations; and
4. Provide for less severe sanctions for
lesser violations of applicable state statutes, conditions, standards or
regulations.
(Added to NRS by 2013, 130)
NRS 449.4337 Notice by Division of disciplinary action; exception; appeal.
1. When the Division intends to deny,
suspend or revoke a certificate to operate an intermediary service
organization, or to impose any sanction prescribed by NRS
449.4335, the Division shall give reasonable notice to the holder of the
certificate by certified mail. The notice must contain the legal authority,
jurisdiction and reasons for the action to be taken. Notice is not required if
the Division finds that the public health requires immediate action. In that
case, the Division may order a summary suspension of a certificate or impose
any sanction prescribed by NRS 449.4335, pending
proceedings for revocation or other action.
2. If a person wants to contest the action
of the Division, the person must file an appeal pursuant to regulations adopted
by the Board.
3. Upon receiving notice of an appeal, the
Division shall hold a hearing pursuant to regulations adopted by the Board.
4. The Board shall adopt such regulations
as are necessary to carry out the provisions of this section.
(Added to NRS by 2013, 131)
NRS 449.4338 Action to enjoin violations.
1. Except as otherwise provided in
subsection 2 of NRS 449.431, the Division may bring
an action in the name of the State to enjoin any person from operating or
maintaining an intermediary service organization within the meaning of NRS 449.4304 to 449.4339,
inclusive:
(a) Without first obtaining a certificate to
operate an intermediary service organization; or
(b) After the person’s certificate has been
revoked or suspended by the Division.
2. It is sufficient in such action to
allege that the defendant did, on a certain date and in a certain place,
operate and maintain the intermediary service organization without a
certificate.
(Added to NRS by 2013, 133)
NRS 449.4339 Prosecution by district attorney. The
district attorney of the county in which an intermediary service organization
operates shall, upon application by the Division, institute and conduct the
prosecution of any action for violation of any provision of NRS 449.4304 to 449.4339,
inclusive.
(Added to NRS by 2013, 134)
PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS
SEDATION AND DEEP SEDATION; NATIONAL ACCREDITATION; INSPECTIONS OF SURGICAL
CENTERS FOR AMBULATORY PATIENTS AND CERTAIN PHYSICIANS’ OFFICES AND FACILITIES
NRS 449.435 Definitions. As used
in NRS 449.435 to 449.448,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.436 to 449.439,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2009, 528)
NRS 449.436 “Conscious sedation” defined. “Conscious
sedation” means a minimally depressed level of consciousness, produced by a
pharmacologic or nonpharmacologic method, or a combination thereof, in which
the patient retains the ability independently and continuously to maintain an
airway and to respond appropriately to physical stimulation and verbal
commands.
(Added to NRS by 2009, 528)
NRS 449.437 “Deep sedation” defined. “Deep
sedation” means a controlled state of depressed consciousness, produced by a
pharmacologic or nonpharmacologic method, or a combination thereof, and
accompanied by a partial loss of protective reflexes and the inability to
respond purposefully to verbal commands.
(Added to NRS by 2009, 528)
NRS 449.438 “General anesthesia” defined. “General
anesthesia” means a controlled state of unconsciousness, produced by a
pharmacologic or nonpharmacologic method, or a combination thereof, and
accompanied by partial or complete loss of protective reflexes and the
inability independently to maintain an airway and respond purposefully to
physical stimulation or verbal commands.
(Added to NRS by 2009, 528)
NRS 449.439 “Physician” defined. “Physician”
means a person who is licensed to practice medicine pursuant to chapter 630 of NRS or osteopathic medicine
pursuant to chapter 633 of NRS.
(Added to NRS by 2009, 528)
NRS 449.441 Exemption from provisions if physician’s office or facility only
administers certain type of pain medication. The
provisions of NRS 449.435 to 449.448,
inclusive, do not apply to an office of a physician or a facility that provides
health care, other than a medical facility, if the office of a physician or the
facility only administers a medication to a patient to relieve the patient’s
anxiety or pain and if the medication is not given in a dosage that is
sufficient to induce in a patient a controlled state of depressed consciousness
or unconsciousness similar to general anesthesia, deep sedation or conscious
sedation.
(Added to NRS by 2009, 529)
NRS 449.442 Permit required for certain physicians’ offices and facilities
to offer services; national accreditation required; cessation of services for
failure to maintain accreditation.
1. An office of a physician or a facility
that provides health care, other than a medical facility, must obtain a permit
pursuant to NRS 449.443 before offering to a
patient a service of general anesthesia, conscious sedation or deep sedation.
An office of a physician or a facility that provides health care, other than a
medical facility, which operates at more than one location must obtain a permit
for each location where a service of general anesthesia, conscious sedation or
deep sedation is offered.
2. To offer to a patient a service of
general anesthesia, conscious sedation or deep sedation in this State, an
office of a physician or a facility that provides health care, other than a
medical facility, must maintain current accreditation by a nationally
recognized organization approved by the Board. Upon receiving an initial
permit, the office or facility shall, within 6 months after obtaining the
permit, submit proof to the Division of accreditation by such an organization.
3. If an office of a physician or a
facility that provides health care, other than a medical facility, fails to
maintain current accreditation or if the accreditation is revoked or is
otherwise no longer valid, the office or facility shall immediately cease
offering to patients a service of general anesthesia, conscious sedation or
deep sedation.
(Added to NRS by 2009, 529)
NRS 449.443 Application for permit; fee; inspection by Division; term of
permit.
1. An office of a physician or a facility
that provides health care, other than a medical facility, desiring a permit
pursuant to NRS 449.435 to 449.448,
inclusive, must submit to the Division, on a form prescribed by the Division
and accompanied by the appropriate fee, an application for a permit.
2. Before issuing a permit, the Division
shall conduct an on-site inspection pursuant to NRS
449.446 of each office of a physician or facility that applies for a
permit.
3. Upon receipt of an application and the
appropriate fee, the Division may, after conducting an inspection pursuant to NRS 449.446, issue a permit.
4. A permit expires 1 year after the date
of issuance and is renewable pursuant to NRS 449.444.
(Added to NRS by 2009, 529)
NRS 449.444 Application for renewal of permit; fee.
1. The holder of a permit issued pursuant
to NRS 449.443 may annually submit to the Division,
on a form prescribed by the Division and accompanied by the appropriate fee, an
application for renewal of the permit before the date on which the permit
expires. The application must include proof satisfactory to the Division that
the office or facility maintains current accreditation by a nationally
recognized organization approved by the Board.
2. Upon receipt of an application for
renewal and the accompanying fee, the Division may renew a permit.
(Added to NRS by 2009, 529)
NRS 449.445 National accreditation required of surgical center for
ambulatory patients; inspection by Division; cessation of operation for failure
to maintain accreditation.
1. To operate in this State, a surgical
center for ambulatory patients must maintain current accreditation by a
nationally recognized organization approved by the Board. Upon initial
licensure, a surgical center for ambulatory patients shall, within 6 months
after obtaining its license, submit proof to the Division of the accreditation
of the surgical center by such an organization.
2. Before issuing a license to a surgical
center for ambulatory patients, the Division shall conduct an on-site
inspection of the surgical center pursuant to NRS
449.446.
3. If a surgical center for ambulatory
patients fails to maintain current accreditation or if the accreditation is
revoked or is otherwise no longer valid, the surgical center shall immediately
cease to operate.
(Added to NRS by 2009, 529)
NRS 449.446 Annual inspections of holders of permits and surgical centers
for ambulatory patients; correction of deficiencies identified in inspections;
reporting of inspections to Legislature.
1. The Division shall conduct annual and
unannounced on-site inspections of each office of a physician or a facility
that provides health care, other than a medical facility, which holds a permit
issued pursuant to NRS 449.443 and each surgical
center for ambulatory patients which holds a license issued pursuant to this
chapter.
2. An inspection conducted pursuant to
this section must focus on the infection control practices and policies of the
surgical center for ambulatory patients, the office or the facility that is the
subject of the inspection. The Division may, as it deems necessary, conduct a
more comprehensive inspection of a surgical center, office or facility.
3. Upon completion of an inspection, the
Division shall:
(a) Compile a report of the inspection, including
each deficiency discovered during the inspection, if any; and
(b) Forward a copy of the report to the surgical
center for ambulatory patients, the office of the physician or the facility
where the inspection was conducted.
4. If a deficiency is indicated in the
report, the surgical center for ambulatory patients, the office of the
physician or the facility shall correct each deficiency indicated in the report
in the manner prescribed by the Board pursuant to NRS
449.448.
5. The Division shall annually prepare and
submit to the Legislative Committee on Health Care and the Legislative
Commission a report which includes:
(a) The number and frequency of inspections
conducted pursuant to this section;
(b) A summary of deficiencies or other
significant problems discovered while conducting inspections pursuant to this
section and the results of any follow-up inspections; and
(c) Any other information relating to the
inspections as deemed necessary by the Legislative Committee on Health Care or
the Legislative Commission.
(Added to NRS by 2009, 530)
NRS 449.447 Disciplinary action for certain violations or failure to correct
deficiency; notification to professional licensing board of violations;
administrative sanctions.
1. If an office of a physician or a
facility that provides health care, other than a medical facility, violates the
provisions of NRS 449.435 to 449.448,
inclusive, or the regulations adopted pursuant thereto, or fails to correct a
deficiency indicated in a report pursuant to NRS
449.446, the Division, in accordance with the regulations adopted pursuant
to NRS 449.448, may take any of the following
actions:
(a) Decline to issue or renew a permit;
(b) Suspend or revoke a permit; or
(c) Impose an administrative penalty of not more
than $1,000 per day for each violation, together with interest thereon at a
rate not to exceed 10 percent per annum.
2. The Division may review a report
submitted pursuant to NRS 630.30665
or 633.524 to determine whether an
office of a physician or a facility is in violation of the provisions of NRS 449.435 to 449.448,
inclusive, or the regulations adopted pursuant thereto. If the Division
determines that such a violation has occurred, the Division shall immediately
notify the appropriate professional licensing board of the physician.
3. If a surgical center for ambulatory
patients violates the provisions of NRS 449.435 to 449.448, inclusive, or the regulations adopted
pursuant thereto, or fails to correct a deficiency indicated in a report
pursuant to NRS 449.446, the Division may impose
administrative sanctions pursuant to NRS 449.163.
(Added to NRS by 2009, 530)
NRS 449.448 Regulations.
1. The Board shall adopt regulations to
carry out the provisions of NRS 449.435 to 449.448, inclusive, including, without limitation,
regulations which:
(a) Prescribe the amount of the fee required for
applications for the issuance and renewal of a permit pursuant to NRS 449.443 and 449.444.
(b) Prescribe the procedures and standards for
the issuance and renewal of a permit.
(c) Identify the nationally recognized
organizations approved by the Board for the purposes of the accreditation
required for the issuance of a:
(1) License to operate a surgical center
for ambulatory patients.
(2) Permit for an office of a physician or
a facility that provides health care, other than a medical facility, to offer
to a patient a service of general anesthesia, conscious sedation or deep
sedation.
(d) Prescribe the procedures and scope of the inspections
conducted by the Division pursuant to NRS 449.446.
(e) Prescribe the procedures and time frame for
correcting each deficiency indicated in a report pursuant to NRS 449.446.
(f) Prescribe the criteria for the imposition of
each sanction prescribed by NRS 449.447, including,
without limitation:
(1) Setting forth the circumstances and
manner in which a sanction applies;
(2) Minimizing the time between the
identification of a violation and the imposition of a sanction; and
(3) Providing for the imposition of
incrementally more severe sanctions for repeated or uncorrected violations.
2. The regulations adopted pursuant to
this section must require that the practices and policies of each holder of a
permit to offer to a patient a service of general anesthesia, conscious
sedation or deep sedation and each holder of a license to operate a surgical
center for ambulatory patients provide adequately for the protection of the
health, safety and well-being of patients.
(Added to NRS by 2009, 531)
ACCOUNTING; FINANCIAL REPORTS; FEES; ENSURING QUALITY OF
CARE
NRS 449.450 Definitions. As
used in NRS 449.450 to 449.530,
inclusive, unless the context otherwise requires:
1. “Admitted health insurer” means an
insurer authorized to transact health insurance in this State under a
certificate of authority issued by the Commissioner of Insurance.
2. “Department” means the Department of
Health and Human Services.
3. “Director” means the Director of the
Department.
4. “Institution” means any person, place,
building or agency which maintains and operates facilities for the diagnosis,
care and treatment of human illness and provides beds for inpatient care. The
term includes but is not limited to hospitals, convalescent care facilities,
nursing care facilities, detoxification centers and all specialized medical
health care facilities.
(Added to NRS by 1975, 702; A 1979, 887; 1983, 1127; 1985, 1362; 1989, 1800; 1991, 2114)
NRS 449.460 Powers of Director. The
Director may:
1. Adopt regulations respecting the
exercise of the powers conferred by NRS 449.450 to 449.530, inclusive.
2. Hold public hearings, conduct
investigations and require the filing of information relating to any matter
affecting the cost of services in all institutions subject to the provisions of
NRS 449.450 to 449.530,
inclusive, and may subpoena witnesses, financial papers, records and documents
in connection therewith. An order requiring the filing of information or a
subpoena issued pursuant to this subsection must state the purpose for which it
is issued. The Director may also administer oaths in any hearing or
investigation.
3. Exercise, subject to the limitations
and restrictions imposed in NRS 449.450 to 449.530, inclusive, all other powers which are
reasonably necessary to carry out the expressed objects of those sections.
4. Delegate to any of the divisions of the
Department the authority to carry out the provisions of NRS
449.450 to 449.530, inclusive.
(Added to NRS by 1975, 702; A 1985, 1363; 1991, 2114; 1997, 2527)
NRS 449.465 Authority of Director to impose fees; maximum amount of fees
collected; fee for support of Legislative Committee on Health Care.
1. The Director may, by regulation, impose
fees upon admitted health insurers to cover the costs of carrying out the
provisions of NRS 449.450 to 449.530,
inclusive. The maximum amount of fees collected must not exceed the amount
authorized by the Legislature in each biennial budget.
2. The Director shall impose a fee of $50
each year upon admitted health insurers for the support of the Legislative
Committee on Health Care. The fee imposed pursuant to this subsection is in
addition to any fee imposed pursuant to subsection 1. The fee collected for the
support of the Legislative Committee on Health Care must be deposited in the
Legislative Fund.
(Added to NRS by 1983, 1126; A 1985, 1363; 1987, 877)
NRS 449.470 Director may use staff or contract for services. In carrying out the duties prescribed by NRS 449.450 to 449.530,
inclusive, the Director may utilize his or her own staff or may contract with
any appropriate, independent and qualified organization. Such a contractor
shall not release or publish or otherwise use any information made available to
it under its contractual responsibility unless permission is specifically
granted by the Director.
(Added to NRS by 1975, 703; A 1985, 1363)
NRS 449.476 Committee to ensure quality of care: Formation by hospital;
general requirements.
1. Each hospital licensed to operate in
this state shall form a committee to ensure the quality of care provided by the
hospital. The committee must be composed of, but is not limited to, physicians
and nurses.
2. Each committee formed pursuant to
subsection 1 must meet the requirements for programs or plans for ensuring the
quality of care specified by the Joint Commission on Accreditation of
Healthcare Organizations or by the Federal Government pursuant to Title XIX of
the Social Security Act (42 U.S.C. §§ 1396 et seq.).
(Added to NRS by 1989, 1799)
NRS 449.485 Hospital required to use discharge form prescribed by Director;
electronic monthly reporting; exception to electronic reporting; use of
information by Department.
1. Each hospital in this State shall use
for all patients discharged a form prescribed by the Director and shall include
in the form all information required by the Department. Any form prescribed by
the Director must be a form that is commonly used nationwide by hospitals, if
applicable, and comply with federal laws and regulations.
2. Each hospital in this State shall, on a
monthly basis, report to the Department the information required to be included
in the form for each patient. The information reported must be complete,
accurate and timely.
3. Each insurance company or other payer
shall accept the form as the bill for services provided by hospitals in this
State.
4. Except as otherwise provided in
subsection 5, each hospital in this State shall provide the information
required pursuant to subsection 2 in an electronic form specified by the
Department.
5. The Director may exempt a hospital from
the requirements of subsection 4 if requiring the hospital to comply with the
requirements would cause the hospital financial hardship.
6. The Department shall use the
information submitted pursuant to this section for the program established
pursuant to NRS 439A.220 to increase
public awareness of health care information concerning the hospitals in this
State.
(Added to NRS by 1987, 875; A 2005, 1736; 2007, 661, 2355)
NRS 449.490 Financial statements and reports required to be filed with
Department; additional reporting requirements for hospitals with 100 or more
beds; availability of complete current charge master.
1. Every institution which is subject to
the provisions of NRS 449.450 to 449.530, inclusive, shall file with the Department the
following financial statements or reports in a form and at intervals specified
by the Director but at least annually:
(a) A balance sheet detailing the assets,
liabilities and net worth of the institution for its fiscal year; and
(b) A statement of income and expenses for the
fiscal year.
2. Each hospital with 100 or more beds
shall file with the Department, in a form and at intervals specified by the
Director but at least annually, a capital improvement report which includes,
without limitation, any major service line that the hospital has added or is in
the process of adding since the previous report was filed, any major expansion
of the existing facilities of the hospital that has been completed or is in the
process of being completed since the previous report was filed, and any major
piece of equipment that the hospital has acquired or is in the process of
acquiring since the previous report was filed.
3. In addition to the information required
to be filed pursuant to subsections 1 and 2, each hospital with 100 or more
beds shall file with the Department, in a form and at intervals specified by
the Director but at least annually:
(a) The expenses that the hospital has incurred
for providing community benefits and the in-kind services that the hospital has
provided to the community in which it is located. These expenses must be
reported as the total amount expended for community benefits and in-kind
services and reported as a percentage of the total net revenues of the
hospital. For the purposes of this paragraph, “community benefits” includes, without
limitation, goods, services and resources provided by a hospital to a community
to address the specific needs and concerns of that community, services provided
by a hospital to the uninsured and underserved persons in that community,
training programs for employees in a community and health care services
provided in areas of a community that have a critical shortage of such
services, for which the hospital does not receive full reimbursement.
(b) A statement of its policies and procedures
for providing discounted services to, or reducing charges for services provided
to, persons without health insurance that are in addition to any reduction or
discount required to be provided pursuant to NRS 439B.260.
(c) A list of the services which the hospital
purchased from its corporate home office.
(d) A report of the cost to the hospital of
providing services to patients covered by Medicare.
(e) Financial information from the consolidated
corporation, if the hospital is owned by such a corporation and if that
information is publicly available, including, without limitation, the annual
report of the consolidated corporation.
(f) A statement of its policies regarding
patients’ account receivables, including, without limitation, the manner in
which a hospital collects or makes payment arrangements for patients’ account
receivables, the factors that initiate collections and the method by which
unpaid account receivables are collected.
4. A complete current charge master must
be available at each hospital during normal business hours for review by the
Director, any payor that has a contract with the hospital to pay for services
provided by the hospital, any payor that has received a bill from the hospital
and any state agency that is authorized to review such information. The
complete and current charge master must be made available to the Department, at
the request of the Director, in an electronic format specified by the
Department. The Department may use the electronic copy of the charge master to
review and analyze the data contained in the charge master and, except as
otherwise provided in NRS 439A.200 to
439A.290, inclusive, shall not
release or publish the information contained in the charge master.
5. The Director shall require the
certification of specified financial reports by an independent certified public
accountant and may require attestations from responsible officers of the
institution that the reports are, to the best of their knowledge and belief,
accurate and complete to the extent that the certifications and attestations
are not required by federal law.
6. The Director shall require:
(a) The filing of all reports by specified dates,
and may adopt regulations which assess penalties for failure to file as
required; and
(b) The submission of a final annual report not
later than 6 months after the close of the fiscal year,
Ê and may
grant extensions to institutions which can show that the required information
is not available on the required reporting date.
7. All reports, except privileged medical
information, filed under any provisions of NRS 449.450
to 449.530, inclusive:
(a) Are open to public inspection;
(b) Must be in a form which is readily
understandable by a member of the general public;
(c) Must, as soon as practicable after those
reports become available, be posted on the Internet website maintained pursuant
to NRS 439A.270; and
(d) Must be available for examination at the
office of the Department during regular business hours.
(Added to NRS by 1975, 702; A 1985, 1364; 1987, 877; 2005, 1737; 2007, 2355; 2011, 967)
NRS 449.500 Director to carry out analyses and studies concerning cost of
health care. The Director shall
engage in or carry out analyses and studies relating to the cost of health care
in Nevada and other states, the financial status of any institution subject to
the provisions of NRS 449.450 to 449.530, inclusive, and any other appropriate related
matters, and the Director may publish and disseminate any information relating
to the financial aspects of health care as the Director deems desirable in the
public interest and in accordance with the provisions of NRS
449.450 to 449.530, inclusive. The Director
shall further require the filing of information concerning the total financial
needs of each institution and the resources available or expected to become
available to meet such needs, including but not limited to the effect of
proposals made by comprehensive areawide and state health planning agencies. The
information must be divided into at least the following components of an
institution’s expenses:
1. Operating expenses related to patient
care.
2. Expenses incurred for rendering
services to patients for whom payment is not made in full including, but not
limited to, the separate expenses for contractual allowances imposed by federal
or state law, charity care and uncollectible accounts.
3. All incurred interest charges on
indebtedness for both capital and operating needs.
4. Costs of education, both primary and
continuing.
5. Expenses for research related to
patient care.
6. Depreciation expenses of both property
and equipment.
7. Amortization of incurred capital and
operating related indebtedness.
8. Requirements for capital expenditures
for replacement, modernization, renovation and expansion of services and
facilities.
9. Requirements for necessary working
capital, including but not limited to operating cash, patients’ accounts
receivable and inventories.
10. Federal, state and local taxes not
ordinarily considered operating expenses where applicable.
11. Operating surpluses necessary for a
fair return to their owners equal to returns on investments in industries of
comparable risk, or for the purpose of assuring continuity of operation and
prudent management.
(Added to NRS by 1975, 703; A 1985, 1364)
NRS 449.510 Director to prepare and file summaries, compilations or other
reports; public inspection; collection, maintenance, disclosure or publication
of contracts or identification of party to contract prohibited.
1. The Director shall prepare and file
such summaries, compilations or other supplementary reports based on the
information filed with the Director pursuant to NRS
449.450 to 449.530, inclusive, as will advance
the purposes of those sections. All such summaries, compilations and reports
are open to public inspection, must be made available to requesting agencies
and must be prepared within a reasonable time following the end of each
institution’s fiscal year or more frequently as specified by the Director.
2. The Director shall not collect,
maintain, disclose, report or publish the details of contracts entered into by
a hospital, or collect, maintain, disclose, report or publish information
pursuant to this section in a manner that would allow identification of an
individual payer or other party to a contract with the hospital, except that
the Director may disclose to other state agencies the details of contracts
between the hospital and a related entity. A state agency shall not collect,
maintain, disclose, report or publish information disclosed to the agency by
the Director pursuant to this subsection in a manner that would allow
identification of an individual payer or other party to a contract with the hospital.
The Director may review any such contracts at the hospital or at a location
specified by the hospital.
3. As used in this section, “related
entity” means an affiliated person or subsidiary as those terms are defined in NRS 439B.430.
(Added to NRS by 1975, 704; A 1985, 1365; 1991, 2333; 1993, 619; 1997, 2527)
NRS 449.520 Reports to Governor and legislative committees; development of
comprehensive plan by Legislative Committee on Health Care.
1. On or before October 1 of each year,
the Director shall prepare and transmit to the Governor, the Legislative
Committee on Health Care and the Interim Finance Committee a report of the
Department’s operations and activities for the preceding fiscal year.
2. The report prepared pursuant to
subsection 1 must include:
(a) Copies of all reports, summaries,
compilations and supplementary reports required by NRS
449.450 to 449.530, inclusive, together with
such facts, suggestions and policy recommendations as the Director deems
necessary;
(b) A summary of the trends of the audits of hospitals
in this State that the Department required or performed during the previous
year;
(c) An analysis of the trends in the costs,
expenses and profits of hospitals in this State;
(d) An analysis of the methodologies used to
determine the corporate home office allocation of hospitals in this State;
(e) An examination and analysis of the manner in
which hospitals are reporting the information that is required to be filed
pursuant to NRS 449.490, including, without
limitation, an examination and analysis of whether that information is being
reported in a standard and consistent manner, which fairly reflect the
operations of each hospital;
(f) A review and comparison of the policies and
procedures used by hospitals in this State to provide discounted services to,
and to reduce charges for services provided to, persons without health
insurance;
(g) A review and comparison of the policies and
procedures used by hospitals in this State to collect unpaid charges for
services provided by the hospitals; and
(h) A summary of the status of the programs
established pursuant to NRS 439A.220
and 439A.240 to increase public
awareness of health care information concerning the hospitals and surgical
centers for ambulatory patients in this State, including, without limitation,
the information that was posted in the preceding fiscal year on the Internet
website maintained for those programs pursuant to NRS 439A.270.
3. The Legislative Committee on Health
Care shall develop a comprehensive plan concerning the provision of health care
in this State which includes, without limitation:
(a) A review of the health care needs in this
State as identified by state agencies, local governments, providers of health
care and the general public; and
(b) A review of the capital improvement reports
submitted by hospitals pursuant to subsection 2 of NRS
449.490.
(Added to NRS by 1975, 704; A 1983, 1127; 1985, 1365; 2005, 1738; 2007, 2357; 2011, 969)
NRS 449.530 Administrative fine for violation. The
Director may impose upon the institutions subject to supervision under NRS 449.450 to 449.530,
inclusive, an administrative fine not exceeding $500 per day for each violation
of any of the provisions of NRS 449.450 to 449.530, inclusive.
(Added to NRS by 1975, 704; A 1985, 1365)
WITHHOLDING OR WITHDRAWAL OF LIFE-SUSTAINING TREATMENT
NRS 449.535 Short title; uniformity of application and construction.
1. NRS 449.535
to 449.690, inclusive, may be cited as the Uniform
Act on Rights of the Terminally Ill.
2. NRS 449.535
to 449.690, inclusive, must be applied and
construed to effectuate its general purpose to make uniform the law with
respect to the subject of those sections among states enacting the Uniform Act
on Rights of the Terminally Ill.
(Added to NRS by 1991, 629)
NRS 449.540 Definitions. As
used in NRS 449.535 to 449.690,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.550 to 449.590,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 1977, 759; A 1991, 632)
NRS 449.550 “Attending physician” defined. “Attending
physician” means the physician who has primary responsibility for the treatment
and care of the patient.
(Added to NRS by 1977, 759; A 1991, 632)
NRS 449.560 “Declaration” defined. “Declaration”
means a writing executed in accordance with the requirements of NRS 449.600.
(Added to NRS by 1977, 759; A 1991, 632)
NRS 449.570 “Life-sustaining treatment” defined. “Life-sustaining
treatment” means a medical procedure or intervention that, when administered to
a patient, serves only to prolong the process of dying.
(Added to NRS by 1977, 759; A 1991, 633)
NRS 449.575 “Person” defined. “Person”
includes a government or a governmental subdivision or agency.
(Added to NRS by 1991, 629)
NRS 449.581 “Provider of health care” defined. “Provider
of health care” means a person who is licensed, certified or otherwise
authorized by the law of this state to administer health care in the ordinary
course of business or practice of a profession.
(Added to NRS by 1991, 629)
NRS 449.585 “Qualified patient” defined. “Qualified
patient” means a patient 18 or more years of age who has executed a declaration
and who has been determined by the attending physician to be in a terminal
condition.
(Added to NRS by 1991, 629)
NRS 449.590 “Terminal condition” defined. “Terminal
condition” means an incurable and irreversible condition that, without the
administration of life-sustaining treatment, will, in the opinion of the
attending physician, result in death within a relatively short time.
(Added to NRS by 1977, 759; A 1991, 633)
NRS 449.600 Declaration relating to use of life-sustaining treatment.
1. A person of sound mind and 18 or more
years of age may execute at any time a declaration governing the withholding or
withdrawal of life-sustaining treatment. The declarant may designate another
natural person of sound mind and 18 or more years of age to make decisions
governing the withholding or withdrawal of life-sustaining treatment. The
declaration must be signed by the declarant, or another at the declarant’s
direction, and attested by two witnesses.
2. A physician or other provider of health
care who is furnished a copy of the declaration shall make it a part of the
declarant’s medical record and, if unwilling to comply with the declaration,
promptly so advise the declarant and any person designated to act for the
declarant.
(Added to NRS by 1977, 759; A 1985, 1747; 1991, 633)
NRS 449.610 Form of declaration directing physician to withhold or withdraw
life-sustaining treatment. A
declaration directing a physician to withhold or withdraw life-sustaining
treatment may, but need not, be in the following form:
DECLARATION
If I should have an incurable and
irreversible condition that, without the administration of life-sustaining
treatment, will, in the opinion of my attending physician, cause my death
within a relatively short time, and I am no longer able to make decisions
regarding my medical treatment, I direct my attending physician, pursuant to NRS 449.535 to 449.690,
inclusive, to withhold or withdraw treatment that only prolongs the process of
dying and is not necessary for my comfort or to alleviate pain.
If you wish to include this
statement in this declaration, you must INITIAL the statement in the box
provided:
Withholding or withdrawal of
artificial nutrition and hydration may result in death by starvation or
dehydration. Initial this box if you want to receive or continue receiving
artificial nutrition and hydration by way of the gastrointestinal tract after
all other treatment is withheld pursuant to this declaration.
[............................................ ]
Signed this ........………...... day of
..…..........., ......
Signature..........................................................
Address.............................................................
The declarant voluntarily signed
this writing in my presence.
Witness.............................................................
Address.............................................................
Witness.............................................................
Address.............................................................
(Added to NRS by 1977, 760; A 1991, 633; 1993, 2790)
NRS 449.613 Form of declaration designating another person to decide to
withhold or withdraw life-sustaining treatment.
1. A declaration that designates another
person to make decisions governing the withholding or withdrawal of
life-sustaining treatment may, but need not, be in the following form:
DECLARATION
If I should have an incurable and
irreversible condition that, without the administration of life-sustaining
treatment, will, in the opinion of my attending physician, cause my death
within a relatively short time, and I am no longer able to make decisions
regarding my medical treatment, I appoint ............................... or,
if he or she is not reasonably available or is unwilling to serve,
.............................., to make decisions on my behalf regarding
withholding or withdrawal of treatment that only prolongs the process of dying
and is not necessary for my comfort or to alleviate pain, pursuant to NRS 449.535 to 449.690,
inclusive. (If the person or persons I have so appointed are not reasonably
available or are unwilling to serve, I direct my attending physician, pursuant
to those sections, to withhold or withdraw treatment that only prolongs the
process of dying and is not necessary for my comfort or to alleviate pain.)
Strike language in parentheses if
you do not desire it.
If you wish to include this
statement in this declaration, you must INITIAL the statement in the box
provided:
Withholding or withdrawal of
artificial nutrition and hydration may result in death by starvation or
dehydration. Initial this box if you want to receive or continue receiving
artificial nutrition and hydration by way of the gastrointestinal tract after
all other treatment is withheld pursuant to this declaration.
[............................................ ]
Signed this ........………...... day of
..…..........., ......
Signature..........................................................
Address.............................................................
The declarant voluntarily signed this
writing in my presence.
Witness.............................................................
Address.............................................................
Witness.............................................................
Address.............................................................
Name and address of each designee.
Name................................................................
Address.............................................................
2. The designation of an agent pursuant to
chapter 162A of NRS, or the judicial
appointment of a guardian, who is authorized to make decisions regarding the
withholding or withdrawal of life-sustaining treatment, constitutes for the
purpose of NRS 449.535 to 449.690,
inclusive, a declaration designating another person to act for the declarant
pursuant to subsection 1.
(Added to NRS by 1991, 630; A 1993, 2791; 2009, 209)
NRS 449.617 Time declaration becomes operative; duty of providers of health
care. A declaration becomes
operative when it is communicated to the attending physician and the declarant
is determined by the attending physician to be in a terminal condition and no
longer able to make decisions regarding administration of life-sustaining
treatment. When the declaration becomes operative, the attending physician and
other providers of health care shall act in accordance with its provisions and
with the instructions of a person designated pursuant to NRS
449.600 or comply with the requirements of NRS
449.628 to transfer care of the declarant.
(Added to NRS by 1991, 631)
NRS 449.620 Revocation of declaration; entry of revocation in medical
records of declarant.
1. A declarant may revoke a declaration at
any time and in any manner, without regard to his or her mental or physical
condition. A revocation is effective upon its communication to the attending
physician or other provider of health care by the declarant or a witness to the
revocation.
2. The attending physician or other
provider of health care shall make the revocation a part of the declarant’s
medical record.
(Added to NRS by 1977, 760; A 1987, 1309; 1991, 635)
NRS 449.622 Recording determination of terminal condition and declaration. Upon determining that a declarant is in a
terminal condition, the attending physician who knows of a declaration shall
record the determination, and the terms of the declaration if not already a
part of the record, in the declarant’s medical record.
(Added to NRS by 1991, 631)
NRS 449.624 Treatment of qualified patients; withholding or withdrawal of
artificial nutrition and hydration; treatment of pregnant patient.
1. A qualified patient may make decisions
regarding life-sustaining treatment so long as the patient is able to do so.
2. NRS 449.535
to 449.690, inclusive, do not affect the
responsibility of the attending physician or other provider of health care to
provide treatment for a patient’s comfort or alleviation of pain.
3. Artificial nutrition and hydration by
way of the gastrointestinal tract shall be deemed a life-sustaining treatment
and must be withheld or withdrawn from a qualified patient unless a different
desire is expressed in writing by the patient. For a patient who has no
effective declaration, artificial nutrition and hydration must not be withheld
unless a different desire is expressed in writing by the patient’s authorized
representative or the family member with the authority to consent or withhold
consent.
4. Life-sustaining treatment must not be
withheld or withdrawn pursuant to a declaration from a qualified patient known
to the attending physician to be pregnant so long as it is probable that the
fetus will develop to the point of live birth with continued application of
life-sustaining treatment.
(Added to NRS by 1991, 631)
NRS 449.626 Written consent to withhold or withdraw life-sustaining
treatment.
1. If written consent to the withholding
or withdrawal of the treatment, attested by two witnesses, is given to the
attending physician, the attending physician may withhold or withdraw
life-sustaining treatment from a patient who:
(a) Has been determined by the attending
physician to be in a terminal condition and no longer able to make decisions
regarding administration of life-sustaining treatment; and
(b) Has no effective declaration.
2. The authority to consent or to withhold
consent under subsection 1 may be exercised by the following persons, in order
of priority:
(a) The spouse of the patient;
(b) An adult child of the patient or, if there is
more than one adult child, a majority of the adult children who are reasonably
available for consultation;
(c) The parents of the patient;
(d) An adult sibling of the patient or, if there
is more than one adult sibling, a majority of the adult siblings who are reasonably
available for consultation; or
(e) The nearest other adult relative of the
patient by blood or adoption who is reasonably available for consultation.
3. If a class entitled to decide whether
to consent is not reasonably available for consultation and competent to
decide, or declines to decide, the next class is authorized to decide, but an
equal division in a class does not authorize the next class to decide.
4. A decision to grant or withhold consent
must be made in good faith. A consent is not valid if it conflicts with the
expressed intention of the patient.
5. A decision of the attending physician
acting in good faith that a consent is valid or invalid is conclusive.
6. Life-sustaining treatment must not be
withheld or withdrawn pursuant to this section from a patient known to the
attending physician to be pregnant so long as it is probable that the fetus
will develop to the point of live birth with continued application of
life-sustaining treatment.
(Added to NRS by 1991, 631)
NRS 449.628 Transfer of care of declarant. An
attending physician or other provider of health care who is unwilling to comply
with NRS 449.535 to 449.690,
inclusive, shall take all reasonable steps as promptly as practicable to
transfer care of the declarant to another physician or provider of health care.
(Added to NRS by 1991, 632)
NRS 449.630 Immunity from civil and criminal liability and discipline for
unprofessional conduct.
1. A physician or other provider of health
care is not subject to civil or criminal liability, or discipline for
unprofessional conduct, for giving effect to a declaration or the direction of
a person designated pursuant to NRS 449.600 in the
absence of knowledge of the revocation of a declaration, or for giving effect
to a written consent under NRS 449.626.
2. A physician or other provider of health
care, whose action pursuant to NRS 449.535 to 449.690, inclusive, is in accord with reasonable
medical standards, is not subject to civil or criminal liability, or discipline
for unprofessional conduct, with respect to that action.
3. A physician or other provider of health
care, whose decision about the validity of consent under NRS
449.626 is made in good faith, is not subject to civil or criminal
liability, or discipline for unprofessional conduct, with respect to that
decision.
4. A person designated pursuant to NRS 449.600 or a person authorized to consent pursuant
to NRS 449.626, whose decision is made or consent
is given in good faith pursuant to NRS 449.535 to 449.690, inclusive, is not subject to civil or
criminal liability, or discipline for unprofessional conduct, with respect to
that decision.
(Added to NRS by 1977, 760; A 1985, 1747; 1991, 635)
NRS 449.640 Consideration of declaration and other factors; failure to
follow directions of patient.
1. If a patient in a terminal condition
has a declaration in effect and becomes comatose or is otherwise rendered
incapable of communicating with his or her attending physician, the physician
must give weight to the declaration as evidence of the patient’s directions
regarding the application of life-sustaining treatments, but the attending
physician may also consider other factors in determining whether the
circumstances warrant following the directions.
2. No hospital or other medical facility,
physician or person working under the direction of a physician is subject to
criminal or civil liability for failure to follow the directions of the patient
to withhold or withdraw life-sustaining treatments.
(Added to NRS by 1977, 761; A 1985, 1747; 1993, 2792)
NRS 449.645 Assumption of validity of declaration; presumption of intent to
use, withhold or withdraw life-sustaining treatment not created.
1. Unless he or she has knowledge to the
contrary, a physician or other provider of health care may assume that a
declaration complies with NRS 449.535 to 449.690, inclusive, and is valid.
2. NRS 449.535
to 449.690, inclusive, create no presumption
concerning the intention of a person who has revoked or has not executed a
declaration with respect to the use, withholding or withdrawal of
life-sustaining treatment in the event of a terminal condition.
(Added to NRS by 1991, 632)
NRS 449.650 Death does not constitute suicide or homicide; effect of
declaration on policy of insurance; prohibiting or requiring execution of
declaration prohibited as condition for insurance or receipt of health care.
1. Death resulting from the withholding or
withdrawal of life-sustaining treatment in accordance with NRS 449.535 to 449.690,
inclusive, does not constitute, for any purpose, a suicide or homicide.
2. The making of a declaration pursuant to
NRS 449.600 does not affect the sale, procurement
or issuance of a policy of life insurance or annuity, nor does it affect,
impair or modify the terms of an existing policy of life insurance or annuity.
A policy of life insurance or annuity is not legally impaired or invalidated by
the withholding or withdrawal of life-sustaining treatment from an insured,
notwithstanding any term to the contrary.
3. A person may not prohibit or require
the execution of a declaration as a condition for being insured for, or
receiving, health care.
(Added to NRS by 1977, 761; A 1991, 636)
NRS 449.660 Penalties.
1. A physician or other provider of health
care who willfully fails to transfer the care of a patient in accordance with NRS 449.628 is guilty of a gross misdemeanor.
2. A physician who willfully fails to
record a determination of terminal condition or the terms of a declaration in
accordance with NRS 449.622 is guilty of a misdemeanor.
3. A person who willfully conceals,
cancels, defaces or obliterates the declaration of another without the
declarant’s consent or who falsifies or forges a revocation of the declaration
of another is guilty of a misdemeanor.
4. A person who falsifies or forges the
declaration of another, or willfully conceals or withholds personal knowledge
of a revocation, with the intent to cause a withholding or withdrawal of
life-sustaining treatment contrary to the wishes of the declarant and thereby
directly causes life-sustaining treatment to be withheld or withdrawn and death
to be hastened is guilty of murder.
5. A person who requires or prohibits the
execution of a declaration as a condition of being insured for, or receiving,
health care is guilty of a misdemeanor.
6. A person who coerces or fraudulently
induces another to execute a declaration, or who falsifies or forges the
declaration of another except as provided in subsection 4, is guilty of a gross
misdemeanor.
7. The penalties provided in this section
do not displace any sanction applicable under other law.
(Added to NRS by 1977, 761; A 1991, 636)
NRS 449.670 Actions contrary to reasonable medical standards not required;
mercy-killing, assisted suicide or euthanasia not authorized.
1. NRS 449.535
to 449.690, inclusive, do not require a physician
or other provider of health care to take action contrary to reasonable medical
standards.
2. NRS 449.535
to 449.690, inclusive, do not condone, authorize or
approve mercy-killing, assisted suicide or euthanasia.
(Added to NRS by 1977, 761; A 1991, 637; 1995, 1794)
NRS 449.680 Other right or responsibility regarding use of life-sustaining
treatment or withholding or withdrawal of medical care not limited. NRS 449.535 to 449.690, inclusive, do not affect the right of a
patient to make decisions regarding use of life-sustaining treatment, so long
as the patient is able to do so, or impair or supersede a right or
responsibility that any person has to effect the withholding or withdrawal of
medical care.
(Added to NRS by 1977, 761; A 1991, 637)
NRS 449.690 Validity of declaration executed in another state; effect of
previously executed instrument.
1. A declaration executed in another state
in compliance with the law of that state or of this State is valid for purposes
of NRS 449.535 to 449.690,
inclusive.
2. An instrument executed anywhere before
July 1, 1977, which clearly expresses the intent of the declarant to direct the
withholding or withdrawal of life-sustaining treatment from the declarant when
the declarant is in a terminal condition and becomes comatose or is otherwise
rendered incapable of communicating with his or her attending physician, if
executed in a manner which attests voluntary execution, or executed anywhere
before October 1, 1991, which substantially complies with NRS 449.600, and has not been subsequently revoked, is
effective under NRS 449.535 to 449.690, inclusive.
3. As used in this section, “state”
includes the District of Columbia, the Commonwealth of Puerto Rico, and a
territory or insular possession subject to the jurisdiction of the United
States.
(Added to NRS by 1977, 761; A 1991, 637)
PHYSICIAN ORDERS FOR LIFE-SUSTAINING TREATMENT
NRS 449.691 Definitions. As
used in NRS 449.691 to 449.697,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.6912 to 449.6934,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2013, 2284)
NRS 449.6912 “Attending physician” defined. “Attending
physician” has the meaning ascribed to it in NRS
449.550.
(Added to NRS by 2013, 2284)
NRS 449.6915 “Do-not-resuscitate identification” defined. “Do-not-resuscitate identification” has the
meaning ascribed to it in NRS 450B.410.
(Added to NRS by 2013, 2284)
NRS 449.6916 “Do-not-resuscitate order” defined. “Do-not-resuscitate
order” has the meaning ascribed to it in NRS
450B.420.
(Added to NRS by 2013, 2284)
NRS 449.6918 “Emergency care” defined. “Emergency
care” means the use of life-resuscitating treatment and other immediate
treatment provided in response to a sudden, acute and unanticipated medical
emergency in order to avoid injury, impairment or death.
(Added to NRS by 2013, 2284)
NRS 449.692 “Health care facility” defined. “Health
care facility” has the meaning ascribed to it in NRS 162A.740.
(Added to NRS by 2013, 2284)
NRS 449.6922 “Incompetent” defined. “Incompetent”
has the meaning ascribed to it in NRS
159.019.
(Added to NRS by 2013, 2284)
NRS 449.6924 “Life-resuscitating treatment” defined. “Life-resuscitating
treatment” has the meaning ascribed to it in NRS 450B.450.
(Added to NRS by 2013, 2284)
NRS 449.6925 “Life-sustaining treatment” defined. “Life-sustaining
treatment” has the meaning ascribed to it in NRS
449.570.
(Added to NRS by 2013, 2284)
NRS 449.6928 “Other types of advance directives” defined. “Other types of advance directives” means an
advance directive as defined in NRS 449.905, but
does not include a POLST form.
(Added to NRS by 2013, 2284)
NRS 449.693 “Physician Order for Life-Sustaining Treatment form” or “POLST
form” defined. “Physician Order
for Life-Sustaining Treatment form” or “POLST form” means the form prescribed
pursuant to NRS 449.694 that:
1. Records the wishes of the patient; and
2. Directs a provider of health care
regarding the provision of life-resuscitating treatment and life-sustaining
treatment.
(Added to NRS by 2013, 2284)
NRS 449.6932 “Provider of health care” defined. “Provider
of health care” means an individual who is licensed, certified or otherwise
authorized or allowed by law to provide health care in the ordinary course of
business or practice of a profession, and includes a person who:
1. Is described in NRS 629.031; or
2. Administers emergency medical services
as defined in NRS 450B.460.
(Added to NRS by 2013, 2284)
NRS 449.6934 “Representative of the patient” defined. “Representative of the patient” means a legal
guardian of the patient, a person designated by the patient to make decisions
governing the withholding or withdrawal of life-sustaining treatment pursuant
to NRS 449.600 or a person given power of attorney
to make decisions concerning health care for the patient pursuant to NRS 162A.700 to 162A.860, inclusive.
(Added to NRS by 2013, 2285)
NRS 449.694 Board required to prescribe standardized POLST form;
requirements. The Board shall
prescribe a standardized Physician Order for Life-Sustaining Treatment form,
commonly known as a POLST form, which:
1. Is uniquely identifiable and has a
uniform color;
2. Provides a means by which to indicate
whether the patient has made an anatomical gift pursuant to NRS 451.500 to 451.598, inclusive;
3. Gives direction to a provider of health
care or health care facility regarding the use of emergency care and
life-sustaining treatment;
4. Is intended to be honored by any
provider of health care who treats the patient in any health-care setting,
including, without limitation, the patient’s residence, a health care facility
or the scene of a medical emergency; and
5. Includes such other features and
information as the Board may deem advisable.
(Added to NRS by 2013, 2285)
NRS 449.6942 Physician required to explain POLST form under certain
circumstances and to complete POLST form upon request of patient; validity.
1. A physician shall take the actions
described in subsection 2:
(a) If the physician diagnoses a patient with a
terminal condition;
(b) If the physician determines, for any reason,
that a patient has a life expectancy of less than 5 years; or
(c) At the request of a patient.
2. Upon the occurrence of any of the
events specified in subsection 1, the physician shall explain to the patient:
(a) The existence and availability of the Physician
Order for Life-Sustaining Treatment form;
(b) The features of and procedures offered by way
of the POLST form; and
(c) The differences between a POLST form and the
other types of advance directives.
3. Upon the request of the patient, the
physician shall complete the POLST form based on the preferences and medical
indications of the patient.
4. A POLST form is valid upon execution by
a physician and:
(a) If the patient is 18 years of age or older
and of sound mind, the patient;
(b) If the patient is 18 years of age or older
and incompetent, the representative of the patient; or
(c) If the patient is less than 18 years of age,
the patient and a parent or legal guardian of the patient.
5. As used in this section, “terminal
condition” has the meaning ascribed to it in NRS
449.590.
(Added to NRS by 2013, 2285)
NRS 449.6944 Revocation of POLST form; entry of revocation in medical records
of patient.
1. A Physician Order for Life-Sustaining
Treatment form may be revoked at any time and in any manner by:
(a) The patient who executed it, if competent,
without regard to his or her age or physical condition;
(b) If the patient is incompetent, the
representative of the patient; or
(c) If the patient is less than 18 years of age,
a parent or legal guardian of the patient.
2. The revocation of a POLST form is
effective upon the communication to a provider of health care, by the patient
or a witness to the revocation, of the desire to revoke the form. The provider
of health care to whom the revocation is communicated shall:
(a) Make the revocation a part of the medical
record of the patient; or
(b) Cause the revocation to be made a part of the
medical record of the patient.
(Added to NRS by 2013, 2285)
NRS 449.6946 Conflict with other advance directive or do-not-resuscitate
identification.
1. If a valid Physician Order for
Life-Sustaining Treatment form sets forth a declaration, direction or order
which conflicts with a declaration, direction or order set forth in one or more
of the other types of advance directives:
(a) The declaration, direction or order set forth
in the document executed most recently is valid; and
(b) Any other declarations, directions or orders
that do not conflict with a declaration, direction or order set forth in
another document referenced in this subsection remain valid.
2. If a valid POLST form sets forth a
declaration, direction or order to provide life-resuscitating treatment to a
patient who also possesses a do-not-resuscitate identification, a provider of
health care shall not provide life-resuscitating treatment if the
do-not-resuscitate identification is on the person of the patient when the need
for life-resuscitating treatment arises.
(Added to NRS by 2013, 2286)
NRS 449.6948 Immunity from civil and criminal liability and discipline for unprofessional
conduct.
1. A provider of health care is not guilty
of unprofessional conduct or subject to civil or criminal liability if:
(a) The provider of health care withholds
emergency care or life-sustaining treatment:
(1) In compliance with a Physician Order
for Life-Sustaining Treatment form and the provisions of NRS
449.691 to 449.697, inclusive; or
(2) In violation of a Physician Order for
Life-Sustaining Treatment form if the provider of health care is acting in
accordance with a declaration, direction or order set forth in one or more of
the other types of advance directives and:
(I) Complies with the provisions of NRS 449.695; or
(II) Reasonably and in good faith,
at the time the emergency care or life-sustaining treatment is withheld, is
unaware of the existence of the POLST form or believes that the POLST form has
been revoked pursuant to NRS 449.6944; or
(b) The provider of health care provides
emergency care or life-sustaining treatment:
(1) Pursuant to an oral or written request
made by the patient, the representative of the patient, or a parent or legal
guardian of the patient, who may revoke the POLST form pursuant to NRS 449.6944;
(2) Pursuant to an observation that the
patient, the representative of the patient or a parent or legal guardian of the
patient has revoked, or otherwise indicated that he or she wishes to revoke,
the POLST form pursuant to NRS 449.6944; or
(3) In violation of a POLST form, if the
provider of health care reasonably and in good faith, at the time the emergency
care or life-sustaining treatment is provided, is unaware of the existence of
the POLST form or believes that the POLST form has been revoked pursuant to NRS 449.6944.
2. A health care facility, ambulance
service, fire-fighting agency or other entity that employs a provider of health
care is not guilty of unprofessional conduct or subject to civil or criminal
liability for the acts or omissions of the employee carried out in accordance
with the provisions of subsection 1.
(Added to NRS by 2013, 2286)
NRS 449.695 Provider of health care required to comply with valid POLST
form; modification by physician; transfer of care of patient; exceptions.
1. Except as otherwise provided in this
section and NRS 449.6946, a provider of health
care shall comply with a valid Physician Order for Life-Sustaining Treatment
form, regardless of whether the provider of health care is employed by a health
care facility or other entity affiliated with the physician who executed the
POLST form.
2. A physician may medically evaluate the
patient and, based upon the evaluation, may recommend new orders consistent
with the most current information available about the patient’s health status
and goals of care. Before making a modification to a valid POLST form, the
physician shall consult the patient or, if the patient is incompetent, shall
make a reasonable attempt to consult the representative of the patient and the
patient’s attending physician.
3. Except as otherwise provided in
subsection 4, a provider of health care who is unwilling or unable to comply
with a valid POLST form shall take all reasonable measures to transfer the
patient to a physician or health care facility so that the POLST form will be
followed.
4. Life-sustaining treatment must not be
withheld or withdrawn pursuant to a POLST form of a patient known to the
attending physician to be pregnant, so long as it is probable that the fetus
will develop to the point of live birth with the continued application of
life-sustaining treatment.
5. Nothing in this section requires a
provider of health care to comply with a valid POLST form if the provider of
health care does not have actual knowledge of the existence of the form.
(Added to NRS by 2013, 2287)
NRS 449.6952 Assumption of validity of POLST form; presumption of intent of
patient not created if patient has revoked or not executed POLST form.
1. Unless he or she has knowledge to the
contrary, a provider of health care may assume that a Physician Order for
Life-Sustaining Treatment form complies with the provisions of NRS 449.691 to 449.697,
inclusive, and is valid.
2. The provisions of NRS 449.691 to 449.697,
inclusive, do not create a presumption concerning the intention of a:
(a) Patient if the patient, the representative of
the patient or a parent or legal guardian of the patient has revoked the POLST
form pursuant to NRS 449.6944; or
(b) Person who has not executed a POLST form,
Ê concerning
the use or withholding of emergency care or life-sustaining treatment.
(Added to NRS by 2013, 2287)
NRS 449.6954 Death does not constitute suicide or homicide; effect of POLST
form on policy of insurance; prohibiting or requiring execution of POLST form
prohibited as condition for insurance or receipt of health care.
1. Death that results when emergency care
or life-sustaining treatment has been withheld pursuant to a Physician Order
for Life-Sustaining Treatment form and in accordance with the provisions of NRS 449.691 to 449.697,
inclusive, does not constitute a suicide or homicide.
2. The execution of a POLST form does not
affect the sale, procurement or issuance of a policy of life insurance or an
annuity, nor does it affect, impair or modify the terms of an existing policy
of life insurance or an annuity. A policy of life insurance or an annuity is
not legally impaired or invalidated if emergency care or life-sustaining
treatment has been withheld from an insured who has executed a POLST form,
notwithstanding any term in the policy or annuity to the contrary.
3. A person may not prohibit or require
the execution of a POLST form as a condition of being insured for, or
receiving, health care.
(Added to NRS by 2013, 2287)
NRS 449.6956 Unlawful acts; penalty.
1. It is unlawful for:
(a) A provider of health care to willfully fail
to transfer the care of a patient in accordance with subsection 3 of NRS 449.695.
(b) A person to willfully conceal, cancel, deface
or obliterate a Physician Order for Life-Sustaining Treatment form without the
consent of the patient who executed the form.
(c) A person to falsify or forge the POLST form
of another person, or willfully conceal or withhold personal knowledge of the
revocation of the POLST form of another person, with the intent to cause the
withholding or withdrawal of emergency care or life-sustaining treatment
contrary to the wishes of the patient.
(d) A person to require or prohibit the execution
of a POLST form as a condition of being insured for, or receiving, health care
in violation of subsection 3 of NRS 449.6954.
(e) A person to coerce or fraudulently induce
another to execute a POLST form.
2. A person who violates any of the
provisions of this section is guilty of a misdemeanor.
(Added to NRS by 2013, 2288)
NRS 449.6958 Actions contrary to reasonable medical standards not required;
mercy-killing, euthanasia or assisted suicide not authorized; rights associated
with other advance directives not impaired; right to make decisions concerning
emergency care or life-sustaining treatment not affected. The provisions of NRS
449.691 to 449.697, inclusive, do not:
1. Require a provider of health care to
take any action contrary to reasonable medical standards;
2. Affect the responsibility of a provider
of health care to provide treatment for a patient’s comfort or alleviation of
pain;
3. Condone, authorize or approve mercy
killing, euthanasia or assisted suicide;
4. Except as otherwise provided in NRS 449.6946, affect or impair any right created
pursuant to the provisions of any other types of advance directives; or
5. Affect the right of a patient to make
decisions concerning the use of emergency care or life-sustaining treatment, if
he or she is able to do so.
(Added to NRS by 2013, 2288)
NRS 449.696 Validity of POLST form executed in another state.
1. A Physician Order for Life-Sustaining
Treatment form executed in another state in compliance with the laws of that
state or this State is valid for the purposes of NRS
449.691 to 449.697, inclusive.
2. As used in this section, “state”
includes the District of Columbia, the Commonwealth of Puerto Rico and a
territory or insular possession subject to the jurisdiction of the United
States.
(Added to NRS by 2013, 2288)
NRS 449.697 Regulations. The
Board may adopt such regulations as it determines to be necessary or advisable
to carry out the provisions of NRS 449.691 to 449.697, inclusive.
(Added to NRS by 2013, 2288)
PATIENT’S RIGHTS
NRS 449.700 Facility to provide necessary services or arrange for transfer
of patient; explanation of need for transfer and alternatives available.
1. Every medical facility and facility for
the dependent must provide the services necessary to treat properly a patient
in a particular case or must be able to arrange the transfer of the patient to
another facility which can provide that care.
2. A patient may be transferred to another
facility only if the patient has received an explanation of the need to
transfer the patient and the alternatives available, unless the condition of
the patient necessitates an immediate transfer to a facility for a higher level
of care and the patient is unable to understand the explanation.
(Added to NRS by 1983, 820; A 1985, 1747; 1999, 1051; 2011, 360)
NRS 449.705 Facility to forward medical records upon certain transfers of
patient.
1. If a patient in a medical facility or
facility for the dependent is transferred to another medical facility or
facility for the dependent, a division facility or a physician licensed to
practice medicine, the facility shall forward a copy of the medical records of
the patient, on or before the date the patient is transferred, to the other
medical facility or facility for the dependent, the division facility or the
physician. The facility is not required to obtain the oral or written consent
of the patient to forward a copy of the medical records.
2. As used in this section:
(a) “Division facility” means any unit or subunit
operated by a division of the Department of Health and Human Services pursuant
to title 39 of NRS.
(b) “Medical records” includes a medical history
of the patient, a summary of the current physical condition of the patient and
a discharge summary which contains the information necessary for the proper
treatment of the patient.
(Added to NRS by 1991, 2349; A 1993, 2725; 1999, 1051; 2011, 360)
NRS 449.710 Specific rights: Information concerning facility; treatment;
billing; visitation. Every patient
of a medical facility or facility for the dependent has the right to:
1. Receive information concerning any
other medical or educational facility or facility for the dependent associated
with the facility at which he or she is a patient which relates to the care of
the patient.
2. Obtain information concerning the
professional qualifications or associations of the persons who are treating the
patient.
3. Receive the name of the person
responsible for coordinating the care of the patient in the facility.
4. Be advised if the facility in which he
or she is a patient proposes to perform experiments on patients which affect
the patient’s own care or treatment.
5. Receive from his or her physician a
complete and current description of the patient’s diagnosis, plan for treatment
and prognosis in terms which the patient is able to understand. If it is not
medically advisable to give this information to the patient, the physician
shall:
(a) Provide the information to an appropriate
person responsible for the patient; and
(b) Inform that person that he or she shall not
disclose the information to the patient.
6. Receive from his or her physician the
information necessary for the patient to give his or her informed consent to a
procedure or treatment. Except in an emergency, this information must not be
limited to a specific procedure or treatment and must include:
(a) A description of the significant medical
risks involved;
(b) Any information on alternatives to the
treatment or procedure if the patient requests that information;
(c) The name of the person responsible for the
procedure or treatment; and
(d) The costs likely to be incurred for the
treatment or procedure and any alternative treatment or procedure.
7. Examine the bill for his or her care
and receive an explanation of the bill, whether or not the patient is
personally responsible for payment of the bill.
8. Know the regulations of the facility
concerning his or her conduct at the facility.
9. Receive, within reasonable restrictions
as to time and place, visitors of the patient’s choosing, including, without
limitation, friends and members of the patient’s family.
(Added to NRS by 1983, 820; A 1985, 906, 1748; 1999, 1052; 2001, 3047; 2011, 360)
NRS 449.715 Specific rights: Designation of persons authorized to visit
patient in facility.
1. If, as a result of the incapacitation
of a patient or the inability of a patient to communicate, the patient of a
medical facility or facility for the dependent who is 18 years of age or older
is unable to inform the staff of the facility of the persons whom the patient
authorizes to visit the patient at the facility, the facility shall allow
visitation rights to any person designated by the patient in a letter, form or
other document authorizing visitation executed in accordance with subsection 2.
The visitation rights required by this subsection must be:
(a) Provided in accordance with the visitation
policies of the facility; and
(b) The same visitation rights that are provided
to a member of the patient’s family who is legally related to the patient.
2. A person 18 years of age or older
wishing to designate a person for the purposes of establishing visitation
rights in a medical facility or facility for the dependent may execute a
letter, form or other document authorizing visitation in substantially the
following form:
(Date)..................................
I,
..............................., (patient who is designating another person as
having visitation rights of the patient) do hereby designate
.................................. (person who is being designated as having
visitation rights of the patient) as having the right to visit me in a medical
facility or facility for the dependent. I hereby instruct all staff of a
medical facility or facility for the dependent in which I am a patient to admit
...................................... (person who is being designated as
having visitation rights of the patient) to my room and afford him or her the
same visitation rights as are provided to members of my family who are legally
related to me during my time as a patient.
........................................................
(Signed)
(Added to NRS by 2003, 1879; A 2011, 361)
NRS 449.720 Specific rights: Care; refusal of treatment and experimentation;
privacy; notice of appointments and need for care; confidentiality of
information concerning patient.
1. Every patient of a medical facility or
facility for the dependent has the right to:
(a) Receive considerate and respectful care.
(b) Refuse treatment to the extent permitted by
law and to be informed of the consequences of that refusal.
(c) Refuse to participate in any medical
experiments conducted at the facility.
(d) Retain his or her privacy concerning the
patient’s program of medical care.
(e) Have any reasonable request for services
reasonably satisfied by the facility considering its ability to do so.
(f) Receive continuous care from the facility.
The patient must be informed:
(1) Of the patient’s appointments for
treatment and the names of the persons available at the facility for those
treatments; and
(2) By his or her physician or an
authorized representative of the physician, of the patient’s need for
continuing care.
2. Except as otherwise provided in NRS 108.640, 239.0115, 439.538, 442.300 to 442.330, inclusive, and 449.705 and chapter 629
of NRS, discussions of the care of a patient, consultation with other persons
concerning the patient, examinations or treatments, and all communications and
records concerning the patient are confidential. The patient must consent to
the presence of any person who is not directly involved with the patient’s care
during any examination, consultation or treatment.
(Added to NRS by 1983, 821; A 1985, 1748; 1989, 2057; 1991, 2350; 1999, 1052, 3512; 2007, 1979, 2110; 2011, 362)
NRS 449.725 Owner and administrator of certain facility prohibited from
receiving money or property by will of resident or former resident or from life
insurance proceeds of resident or former resident; exception.
1. Except as otherwise provided in subsection
3 and notwithstanding any other provision of law, an owner or administrator of
a medical facility or facility for the dependent is not entitled to receive,
and must not receive:
(a) Any money, personal property or real property
that is devised or bequeathed by will to the owner or administrator by a
resident or former resident of the facility.
(b) Any proceeds from a life insurance policy
upon the life or body of a resident or former resident of the facility.
2. Except as otherwise provided in subsection
3, any money, property, proceeds or interest therein that is described in
subsection 1 passes in accordance with law as if the owner or administrator of
the medical facility or facility for the dependent had predeceased the decedent
resident or former resident.
3. The provisions of subsections 1 and 2
do not apply if the owner or administrator of the medical facility or facility
for the dependent is the spouse, legal guardian or next of kin of the resident
or former resident of the facility or home, as applicable.
(Added to NRS by 2011, 696)
NRS 449.730 Patient to be informed of rights upon admission to facility;
required disclosures and notices.
1. Every medical facility and facility for
the dependent shall inform each patient or the patient’s legal representative,
upon the admission of the patient to the facility, of the patient’s rights as
listed in NRS 449.700, 449.710,
449.715, 449.720 and 449.725.
2. In addition to the requirements of
subsection 1, if a person with a disability is a patient at a facility, as that
term is defined in NRS 449.771, the facility shall
inform the patient of his or her rights pursuant to NRS
449.765 to 449.786, inclusive.
3. In addition to the requirements of
subsections 1 and 2, every hospital shall, upon the admission of a patient to
the hospital, provide to the patient or the patient’s legal representative a
written disclosure approved by the Director of the Department of Health and
Human Services, which written disclosure must set forth:
(a) Notice of the existence of the Bureau for
Hospital Patients created pursuant to NRS
223.575;
(b) The address and telephone number of the
Bureau; and
(c) An explanation of the services provided by
the Bureau, including, without limitation, the services for dispute resolution
described in subsection 3 of NRS 223.575.
4. In addition to the requirements of
subsections 1, 2 and 3, every hospital shall, upon the discharge of a patient
from the hospital, provide to the patient or the patient’s legal representative
a written disclosure approved by the Director, which written disclosure must
set forth:
(a) If the hospital is a major hospital:
(1) Notice of the reduction or discount
available pursuant to NRS 439B.260,
including, without limitation, notice of the criteria a patient must satisfy to
qualify for a reduction or discount under that section; and
(2) Notice of any policies and procedures
the hospital may have adopted to reduce charges for services provided to
persons or to provide discounted services to persons, which policies and
procedures are in addition to any reduction or discount required to be provided
pursuant to NRS 439B.260. The notice
required by this subparagraph must describe the criteria a patient must satisfy
to qualify for the additional reduction or discount, including, without
limitation, any relevant limitations on income and any relevant requirements as
to the period within which the patient must arrange to make payment.
(b) If the hospital is not a major hospital,
notice of any policies and procedures the hospital may have adopted to reduce
charges for services provided to persons or to provide discounted services to
persons. The notice required by this paragraph must describe the criteria a
patient must satisfy to qualify for the reduction or discount, including,
without limitation, any relevant limitations on income and any relevant
requirements as to the period within which the patient must arrange to make
payment.
Ê As used in
this subsection, “major hospital” has the meaning ascribed to it in NRS 439B.115.
5. In addition to the requirements of
subsections 1 to 4, inclusive, every hospital shall post in a conspicuous place
in each public waiting room in the hospital a legible sign or notice in
14-point type or larger, which sign or notice must:
(a) Provide a brief description of any policies
and procedures the hospital may have adopted to reduce charges for services
provided to persons or to provide discounted services to persons, including,
without limitation:
(1) Instructions for receiving additional
information regarding such policies and procedures; and
(2) Instructions for arranging to make
payment;
(b) Be written in language that is easy to
understand; and
(c) Be written in English and Spanish.
(Added to NRS by 1983, 822; A 1985, 1749; 1999, 1053, 3252; 2003, 1880; 2005, 947; 2011, 362, 697)
NRS 449.740 Procedure to insert implant in breast of patient: Informed
consent required; withdrawal of consent; penalty.
1. A physician shall not perform any
procedure to insert an implant in the breast of a patient unless within 5 days
before the procedure is performed the physician has:
(a) Discussed with the patient and any other
person whose consent is required pursuant to paragraph (b), the advantages,
disadvantages and risks associated with the procedure; and
(b) Obtained informed consent in writing from the
following persons freely and without coercion:
(1) The patient if he or she is 18 years
of age or over or legally emancipated and competent to give that consent, and
from the patient’s legal guardian, if any;
(2) The parent or guardian of a patient
under 18 years of age and not legally emancipated; or
(3) The legal guardian of a patient of any
age who has been adjudicated mentally incompetent,
Ê and the
required consent was not withdrawn pursuant to subsection 3 before the
procedure began.
2. An informed consent requires that the
person whose consent is sought be adequately informed as to:
(a) The nature and consequences of the procedure;
(b) The reasonable risks, possible side effects,
benefits and purposes of the procedure; and
(c) Any alternative procedures available.
3. The consent of a patient or other
person whose consent is required pursuant to paragraph (b) of subsection 1 may
be withdrawn in writing at any time before the procedure has begun, with or
without cause.
4. A physician satisfies the requirements
of:
(a) Paragraph (a) of subsection 1 if the
physician provides the patient and any other person whose consent is required
pursuant to paragraph (b) of subsection 1 with a copy of the current
explanation form prepared by the Division pursuant to NRS
449.750 in a language that the person is able to read.
(b) Paragraph (b) of subsection 1 if the person
or persons whose consent is required sign a copy of the current consent form
prepared by the Division pursuant to NRS 449.750
freely and without coercion and the consent is not withdrawn pursuant to
subsection 3 before the procedure has begun. The consent form must be in a
language that the person who signs the form is able to read.
5. Any person who violates the provisions
of this section is guilty of a misdemeanor.
(Added to NRS by 1991, 1690)
NRS 449.750 Procedure to insert implant in breast of patient: Contents of
explanation form and consent form; fee for forms.
1. The Division shall prepare and provide
to physicians upon request:
(a) An explanation form for a procedure to insert
an implant in the breast of a person which includes:
(1) An explanation of the advantages,
disadvantages and risks associated with a procedure to insert an implant in the
breast of a person, including any known side effects; and
(2) Any other information the Division
determines to be useful to a person contemplating a procedure to insert an
implant in the breast; and
(b) A consent form for a procedure to insert an
implant in the breast of a person which includes:
(1) The nature and consequences of the
procedure;
(2) The reasonable risks, possible side
effects, benefits and purposes of the procedure; and
(3) Any alternative procedures available.
2. The Division shall revise the
explanation form and consent form as necessary to keep the medical information
current.
3. The Division shall charge and collect a
fee for all forms distributed pursuant to this section that is adequate to
cover the cost of producing the forms.
(Added to NRS by 1991, 1690)
COLLECTION OF AMOUNT OWED TO HOSPITAL FOR HOSPITAL CARE
NRS 449.751 Definitions. As used
in NRS 449.751 to 449.759,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.753 and 449.755
have the meanings ascribed to them in those sections.
(Added to NRS by 2007, 1497; A 2011, 1524)
NRS 449.753 “Hospital care” defined. “Hospital
care” has the meaning ascribed to it in NRS
428.155.
(Added to NRS by 2007, 1497)
NRS 449.755 “Responsible party” defined. “Responsible
party” means the person who received the hospital care, the parent or guardian
of the person who received the hospital care or another natural person who is
legally responsible or has agreed to be responsible for the payment to the
hospital of any charges incurred in connection with the hospital care.
(Added to NRS by 2007, 1497)
NRS 449.757 Limitations on efforts of hospitals to collect; date for accrual
of interest; rate of interest; limitations on additional fees.
1. When a person receives hospital care,
the hospital must not proceed with any efforts to collect on any amount owed to
the hospital for the hospital care from the responsible party, other than for
any copayment or deductible, if the responsible party has health insurance or
may be eligible for Medicaid, the Children’s Health Insurance Program or any
other public program which may pay all or part of the bill, until the hospital
has submitted a bill to the health insurance company or public program and the
health insurance company or public program has made a determination concerning
payment of the claim.
2. Collection efforts may begin and
interest may begin to accrue on any amount owed to the hospital for hospital
care which remains unpaid by the responsible party not sooner than 30 days
after the responsible party is sent a bill by mail stating the amount that he
or she is responsible to pay which has been established after receiving a
determination concerning payment of the claim by any insurer or public program
and after applying any discounts. Interest must accrue at a rate which does not
exceed the prime rate at the largest bank in Nevada as ascertained by the
Commissioner of Financial Institutions on January 1 or July 1, as the case may
be, immediately preceding the date on which the payment becomes due, plus 2
percent. The rate must be adjusted accordingly on each January 1 and July 1
thereafter until the payment is satisfied.
3. Except for the interest authorized
pursuant to subsection 2 and any court costs and attorney’s fees awarded by a
court, no other fees may be charged concerning the amount that remains unpaid,
including, without limitation, collection fees, other attorney’s fees or any
other fees or costs.
(Added to NRS by 2007, 1497; A 2011, 1525)
NRS 449.758 Limitations on efforts of hospital to collect when hospital has
contractual agreement with third party that provides health coverage for care
provided; exception.
1. Except as otherwise provided in
subsection 2, if a hospital provides hospital care to a person who has a policy
of health insurance issued by a third party that provides health coverage for
care provided at that hospital and the hospital has a contractual agreement
with the third party, the hospital shall proceed with any efforts to collect on
any amount owed to the hospital for the hospital care in accordance with the
provisions of NRS 449.757 and shall not collect or
attempt to collect that amount from:
(a) Any proceeds or potential proceeds of a civil
action brought by or on behalf of the patient, including, without limitation,
any amount awarded for medical expenses; or
(b) An insurer other than a health insurer,
including, without limitation, an insurer that provides coverage under a policy
of casualty or property insurance.
2. This section does not apply to:
(a) Amounts owed to the hospital under the policy
of health insurance that are not collectible; or
(b) Medicaid, the Children’s Health Insurance
Program or any other public program which may pay all or part of the bill.
3. This section does not limit any rights
of a patient to contest an attempt to collect an amount owed to a hospital,
including, without limitation, contesting a lien obtained by a hospital.
4. As used in this section, “third party”
has the meaning ascribed to it in NRS
439B.260.
(Added to NRS by 2011, 1524)
NRS 449.759 Manner of collection. A
hospital, or any person acting on its behalf who seeks to collect a debt from a
responsible party for any amount owed to the hospital for hospital care must
collect the debt in a professional, fair and lawful manner. When collecting
such a debt, the hospital or other person acting on its behalf must act in
accordance with sections 803 to 812, inclusive, of the federal Fair Debt
Collection Practices Act, as amended, 15 U.S.C. §§ 1692a to 1692j, inclusive,
even if the hospital or person acting on its behalf is not otherwise subject to
the provisions of that Act.
(Added to NRS by 2007, 1498)
PREVENTING PERSONS FROM ENTERING OR EXITING HEALTH FACILITY
NRS 449.760 Unlawful acts; exception; penalty.
1. Except as otherwise provided in this
section, a person shall not intentionally prevent another person from entering
or exiting the office of a physician, a health facility, a nonprofit health
facility, a public health center, a medical facility or a facility for the
dependent by physically:
(a) Detaining the other person; or
(b) Obstructing, impeding or hindering the other
person’s movement.
2. The provisions of subsection 1 are
inapplicable to:
(a) An officer, employee or agent of the
physician, health facility, nonprofit health facility, public health center,
medical facility or facility for the dependent; or
(b) A peace officer as defined in NRS 169.125,
Ê while acting
within the course and scope of his or her duties or employment.
3. The provisions of subsection 1 do not
prohibit a person from maintaining a picket during a strike or work stoppage in
compliance with the provisions of NRS
614.160, or from engaging in any constitutionally protected exercise of
free speech.
4. A person who violates the provisions of
subsection 1 is guilty of a misdemeanor and shall be punished by a fine of not
more than $1,000, or by imprisonment in the county jail for not more than 3
months, or by both fine and imprisonment.
5. As used in this section, the terms
“health facility,” “nonprofit health facility” and “public health center” have
the meanings ascribed to them in NRS 449.260.
(Added to NRS by 1991, 1687)
USE OF AVERSIVE INTERVENTION OR FORMS OF RESTRAINT ON
PATIENTS WITH DISABILITIES
NRS 449.765 Definitions. As
used in NRS 449.765 to 449.786,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.766 to 449.775,
inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 1999, 3247)
NRS 449.766 “Aversive intervention” defined. “Aversive
intervention” means any of the following actions if the action is used to
punish a person with a disability or to eliminate, reduce or discourage
maladaptive behavior of a person with a disability:
1. The use of noxious odors and tastes;
2. The use of water and other mists or
sprays;
3. The use of blasts of air;
4. The use of corporal punishment;
5. The use of verbal and mental abuse;
6. The use of electric shock;
7. Requiring a person to perform exercise
under forced conditions if the:
(a) Person is required to perform the exercise
because the person exhibited a behavior that is related to his or her
disability;
(b) Exercise is harmful to the health of the
person because of his or her disability; or
(c) Nature of the person’s disability prevents
the person from engaging in the exercise;
8. Any intervention, technique or
procedure that deprives a person of the use of one or more of the person’s
senses, regardless of the length of the deprivation, including, without
limitation, the use of sensory screens; or
9. The deprivation of necessities needed
to sustain the health of a person, regardless of the length of the deprivation,
including, without limitation, the denial or unreasonable delay in the
provision of:
(a) Food or liquid at a time when it is
customarily served; or
(b) Medication.
Ê The term
does not include the withholding or withdrawal of life-sustaining treatment in
accordance with NRS 449.626 or 449.691 to 449.697,
inclusive.
(Added to NRS by 1999, 3247; A 2013, 2288)
NRS 449.767 “Chemical restraint” defined. “Chemical
restraint” means the administration of drugs for the specific and exclusive
purpose of controlling an acute or episodic aggressive behavior when
alternative intervention techniques have failed to limit or control the
behavior. The term does not include the administration of drugs on a regular
basis, as prescribed by a physician, to treat the symptoms of mental, physical,
emotional or behavioral disorders and for assisting a person in gaining self-control
over his or her impulses.
(Added to NRS by 1999, 3247)
NRS 449.768 “Corporal punishment” defined. “Corporal
punishment” means the intentional infliction of physical pain, including,
without limitation, hitting, pinching or striking.
(Added to NRS by 1999, 3248)
NRS 449.769 “Electric shock” defined. “Electric
shock” means the application of electric current to a person’s skin or body.
The term does not include electroconvulsive therapy.
(Added to NRS by 1999, 3248)
NRS 449.770 “Emergency” defined. “Emergency”
means a situation in which immediate intervention is necessary to protect the
physical safety of a person or others from an immediate threat of physical
injury or to protect against an immediate threat of severe property damage.
(Added to NRS by 1999, 3248)
NRS 449.771 “Facility” defined. “Facility”
means a facility licensed pursuant to this chapter that is a psychiatric
hospital or a unit of a hospital that is specifically designated to provide
care and services to persons with psychiatric or developmental disabilities.
(Added to NRS by 1999, 3248)
NRS 449.772 “Mechanical restraint” defined. “Mechanical
restraint” means the use of devices, including, without limitation, mittens,
straps and restraint chairs to limit a person’s movement or hold a person
immobile.
(Added to NRS by 1999, 3248)
NRS 449.773 “Person with a disability” defined. “Person
with a disability” means a person who:
1. Has a physical or mental impairment
that substantially limits one or more of the major life activities of the
person;
2. Has a record of such an impairment; or
3. Is regarded as having such an
impairment.
(Added to NRS by 1999, 3248)
NRS 449.774 “Physical restraint” defined. “Physical
restraint” means the use of physical contact to limit a person’s movement or
hold a person immobile.
(Added to NRS by 1999, 3248)
NRS 449.775 “Verbal and mental abuse” defined. “Verbal
and mental abuse” means actions or utterances that are intended to cause and
actually cause severe emotional distress to a person.
(Added to NRS by 1999, 3248)
NRS 449.776 Aversive intervention: Prohibition on use. A person employed by a facility licensed
pursuant to this chapter or any other person shall not use any aversive
intervention on a person with a disability who is a patient at the facility.
(Added to NRS by 1999, 3248)
NRS 449.777 Forms of restraint: Restrictions on use. A person employed by a facility licensed
pursuant to this chapter or any other person shall not:
1. Except as otherwise provided in NRS 449.778, use physical restraint on a person with a
disability who is a patient at the facility.
2. Except as otherwise provided in NRS 449.779, use mechanical restraint on a person with
a disability who is a patient at the facility.
3. Except as otherwise provided in NRS 449.780, use chemical restraint on a person with a
disability who is a patient at the facility.
(Added to NRS by 1999, 3248)
NRS 449.778 Physical restraint: Permissible use; report of use in emergency.
1. Except as otherwise provided in
subsection 2, physical restraint may be used on a person with a disability who
is a patient at a facility only if:
(a) An emergency exists that necessitates the use
of physical restraint;
(b) The physical restraint is used only for the
period that is necessary to contain the behavior of the patient so that the
patient is no longer an immediate threat of causing physical injury to himself
or herself or others or causing severe property damage; and
(c) The use of force in the application of
physical restraint does not exceed the force that is reasonable and necessary
under the circumstances precipitating the use of physical restraint.
2. Physical restraint may be used on a
person with a disability who is a patient at a facility and the provisions of
subsection 1 do not apply if the physical restraint is used to:
(a) Assist the patient in completing a task or
response if the patient does not resist the application of physical restraint
or if the patient’s resistance is minimal in intensity and duration;
(b) Escort or carry a patient to safety if the
patient is in danger in his or her present location; or
(c) Conduct medical examinations or treatments on
the patient that are necessary.
3. If physical restraint is used on a
person with a disability who is a patient at a facility in an emergency, the
use of the procedure must be reported as a denial of rights pursuant to NRS 449.786, regardless of whether the use of the
procedure is authorized by statute. The report must be made not later than 1
working day after the procedure is used.
(Added to NRS by 1999, 3249)
NRS 449.779 Mechanical restraint: Permissible use; report of use in
emergency.
1. Except as otherwise provided in
subsection 2, mechanical restraint may be used on a person with a disability
who is a patient at a facility only if:
(a) An emergency exists that necessitates the use
of mechanical restraint;
(b) A medical order authorizing the use of
mechanical restraint is obtained from the patient’s treating physician before
the application of the mechanical restraint or not later than 15 minutes after
the application of the mechanical restraint;
(c) The physician who signed the order required pursuant
to paragraph (b) or the attending physician examines the patient not later than
1 working day immediately after the application of the mechanical restraint;
(d) The mechanical restraint is applied by a
member of the staff of the facility who is trained and qualified to apply
mechanical restraint;
(e) The patient is given the opportunity to move
and exercise the parts of his or her body that are restrained at least 10
minutes per every 60 minutes of restraint;
(f) A member of the staff of the facility lessens
or discontinues the restraint every 15 minutes to determine whether the patient
will stop or control his or her inappropriate behavior without the use of the
restraint;
(g) The record of the patient contains a notation
that includes the time of day that the restraint was lessened or discontinued
pursuant to paragraph (f), the response of the patient and the response of the
member of the staff of the facility who applied the mechanical restraint;
(h) A member of the staff of the facility continuously
monitors the patient during the time that mechanical restraint is used on the
patient; and
(i) The patient is released from the mechanical
restraint as soon as the behavior of the patient no longer presents an
immediate threat to himself or herself or others.
2. Mechanical restraint may be used on a
person with a disability who is a patient at a facility and the provisions of
subsection 1 do not apply if the mechanical restraint is used to:
(a) Treat the medical needs of a patient;
(b) Protect a patient who is known to be at risk
of injury to himself or herself because the patient lacks coordination or
suffers from frequent loss of consciousness;
(c) Provide proper body alignment to a patient;
or
(d) Position a patient who has physical disabilities
in a manner prescribed in the patient’s plan of treatment.
3. If mechanical restraint is used on a
person with a disability who is a patient at a facility in an emergency, the
use of the procedure must be reported as a denial of rights pursuant to NRS 449.786, regardless of whether the use of the
procedure is authorized by statute. The report must be made not later than 1
working day after the procedure is used.
(Added to NRS by 1999, 3249)
NRS 449.780 Chemical restraint: Permissible use; report of use.
1. Chemical restraint may only be used on
a person with a disability who is a patient at a facility if:
(a) The patient has been diagnosed as a person
with mental illness, as defined in NRS
433A.115, and is receiving mental health services from a facility;
(b) The chemical restraint is administered to the
patient while he or she is under the care of the facility;
(c) An emergency exists that necessitates the use
of chemical restraint;
(d) A medical order authorizing the use of chemical
restraint is obtained from the patient’s attending physician or psychiatrist;
(e) The physician or psychiatrist who signed the
order required pursuant to paragraph (d) examines the patient not later than 1
working day immediately after the administration of the chemical restraint; and
(f) The chemical restraint is administered by a
person licensed to administer medication.
2. If chemical restraint is used on a
person with a disability who is a patient, the use of the procedure must be
reported as a denial of rights pursuant to NRS 449.786,
regardless of whether the use of the procedure is authorized by statute. The
report must be made not later than 1 working day after the procedure is used.
(Added to NRS by 1999, 3250)
NRS 449.781 Use of forms of restraint by certain facilities. Notwithstanding the provisions of NRS 449.777 to 449.780,
inclusive, to the contrary, a facility may use or authorize the use of physical
restraint, mechanical restraint or chemical restraint on a person with a
disability who is a patient if the facility is:
1. Accredited by a nationally recognized
accreditation association or agency; or
2. Certified for participation in the
Medicaid or Medicare program,
Ê only to the
extent that the accreditation or certification allows the use of such
restraint.
(Added to NRS by 1999, 3248)
NRS 449.782 Education and training of members of staff of facility.
1. Each facility shall develop a program
of education for the members of the staff of the facility to provide
instruction in positive behavioral interventions and positive behavioral
supports that:
(a) Includes positive methods to modify the
environment of patients to promote adaptive behavior and reduce the occurrence
of inappropriate behavior;
(b) Includes methods to teach skills to patients
so that patients can replace inappropriate behavior with adaptive behavior;
(c) Includes methods to enhance a patient’s
independence and quality of life;
(d) Includes the use of the least intrusive
methods to respond to and reinforce the behavior of patients; and
(e) Offers a process for designing interventions
based upon the patient that are focused on promoting appropriate changes in
behavior as well as enhancing the overall quality of life for the patient.
2. Each facility shall provide appropriate
training for the members of the staff of the facility who are authorized to
carry out and monitor physical restraint and mechanical restraint to ensure
that those members of the staff are competent and qualified to carry out the
procedures in accordance with NRS 449.765 to 449.786, inclusive.
(Added to NRS by 1999, 3250)
NRS 449.783 Violations: Criminal penalties; ineligibility for employment;
disciplinary action.
1. Unless a more severe penalty is
prescribed by specific statute, a person who willfully uses aversive
intervention on a person with a disability who is a patient at a facility or,
except as otherwise provided in NRS 449.781,
violates NRS 449.777:
(a) For a first violation that does not result in
substantial bodily harm to the person with a disability, is guilty of a gross
misdemeanor.
(b) For a first violation that results in
substantial bodily harm to the person with a disability, is guilty of a
category B felony.
(c) For a second or subsequent violation, is
guilty of a category B felony.
Ê A person who
is convicted of a category B felony pursuant to this section shall be punished
by imprisonment in the state prison for a minimum term of not less than 1 year
and a maximum term of not more than 6 years, or by a fine of not more than
$5,000, or by both fine and imprisonment.
2. A person who is convicted pursuant to
this section is ineligible for 5 years for employment with a facility.
3. A conviction pursuant to this section
is, when applicable, grounds for disciplinary action against the person so
convicted and the facility where the violation occurred. The Division may
recommend to the appropriate agency or board the suspension or revocation of
the professional license, registration, certificate or permit of a person
convicted.
(Added to NRS by 1999, 3251)
NRS 449.784 Violations: Report required; development and review of and
compliance with corrective plan.
1. A facility where a violation of the
provisions of NRS 449.765 to 449.786,
inclusive, occurs shall report the violation to the Division not later than 24
hours after the violation occurred, or as soon thereafter as the violation is
discovered.
2. A facility where a violation occurred
shall develop, in cooperation with the Division, a corrective plan to ensure
that within 30 calendar days after the violation occurred, appropriate action
is taken by the facility to prevent future violations.
3. The Division shall forward the plan to
the Board. The Board shall review the plan to ensure that it complies with
applicable federal law and the statutes and regulations of this state. The
Board may require appropriate revision of the plan to ensure compliance.
4. If the facility where the violation
occurred does not meet the requirements of the plan to the satisfaction of the
Board, the Board may direct the agency that administers funding for the
facility to withhold state funding for the facility until the facility meets
the requirements of the plan.
(Added to NRS by 1999, 3251)
NRS 449.785 Prohibition on retaliation against person for reporting or
providing information regarding violation. An
officer, administrator or employee of a facility licensed pursuant to this
chapter shall not retaliate against any person for having:
1. Reported a violation of NRS 449.765 to 449.786,
inclusive; or
2. Provided information regarding a
violation of NRS 449.765 to 449.786,
inclusive,
Ê by a
facility or a member of the staff of the facility.
(Added to NRS by 1999, 3252)
NRS 449.786 Entry of denial of rights in patient’s record; notice and report
of denial; action by Division.
1. A denial of rights of a person with a
disability who is a patient of a facility pursuant to NRS
449.765 to 449.786, inclusive, must be entered
in the patient’s record. Notice of the denial must be provided to the
administrator of the facility.
2. If the administrator of a facility
receives notice of a denial of rights pursuant to subsection 1, the
administrator shall cause a full report to be prepared which must set forth in
detail the factual circumstances surrounding the denial. A copy of the report
must be provided to the Division.
3. The Division:
(a) Shall receive reports made pursuant to
subsection 2;
(b) May investigate apparent violations of the
rights of persons with disabilities who are patients at facilities; and
(c) May act to resolve disputes relating to
apparent violations.
(Added to NRS by 1999, 3252)
REGISTRY OF ADVANCE DIRECTIVES FOR HEALTH CARE
NRS 449.900 Definitions. As used
in NRS 449.900 to 449.965,
inclusive, unless the context otherwise requires, the words and terms defined
in NRS 449.905, 449.910
and 449.915 have the meanings ascribed to them in
those sections.
(Added to NRS by 2007, 2515)
NRS 449.905 “Advance directive” defined. “Advance
directive” means an advance directive for health care. The term includes:
1. A declaration governing the withholding
or withdrawal of life-sustaining treatment as set forth in NRS 449.535 to 449.690,
inclusive;
2. A durable power of attorney for health
care as set forth in NRS 162A.700 to 162A.860, inclusive;
3. A do-not-resuscitate order as defined
in NRS 450B.420; and
4. A Physician Order for Life-Sustaining
Treatment form as defined in NRS 449.693.
(Added to NRS by 2007, 2515; A 2009, 210; 2013, 2289)
NRS 449.910 “Registrant” defined. “Registrant”
means a person whose advance directive is registered with the Secretary of
State pursuant to NRS 449.925.
(Added to NRS by 2007, 2515)
NRS 449.915 “Registry” defined. “Registry”
means the Registry of Advance Directives for Health Care established by the
Secretary of State pursuant to NRS 449.920.
(Added to NRS by 2007, 2515)
NRS 449.920 Establishment and maintenance; information to be included in
Registry. The Secretary of State
shall establish and maintain the Registry of Advance Directives for Health Care
on the Internet website of the Secretary of State. The Registry must include,
without limitation, in a secure portion of the website, an electronic
reproduction of each advance directive. The electronic reproduction must be
capable of being viewed on the website and downloaded, printed or otherwise
retrieved by a person as set forth in NRS 449.930.
(Added to NRS by 2007, 2515)
NRS 449.925 Registration of advance directive: Requirements; duties of
Secretary of State.
1. A person who wishes to register an
advance directive must submit to the Secretary of State:
(a) An application in the form prescribed by the
Secretary of State;
(b) A copy of the advance directive; and
(c) The fee, if any, established by the Secretary
of State pursuant to NRS 449.955.
2. If the person satisfies the
requirements of subsection 1, the Secretary of State shall:
(a) Make an electronic reproduction of the
advance directive and post it to the Registry and, if the person consents
pursuant to NRS 439.591, the statewide
health information exchange system established pursuant to NRS 439.581 to 439.595, inclusive;
(b) Assign a registration number and password to
the registrant; and
(c) Provide the registrant with a registration
card that includes, without limitation, the name, registration number and
password of the registrant.
3. The Secretary of State shall establish
procedures for:
(a) The registration of an advance directive that
replaces an advance directive that is posted on the Registry;
(b) The removal from the Registry of an advance
directive that has been revoked following the revocation of the advance
directive or the death of the registrant; and
(c) The issuance of a duplicate registration card
or the provision of other access to the registrant’s registration number and
password if a registration card issued pursuant to this section is lost,
stolen, destroyed or otherwise unavailable.
(Added to NRS by 2007, 2515; A 2013, 2289)
NRS 449.930 Access to advance directive.
1. Except as otherwise provided in this
section, the Secretary of State shall not provide access to a registrant’s
advance directive unless:
(a) The person requesting access provides the
registration number and password of the registrant;
(b) The Secretary of State determines that
providing access to the advance directive is in the best interest of the
registrant;
(c) Access to the advance directive is required
pursuant to the lawful order of a court of competent jurisdiction; or
(d) Access to the advance directive is requested
by the registrant or the registrant’s personal representative.
2. A registrant or the personal
representative of a registrant may access the registrant’s advance directive
for any purpose. A provider of health care to the registrant may access the
registrant’s advance directive only in connection with the provision of health
care to the registrant.
(Added to NRS by 2007, 2516)
NRS 449.935 Removal of advance directive of deceased registrant. The Secretary of State shall remove from the
Registry the advance directives of deceased registrants. The State Registrar of
Vital Statistics shall cooperate with the Secretary of State to identify
registrants whose advance directives must be removed from the Registry. The
Secretary of State shall remove from the Registry the advance directives of
deceased registrants at least once every 5 years.
(Added to NRS by 2007, 2516)
NRS 449.940 Secretary of State not required to determine accuracy of
contents of advance directive or validity of advance directive; effect of
registration, failure to register and failure to notify Secretary of State of
revocation of advance directive.
1. The provisions of NRS 449.900 to 449.965,
inclusive, do not require the Secretary of State to determine whether the
contents of an advance directive submitted for registration are accurate or the
execution or issuance of the advance directive complies with the requirements
necessary to make the advance directive valid.
2. The registration of an advance
directive does not establish or create a presumption that the contents of the
advance directive are accurate or the execution or issuance of the advance
directive complies with the requirements necessary to make the advance
directive valid.
3. Failure to register an advance
directive does not affect the validity of the advance directive.
4. Failure to notify the Secretary of
State of the revocation of a registrant’s advance directive does not affect the
validity of the revocation.
(Added to NRS by 2007, 2516)
NRS 449.945 Provider of health care not required to inquire whether patient
has registered advance directive or access Registry; immunity of provider of
health care from criminal and civil liability.
1. The provisions of NRS 449.900 to 449.965,
inclusive, do not require a provider of health care to inquire whether a
patient has an advance directive registered on the Registry or to access the
Registry to determine the terms of the advance directive.
2. A provider of health care who relies in
good faith on the provisions of an advance directive retrieved from the
Registry is immune from criminal and civil liability as set forth in:
(a) NRS 449.630, if
the advance directive is a declaration governing the withholding or withdrawal
of life-sustaining treatment executed pursuant to NRS
449.535 to 449.690, inclusive, or a durable
power of attorney for health care executed pursuant to NRS 162A.700 to 162A.860, inclusive;
(b) NRS 449.691 to 449.697, inclusive, if the advance directive is a
Physician Order for Life-Sustaining Treatment form; or
(c) NRS
450B.540, if the advance directive is a do-not-resuscitate order as defined
in NRS 450B.420.
(Added to NRS by 2007, 2516; A 2009, 210; 2013, 2290)
NRS 449.950 Immunity of Secretary of State and deputies, employees and
attorneys of Secretary of State. The
Secretary of State and the deputies, employees and attorneys of the Secretary
of State are not liable for any action or omission made in good faith by the
Secretary of State, deputy, employee or attorney in carrying out the provisions
of NRS 449.900 to 449.965,
inclusive.
(Added to NRS by 2007, 2516)
NRS 449.955 Suspension of components of Registry and duties of Secretary of
State if sufficient money not available; fees authorized; acceptance of gifts
and grants.
1. On or before July 1 of each
odd-numbered year, the Secretary of State shall make a determination of whether
sufficient money is available and authorized for expenditure to fund one or
more components of the programs and other duties of the Secretary of State
relating to NRS 449.900 to 449.965,
inclusive.
2. The Secretary of State shall
temporarily suspend any components of the programs or duties of the Secretary
of State for which he or she determines pursuant to subsection 1 that
sufficient money is not available.
3. The Secretary of State may charge and
collect fees and accept gifts, grants, bequests and other contributions from
any source for the purpose of carrying out the provisions of NRS 449.900 to 449.965,
inclusive.
(Added to NRS by 2007, 2517)
NRS 449.960 Deposit, accounting and use of money received; interest and
income earned on money received; payment of claims.
1. All money received by the Secretary of
State pursuant to NRS 449.900 to 449.965, inclusive, must be:
(a) Deposited in the State Treasury and accounted
for separately in the State General Fund; and
(b) Used only for the purpose of carrying out the
provisions of NRS 449.900 to 449.965,
inclusive.
2. The Secretary of State shall administer
the account. The interest and income earned on the money in the account, after
deducting any applicable charges, must be credited to the account.
3. The money in the account does not lapse
to the State General Fund at the end of any fiscal year.
4. Claims against the account must be paid
as other claims against the State are paid.
(Added to NRS by 2007, 2517)
NRS 449.965 Regulations. The
Secretary of State may adopt regulations to carry out the provisions of NRS 449.900 to 449.965,
inclusive.
(Added to NRS by 2007, 2517)
