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2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 or a health services executive licensed pursuant to the provisions of chapter 654 of NRS.
(Added to NRS by 1993, 2144; A 2017, 603)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.1865 - Certain residential facilities for groups to be equipped with fire sprinkler system.

A residential facility for groups must be equipped with a fire sprinkler system if the facility has three or more residents who would have difficulty perceiving danger or moving to safety in the event of a fire.
(Added to NRS by 2017, 2049)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 449.029 to 449.2428, inclusive, may not be operated except under the supervision of a nursing facility administrator or a health services executive 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; 2017, 603)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.1915 - Provision of special diet to patient for whom special diet has been ordered; documentation; clinical privileges for licensed dietitian.

1. A medical facility shall take such actions as necessary to ensure that the facility provides a diet for each patient for whom a special diet has been ordered by a licensed dietitian or prescribed by a physician, physician assistant, dentist, advanced practice registered nurse or podiatric physician that complies with the order or prescription. Such actions may include, without limitation, purchasing any food or beverage necessary to comply.
2. A medical facility shall maintain documentation which demonstrates that the facility is in compliance with the requirements of subsection 1 and make such documentation available to the Division upon request.
3. A hospital may grant clinical privileges to a licensed dietitian for the purposes of:
(a) Ordering special diets for patients;
(b) Ordering laboratory tests to monitor the effectiveness of special diets or other dietary plans; and
(c) Modifying special diets or other dietary plans based on the results of laboratory tests.
(Added to NRS by 2019, 1111)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.1923 - Admission of advanced practice registered nurse to membership on medical staff of hospital.

A hospital may admit an advanced practice registered nurse to membership on the medical staff of the hospital to perform any act authorized pursuant to NRS 632.237 that is within the scope of practice of the advanced practice registered nurse. A hospital shall not:
1. Automatically admit an advanced practice registered nurse to membership on the medical staff of the hospital solely because he or she is licensed as an advanced practice registered nurse in this State, is authorized pursuant to NRS 632.237 to perform certain functions or certain functions are within his or her scope of practice; or
2. Deny admission to membership on the medical staff of the hospital to an advanced practice registered nurse solely because he or she is licensed as an advanced practice registered nurse and not as a physician.
(Added to NRS by 2019, 1398)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.1925 - Staff privileges for telehealth providers.

A hospital may grant staff privileges to a provider of health care who is at another location for the purpose of providing services through telehealth, as defined in NRS 629.515, to patients at the hospital in the manner prescribed in 42 C.F.R. §§ 482.12, 482.22 and 485.616.
(Added to NRS by 2015, 631)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.1935 - Agency to provide personal care services in the home authorized to provide certain services to elderly persons and persons with disabilities.

An agency to provide personal care services in the home that is licensed pursuant to this section and NRS 449.029 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.
(Added to NRS by 2013, 134; A 2017, 1573)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.194 - Certain employees of agency to provide personal care services in the home or community health worker pool 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 or a community health worker pool 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,
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; A 2015, 2167, 2177; 2021, 2830)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.198 - Requirements for freestanding birthing center; prohibition on surgery; qualifications of director.

1. A freestanding birthing center must:
(a) Provide sufficient space for members of the family of the pregnant person and other persons chosen by the pregnant person to assist with the birth;
(b) Have obstetrical services available to meet the needs of an acute patient; and
(c) Be located within 30 miles of a hospital that offers obstetric, neonatal and emergency services relating to pregnancy.
2. Surgery, including, without limitation, the use of forceps, vacuum extractions, cesarean sections and tubal ligations, must not be performed at a freestanding birthing center.
3. A freestanding birthing center must have a director who is responsible for the operation of the freestanding birthing center. The director of a freestanding birthing center must be:
(a) A physician;
(b) A person who:
(1) Is certified as a Certified Professional Midwife by the North American Registry of Midwives, or its successor organization; and
(2) Has successfully completed a program of education and training in midwifery that:
(I) Is accredited by the Midwifery Education Accreditation Council, or its successor organization; and
(II) Provides instruction and training in the Essential Competencies for Midwifery Practice prescribed by the International Confederation of Midwives, or its successor organization; or
(c) A certified nurse-midwife.
4. As used in this section, "certified nurse-midwife" means a person who is:
(a) Certified as a Certified Nurse-Midwife by the American Midwifery Certification Board, or its successor organization; and
(b) Licensed as an advanced practice registered nurse pursuant to NRS 632.237.
(Added to NRS by 1985, 1735; A 2021, 3442)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.201 - Certification required for programs for alcohol or other substance use disorders operated or provided by facility for transitional living for released offenders.

Each program for alcohol or other substance use disorders 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, "program for alcohol or other substance use disorders" has the meaning ascribed to it in NRS 458.010.
(Added to NRS by 2005, 2350; A 2013, 3060)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.202 - Classification of hospitals.

A hospital which provides only one or two of the following categories of service:
1. Medical;
2. Surgical;
3. Obstetrical; or
4. Psychiatric,
shall be designated a medical hospital, surgical hospital, obstetrical hospital or psychiatric hospital or combined-categories hospital, as the case may be.
(Added to NRS by 1971, 933; A 1973, 1280; 2019, 2644)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.203 - Designation of hospital as comprehensive or primary stroke center; Division to maintain list of hospitals so designated; regulations.

1. A hospital licensed pursuant to NRS 449.029 to 449.2428, inclusive, may submit to the Division proof that the hospital is certified as a comprehensive or 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 comprehensive or 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 comprehensive or primary stroke centers on an Internet website maintained by the Division.
3. If a hospital wishes to be included as a comprehensive or 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 comprehensive or 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 comprehensive or primary stroke center shall not represent, advertise or imply that the hospital is designated as a comprehensive or primary stroke center.
6. A hospital that is included on the list established pursuant to subsection 2 as a comprehensive or primary stroke center shall report to the Stroke Registry all consensus measures prescribed by the Paul Coverdell National Acute Stroke Registry of the Centers for Disease Control and Prevention of the United States Department of Health and Human Services, the Joint Commission, the American Heart Association and the American Stroke Association.
7. The provisions of this section do not prohibit a hospital that is licensed pursuant to NRS 449.029 to 449.2428, inclusive, from providing care to a victim of stroke if the hospital does not have a designation as a comprehensive or primary stroke center.
8. 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.
9. As used in this section, "Stroke Registry" means the Stroke Registry established pursuant to NRS 439.5295.
(Added to NRS by 2011, 1363; A 2015, 249)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 449.029 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 449.029 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 NRS 449.029 to 449.2428, inclusive.
(b) A facility for the dependent that is required to be licensed pursuant to NRS 449.029 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.210 - Penalties for unlicensed operation of medical facility, facility for the dependent or other facility required to be licensed by Division; cease and desist order; authority of Division to bring action; penalty for operating without a license; use of money collected.

1. In addition to the payment of the amount required by NRS 449.0308 and any civil penalty imposed pursuant to subsection 4, a person who operates a medical facility, facility for the dependent or a facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed without a license issued by the Division is guilty of a misdemeanor.
2. If the Division believes that a person is operating a medical facility, facility for the dependent or a facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed 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 by personal delivery or by certified or registered mail, return receipt requested. The order is effective upon service.
3. If a person does not voluntarily cease operating a medical facility, facility for the dependent or a facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed without a license or apply for licensure within 30 days after the date of service of the order pursuant to subsection 2, the Division may bring an action in a court of competent jurisdiction pursuant to NRS 449.220.
4. Upon a showing by the Division that a person is operating a medical facility, facility for the dependent or a facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed without a license, a court of competent jurisdiction may:
(a) Enjoin the person from operating the facility.
(b) Impose a civil penalty on the operator to be recovered by the Division of not more than $10,000 for the first offense or not less than $10,000 or more than $25,000 for a second or subsequent offense.
5. Unless otherwise required by federal law, the Division shall deposit all civil penalties collected pursuant to paragraph (b) of subsection 4 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 to protect the health, safety, well-being and property of the patients and residents of facilities 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; 2015, 356; 2017, 1910)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 449.029 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; 2015, 635; 2017, 337, 1573, 1911, 2309, 4170; 2019, 340, 1117, 1679, 2645; 2023, 1851, 3336)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 449.029 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; 2017, 337, 2309; 2019, 341, 1117, 1340, 1403, 1922, 2156, 2599, 2645, 2923, 4039; 2021, 375; 2023, 573, 912, 1851, 3336, 3446)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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; 2017, 37, 4171)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.2417 - "Practice of surgical technology" defined.

1. "Practice of surgical technology" means performing tasks in preparation for surgery and providing care in collaboration with a team of providers of health care and other persons to a patient before, during and after surgery. The term includes, without limitation:
(a) Working with a registered nurse to carry out a plan to care for the patient and prepare the operating room for surgery;
(b) Preparing and gathering sterile supplies, instruments and equipment necessary for a surgical procedure;
(c) Ensuring that surgical equipment is functioning properly and safely; and
(d) In the operating room under the direction of an appropriate provider of health care:
(1) Ensuring that the area in which the surgery is conducted remains sterile;
(2) Anticipating and responding to the needs of the surgeon and other members of the team during surgery;
(3) Passing supplies, instruments and equipment to other members of the team;
(4) Sponging or suctioning the operative site of the patient;
(5) Preparing and cutting materials for sutures;
(6) Transferring and irrigating with fluids;
(7) Transferring drugs to other members of the team;
(8) Handling specimens;
(9) Holding retractors and other instruments and equipment;
(10) Applying electrocautery to clamps on blood vessels cut during surgery;
(11) Connecting drains and catheters to suction or drainage apparatus;
(12) Applying skin staples and dressings to closed wounds;
(13) Counting sponges, needles and other supplies and instruments; and
(14) Removing instruments after the completion of surgery.
2. The term does not include administering a drug to a patient.
(Added to NRS by 2017, 330)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.24185 - Conditions under which health care facility may employ or allow person to engage in practice of surgical technology.

Except as otherwise provided in this section and NRS 449.0301, 449.24195 and 449.2455:
1. A health care facility may not employ or otherwise allow a person to engage in the practice of surgical technology at the health care facility unless the person has:
(a) Successfully completed a program for surgical technologists that is accredited by a national accrediting organization and is certified as a Certified Surgical Technologist by the National Board of Surgical Technology and Surgical Assisting or a successor organization;
(b) Successfully completed a training program for surgical technologists administered by the United States Public Health Service, Army, Navy, Air Force, Marine Corps or Coast Guard; or
(c) Engaged in the practice of surgical technology in a health care facility before January 1, 2018.
2. A health care facility may employ or otherwise allow a person who has successfully completed a program for surgical technologists that is accredited by a national accrediting organization but who is not certified as a Certified Surgical Technologist pursuant to paragraph (a) of subsection 1 to engage in the practice of surgical technology at the health care facility for 180 days after the date on which the person successfully completed the program.
3. A health care facility may employ a person who does not possess the qualifications prescribed by subsection 1 to engage in the practice of surgical technology at the health care facility if, after conducting a thorough and diligent search, the health care facility is unable to employ a sufficient number of surgical technologists who possess such qualifications. A health care facility may continue to employ such a person after the health care facility determines it is able to employ a sufficient number of surgical technologists who possess such qualifications.
(Added to NRS by 2017, 330; A 2023, 420)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.2419 - Duties of health care facility that employs or allows person to engage in practice of surgical technology.

Except as otherwise provided in NRS 449.24195, a health care facility that employs or otherwise allows a person to engage in the practice of surgical technology at the health care facility shall:
1. Ensure that each such person, including, without limitation, a person who does not possess the qualifications prescribed by subsection 1 of NRS 449.24185, successfully completes not less than 15 hours annually of continuing education concerning the practice of surgical technology; and
2. Maintain records showing that the health care facility is in compliance with this section and NRS 449.24185, including, without limitation:
(a) Records of continuing education completed by surgical technologists;
(b) Records demonstrating that a surgical technologist employed by the health care facility possesses the qualifications prescribed by subsection 1 of NRS 449.24185; and
(c) If the health care facility employs a person who does not possess the qualifications prescribed by subsection 1 of NRS 449.24185 pursuant to subsection 3 of that section, records of the efforts of the health care facility to search for a sufficient number of surgical technologists who possess the qualifications prescribed by subsection 1 of that section before employing the person.
(Added to NRS by 2017, 331)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.24195 - Applicability of provisions concerning surgical technology.

NRS 449.24185 and 449.2419 do not apply to a person who is licensed or certified pursuant to title 54 of NRS and performs an activity listed in NRS 449.2417 that is within the scope of such licensure or certification.
(Added to NRS by 2017, 331)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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. If the health care facility is a hospital, the written policy and the documented staffing plan must:
(a) Be signed by each member of the staffing committee of the hospital established pursuant to NRS 449.242 to indicate that the member has received a copy of the written policy and the staffing plan and, if applicable, actively participated in the development of the written policy and the staffing plan; and
(b) Include a place where a member of the staffing committee may note any objections to the written policy or the staffing plan.
2. 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.
3. A documented staffing plan must provide sufficient flexibility to allow for adjustments based upon changes in a unit of the health care facility.
4. 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; 2017, 4172)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › NRS 449.2425 - Division to adopt regulations establishing system for rating certain health care facilities on compliance with requirements relating to staffing: Division to post final star rating and report of unresolved violations of law on Internet website; health care facility to post its rating in facility.

1. The Division shall adopt regulations establishing:
(a) A system for rating each health care facility located in a county whose population is 100,000 or more and which is licensed to have more than 70 beds on the compliance by the facility with the provisions of this section and NRS 449.241 to 449.2428, inclusive, including, without limitation, the number of resolved and unresolved violations and the severity of those violations. The rating system must provide for the assignment of a star rating of not more than five stars and not less than one star to each such facility after:
(1) Each inspection conducted by the Division pursuant to NRS 449.132; and
(2) Each investigation conducted by the Division pursuant to NRS 449.0307 concerning a complaint that alleges a violation of the provisions of this section and NRS 449.241 to 449.2428, inclusive.
(b) Procedures by which 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 may, not later than 30 days after an investigation or inspection, appeal a finding concerning a violation of the provisions of this section and NRS 449.241 to 449.2428, inclusive, or request a follow-up inspection.
2. A star rating assigned pursuant to subsection 1 becomes final:
(a) Thirty days after the investigation or inspection on which the star rating is based; or
(b) After the completion of any follow-up inspection or the final determination of any appeal pursuant to subsection 1,
whichever is later.
3. Not later than 5 days after a star rating becomes final pursuant to subsection 2, the Division shall post on an Internet website maintained by the Division a report which must include:
(a) The final star rating assigned to the facility pursuant to subsection 1; and
(b) A report of each unresolved violation of an applicable statute or regulation and all proposed actions to correct the violation.
4. 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 post the final star rating assigned to the facility pursuant to subsection 1 after the most recent investigation or inspection in a conspicuous place near each entrance to the facility that is regularly used by the public and, if the facility maintains an Internet website that is accessible to the public, on that Internet website.
(Added to NRS by 2017, 4164)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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; A 2017, 4173)
2023 Nevada Revised Statutes › Chapter 449 - Medical Facilities and Other Related Entities › 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 449.029 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.
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)