reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › General Provisions › Section 449.97422 - "Reprocess" defined

Current through June 11,
			 2024
"Reprocess" means the process of subjecting a
			 single-use medical device that has been previously used on a patient to
			 additional cleaning, disinfection or sterilization, manufacturing steps,
			 including, without limitation, repackaging and relabeling, and testing of the
			 technical and functional safety of the device to make the device ready for safe
			 use on another patient.
Added to NAC by Bd. of Health by
			 R096-08, 8-26-2008, eff. 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › General Provisions › Section 449.97426 - "Single-dose vial" defined

Current through June 11,
			 2024
"Single-dose vial" means a vial, including,
			 without limitation, a sealed sterile vial, which may be accessed by insertion
			 of a needle and which, according to the manufacturer's instructions:
1. Contains only one dose of a medication;
			 and
2. May be used for only one
			 patient.
Added to NAC by Bd. of Health by
			 R096-08, 8-26-2008, eff. 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › General Provisions › Section 449.97428 - "Sterilization" defined

Current through June 11,
			 2024
"Sterilization" means a process using medical
			 equipment, including, without limitation, a dry heat sterilizer or an
			 autoclave, to destroy all forms of microbial life.
Added to NAC by Bd. of Health by
			 R096-08, 8-26-2008, eff. 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › General Provisions › Section 449.9743 - "Surgery" defined

Current through June 11,
			 2024
"Surgery" means the treatment of a human being
			 by operative methods.
Added to NAC by Bd. of Health by
			 R049-99, eff. 9-27-99; A by R181-09, 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Licensing › Section 449.9745 - Center required to provide proof of national accreditation; submission of reports to Division; application by accrediting organization for recognition by State Board of Health

Current through June 11,
			 2024
1. The operator of
			 an ambulatory surgical center shall:
(a) Not
			 later than 6 months after obtaining a license, submit proof to the Division of
			 accreditation by:
(1) The Joint
			 Commission;
(2) The Accreditation
			 Association for Ambulatory Health Care;
(3) The American Association for
			 Accreditation for Ambulatory Surgery Facilities; or
(4) Any other nationally recognized
			 organization approved by the State Board of Health pursuant to subsection 3;
			 and
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Licensing › Section 449.9755 - Investigation of applicant and inspection of facility

Current
			 through June 11, 2024
After it receives a properly
			 completed application, proof of the identity of the applicant that is
			 acceptable to the Division and the appropriate fee, the Division shall conduct
			 an investigation of the applicant and inspect the facility of the proposed
			 ambulatory surgical center.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R078-12, 12-20-2012; R181-09,
			 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Licensing › Section 449.978 - Effect of expiration of license

Current through June 11,
			 2024
If a license authorizing an ambulatory surgical
			 center expires, patients must not occupy the center.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R044-97, 10-30-97
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Licensing › Section 449.9785 - Conformance with regulations required

Current through June 11,
			 2024
During the term of his or her license, the
			 licensee shall continuously maintain the ambulatory surgical center in
			 conformance with the provisions of NAC 449.971 to 449.996, inclusive. Any
			 violation of these provisions may result in the suspension or revocation of the
			 license.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R096-08, 8-26-2008, eff.
			 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.979 - Governing body required

Current through June 11,
			 2024
Except as otherwise provided by NAC 449.9835,
			 each ambulatory surgical center must have a governing body, chaired by a
			 principal in the organization of the licensee, with legal authority for the
			 operation of the center.
Added to NAC by Bd. of Health,
			 eff. 12-15-88
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9795 - Duties of governing body

Current through June 11,
			 2024
The governing body shall:
1. Adopt a set of rules which include
			 provisions concerning:
(a) The criteria by
			 which the members and officers of the governing body are selected, their terms
			 of office and their duties;
(b) The
			 frequency of its meetings; and
(c)
			 The annual revision and approval of the rules by the governing body.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.980 - Responsibilities of governing body

Current through June 11,
			 2024
The governing body shall ensure that:
1. Each patient of the center is under the
			 care of a physician.
2. Except as
			 otherwise provided in this subsection, each patient admitted to the center
			 receives a:
(a) Physical examination, which
			 must include a medical history of the patient, within the 30 days immediately
			 preceding the date of the patient's surgery; and
(b) Presurgical evaluation conducted by a
			 physician on the day of the patient's surgery or within the 7 days immediately
			 preceding the date of the patient's surgery. A podiatric physician licensed
			 pursuant to chapter 635 of NRS may conduct the presurgical evaluation for a
			 podiatric patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9801 - Procedures for granting privileges to members of medical staff

Current through June 11, 2024
1. The governing body shall:
(a) Adopt criteria for granting privileges to
			 members of the medical staff based upon the size and complexity of the services
			 provided by the center.
(b) Ensure
			 that an application to be accorded privileges or for the renewal of those
			 privileges is processed in an expeditious manner.
(c) Adopt procedures for verifying
			 information contained in an application to be accorded privileges or for the
			 renewal of those privileges. The procedures may include a requirement for the
			 applicant to sign a statement granting immunity from liability to the center
			 for actions taken to verify the information and attesting to the accuracy and
			 completeness of the information contained in the application.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9805 - Establishment of policy for authentication

Current through June 11,
			 2024
The governing body shall establish a policy for
			 authentication that:
1. Authorizes the
			 use of rubber stamps and prohibits the use of any stamp by any person other
			 than the person whose signature the stamp represents;
2. Approves a method for identifying the
			 person making an entry in any record or chart; and
3. Requires that the professional title of
			 the person making such an entry and the date of that entry is included with the
			 entry.
Added to NAC by Bd. of Health,
			 eff. 12-15-88
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.981 - Appointment and responsibilities of administrator

Current through
			 June 11, 2024
1. The
			 governing body shall appoint a qualified administrator for the center who is
			 responsible to the governing board for the performance of his or her
			 duties.
2. The administrator must:
(a) Be at least 21 years of age;
(b) Possess one of the following
			 qualifications:
(1) Be a physician;
(2) Be a registered nurse;
(3) Have a bachelor's or postgraduate degree
			 in administration or a field related to health care; or
(4) Have at least 1 year of administrative
			 experience in a health care setting;
(c) Have experience in the administration and
			 supervision of personnel; and
(d)
			 Possess such knowledge of the practice of medicine as to enable him or her to
			 be conversant in surgical protocols.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9811 - Program for review of surgical procedures and patient outcomes

Current through June 11, 2024
An
			 ambulatory surgical center shall establish a program for the review of surgical
			 procedures and patient outcomes, including, without limitation, a review of the
			 program for the control and prevention of infections and the rates of
			 infections occurring at the center. The program must require the review to be
			 conducted by a person who does not have a financial interest in the ambulatory
			 surgical center.
Added to NAC by Bd. of Health by
			 R181-09, eff. 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9812 - Program for quality assurance

Current through June 11,
			 2024
1. The
			 administrator of an ambulatory surgical center shall establish a program for
			 quality assurance for the center.
2. The program for quality assurance must
			 include, without limitation:
(a) Periodic
			 reviews of the clinical responsibilities and authority of the members of the
			 staff.
(b) Periodic evaluations of
			 members of the staff that are conducted by their peers.
(c) Procedures for the supervision of the
			 professional and technical activities of the members of the staff.
(d) Procedures for identifying and correcting
			 any problems or concerns that provide an opportunity for all members of the
			 staff who are health care practitioners to participate in the program for
			 quality assurance.
(e) Techniques
			 for self-assessment that are required to be used by the members of the staff
			 and provide for an examination of the manner in which care has been, is and
			 will be provided and the quality of the care provided.
(f) Procedures for identifying and addressing
			 any problems or concerns related to the care provided to patients using the
			 medical records of the center and any other sources of data that may be useful
			 to identify previously unrecognized concerns, and for assessing the frequency,
			 severity and sources of suspected problems and concerns. The procedures must
			 include, without limitation, procedures for assessing:
(1) The clinical performances of members of
			 the staff who are health care practitioners;
(2) The standards used for the maintenance of
			 medical records;
(3) The procedures
			 used to control the quality of radiological, pathological, laboratory and
			 pharmaceutical services provided by the center;
(4) The procedures used to control the
			 quality of other professional and technical services provided by the
			 center;
(5) The care and services
			 provided by the extended recovery unit, if such a unit is operated by the
			 center;
(6) The procedures used to
			 control infection; and
(7) The
			 satisfaction of patients who have been treated at the center.
(g) The maintenance of a record of
			 all fires and deaths that have occurred at the center and the transfer of all
			 patients from the center to a hospital.
(h) Procedures for assessing any actions
			 taken to correct identified problems or concerns and for determining whether
			 the actions taken have achieved or sustained the desired result and, if not,
			 why not.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9813 - Committee for quality assurance

Current through June 11,
			 2024
1. The governing
			 body shall establish a committee for quality assurance.
2. The committee must be composed of members
			 of the staff who represent the various clinical and medical services provided
			 by the center.
3. The committee
			 shall:
(a) Meet at least once each quarter
			 and maintain minutes of its meetings.
(b) Develop and make available a plan of
			 action for carrying out the program for quality assurance established pursuant
			 to NAC 449.9812.
(c) Carry out the
			 program for quality assurance established pursuant to NAC 449.9812.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9815 - Maintenance

Current through June 11, 2024
The
			 administrator shall ensure that the person in charge of maintenance at the
			 center:
1. Has a written program of
			 maintenance of all of the equipment used at the center.
2. Has written service contracts with vendors
			 that require the inspection and repair of equipment as needed.
3. Maintains written records of the
			 inspections of the equipment used at the center.
4. Keeps the temperature in the center at a
			 comfortable level.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.982 - Sanitation and housekeeping

Current through June 11,
			 2024
The administrator shall ensure that the
			 sanitation and housekeeping staff of the center:
1. Maintains a clean and sanitary environment
			 in the center with particular regard for:
(a)
			 The sanitary disposal of pathological and infectious waste;
(b) Methods for handling contaminated linen
			 or substitutes for linen; and
(c)
			 An effective program to control pests.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.983 - Protection from fire and other disasters

Current through June
			 11, 2024
1. The
			 administrator shall ensure that the center, members of the staff and patients
			 are adequately protected from fire or other disasters. He or she shall prepare
			 a written plan describing all actions to be taken by the members of the staff
			 and patients in the case of any such incident. This plan must be approved by
			 the governing body and the local fire department and must include provisions
			 for:
(a) Evacuation routes and procedures
			 that are posted in the center.
(b)
			 The assignment of personnel to specific tasks and responsibilities.
(c) Instruction on the use of alarm stations
			 and the location of signals.
(d)
			 Instruction concerning methods of containing a fire.
(e) Procedures for the notification of
			 appropriate persons.
(f) The
			 location of equipment for fighting fires.
(g) The conduct of fire drills not less
			 frequently than once each quarter for each shift of employees and requirements
			 for a dated, written report and an evaluation of each drill.
(h) The maintenance of records showing that
			 all employees have been trained in the execution of the plan at the beginning
			 of their employment and annually thereafter.
(i) A rehearsal and a review of the plan at
			 least once each year with a separate rehearsal for other disasters at least
			 once each year. A written report and evaluation of each rehearsal must be on
			 file.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9832 - Establishment of policies for provision of services and care by persons under contract with or who are otherwise not employed by center

Current
			 through June 11, 2024
If services and care are
			 provided at an ambulatory surgical center by persons who are under contract
			 with the center or who are otherwise not employees of the center, the governing
			 body shall establish policies for the provision of services and care by those
			 persons, including, without limitation, policies relating to the supervision of
			 such persons and the coordination of services and care. The policies must
			 ensure that services and care are provided at the ambulatory surgical center in
			 a safe and effective manner.
Added to NAC by Bd. of Health by
			 R181-09, eff. 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9835 - Exemption from requirements for governing body and administrator

Current through June 11, 2024
1. If a licensee is a sole physician
			 operator, the ambulatory surgical center operated by the licensee is not
			 required to have a governing body or an administrator. In such a case, in the
			 absence of a governing body or an administrator, the sole physician operator is
			 responsible for complying with all the provisions of NAC 449.971 to 449.996,
			 inclusive.
2. As used in this
			 section, "sole physician operator" means a physician, a podiatric physician
			 licensed pursuant to chapter 635 of NRS or a dentist licensed pursuant to
			 chapter 631 of NRS who is operating an ambulatory surgical center for the
			 purpose of performing surgery only upon his or her patients.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R096-08, 8-26-2008, eff. 10-25-2008;
			 R170-12, 10-4-2013
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9837 - Restrictions on operation of ambulatory surgical center; maintenance of records

Current through June 11,
			 2024
1. An ambulatory
			 surgical center:
(a) May be operated only for
			 the purpose of providing surgical services to patients who do not require care
			 for more than 24 hours.
(b) Except
			 as otherwise provided in subsection 2, may not be operated in:
(1) Conjunction with any other medical
			 facility; or
(2) A common area with
			 any other medical facility during its hours of operation.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Administration › Section 449.9843 - Compliance with certain standards, laws, ordinances and codes; submission and approval of building plans; prerequisites to approval of center for licensure

Current through June 11,
			 2024
1. An ambulatory
			 surgical center shall comply with the provisions of NFPA 99: Health Care
			 Facilities Code concerning medical gases, adopted by reference pursuant to NAC
			 449.0105, and the provisions of
			 NFPA 101: Life Safety Code, adopted by reference pursuant to NAC
			 449.0105.
2. Any new construction, remodeling or change
			 in the use of an ambulatory surgical center must comply with the applicable
			 provisions of the guidelines adopted by reference in paragraphs (c), (d) and
			 (e) of subsection 1 of NAC
			 449.0105, unless the remodeling
			 is limited to refurbishing an area within the center, including, without
			 limitation, painting the area, replacing flooring in the area, repairing
			 windows in the area and replacing window or wall coverings in the
			 area.
3. An ambulatory surgical
			 center shall be deemed to be in compliance with the provisions of subsection 2
			 and subsection 2 of NAC
			 449.983 if:
(a) The center is licensed on February 1,
			 1999, the use of the physical space in the center is not changed and there are
			 no deficiencies in the construction of the center that are likely to cause
			 serious injury, harm or impairment to the public health and welfare;
			 or
(b) The center has submitted
			 building plans to the Bureau before February 1, 1999, and:
(1) The Bureau determines that the plans
			 comply with standards for construction in effect before December 11,
			 1998;
(2) The center is constructed
			 in accordance with those standards;
(3) Construction of the center is begun
			 before August 1, 1999; and
(4)
			 There are no deficiencies in the construction of the center that are likely to
			 cause serious injury, harm or impairment to the public health and
			 welfare.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98451 - Adoption of guidelines by governing body for establishment of program

Current through June 11, 2024
1. The governing body shall adopt guidelines
			 which must be used by the ambulatory surgical center in establishing the
			 program for the prevention and control of infections and communicable diseases
			 required pursuant to NAC 449.98452.
2. The guidelines adopted pursuant to
			 subsection 1 may include, without limitation, guidelines, statements or
			 recommendations issued or published by other agencies or organizations, and
			 must:
(a) Be based on evidence, theoretical
			 rationale or scientific data; and
(b) Include well-designed experimental,
			 clinical or epidemiological studies which document the processes used in the
			 development of the studies and grade the strength of the evidence relied on in
			 the studies.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98452 - General requirements of program

Current through June 11,
			 2024
1. Each ambulatory
			 surgical center shall establish and maintain a program for the prevention and
			 control of infections and communicable diseases.
2. In addition to complying with the
			 provisions of NAC 449.98451 to 449.98457, inclusive, a program for the
			 prevention and control of infections and communicable diseases must be:
(a) Appropriate for the services provided at
			 the ambulatory surgical center;
(b)
			 Based on the guidelines adopted by the governing body pursuant to NAC
			 449.98451; and
(c) Developed in a
			 manner that takes into consideration:
(1) All
			 the surgical and other medical services provided at the ambulatory surgical
			 center;
(2) The types of patients
			 typically treated at the ambulatory surgical center, including, without
			 limitation, those whose age or medical condition makes them vulnerable to
			 infections and communicable diseases;
(3) The types of injuries or illnesses
			 typically treated at the ambulatory surgical center;
(4) The number of patients typically treated
			 at the ambulatory surgical center;
(5) The level of education and training of
			 the staff of the ambulatory surgical center;
(6) The number of nurses available at the
			 ambulatory surgical center, the qualifications of such nurses and the amount of
			 support required of the nurses by the physicians at the ambulatory surgical
			 center;
(7) The types of invasive
			 procedures performed at the ambulatory surgical center;
(8) The locations within the ambulatory
			 surgical center where invasive procedures are performed;
(9) The specific medical instruments and
			 equipment used at the ambulatory surgical center;
(10) The physical design of the ambulatory
			 surgical center; and
(11) The
			 causes, risks and patterns of infections and transmission of communicable
			 diseases that arise in the setting of each medical procedure performed at the
			 ambulatory surgical center.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98453 - Program required to include policies and procedures for prevention of exposure to blood-borne and other potentially infectious pathogens

Current through June 11, 2024
Each program
			 for the prevention and control of infections and communicable diseases must
			 include policies and procedures to prevent exposure to blood-borne and other
			 potentially infectious pathogens, including, without limitation, policies and
			 procedures relating to:
1. Hand
			 hygiene, including provisions regarding the time and procedure for handwashing
			 with soap and water or use of an alcohol-based hand rub.
2. The proper use of medical gloves. Those
			 policies and procedures must, at a minimum, provide that each person who works
			 at the ambulatory surgical center must wear medical gloves when the person:
(a) Anticipates coming in contact with blood
			 or bodily fluids;
(b) Handles
			 contaminated instruments, items and equipment;
(c) Handles biohazardous waste;
(d) Handles linens potentially contaminated
			 with biohazardous waste; and
(e)
			 Performs housekeeping activities or cleans contaminated surfaces.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98454 - Program required to include policies and procedures for single-dose vials and multidose vials

Current through June 11,
			 2024
1. Each program for
			 the prevention and control of infections and communicable diseases must include
			 policies and procedures for single-dose vials which provide that a single-dose
			 vial may be accessed only by using an aseptic technique. The policies and
			 procedures must provide that:
(a) Each
			 injection of a medication from a single-dose vial must be prepared in a clean,
			 designated area where contamination by blood or bodily fluid is unlikely to
			 occur;
(b) The medication in a
			 single-dose vial must not be used for more than one patient;
(c) A single-dose vial, including any
			 remaining medication in the vial after its use, must be discarded;
			 and
(d) Any remaining medication in
			 a single-dose vial after its use must not be combined with any other medication
			 or otherwise used for any other patients.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98455 - Sterilization and disinfection of surgical instruments, items and equipment; training required for employees and contractors responsible for sterilization or disinfection

Current through June 11,
			 2024
1. All surgical
			 instruments, items or equipment used in the care of patients at an ambulatory
			 surgical center must be sterilized or disinfected according to the program for
			 the prevention and control of infections and communicable diseases adopted by
			 the ambulatory surgical center pursuant to NAC 449.98452.
2. If such instruments, items and equipment
			 are sterilized or disinfected by equipment or cleaning agents at the ambulatory
			 surgical center:
(a) Before an employee or
			 independent contractor may be assigned the responsibility for sterilizing or
			 disinfecting any instrument, item or equipment, the employee or independent
			 contractor must receive training concerning the instructions of the
			 manufacturer of the device or sterilizer for:
(1) Sterilizing and disinfecting the
			 instrument, item or equipment;
(2)
			 The use and maintenance of the sterilizer or disinfecting equipment;
			 and
(3) The agents used to
			 sterilize and disinfect the instrument, item or equipment.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98456 - Center required to designate employee or enter into contract for overseeing and managing program; qualifications and duties of employee or contractor

Current through June 11,
			 2024
1. Each ambulatory
			 surgical center shall designate an employee or enter into a contract with a
			 person to oversee and manage all aspects of the program for the prevention and
			 control of infections and communicable diseases.
2. The person described in subsection 1:
(a) Shall have completed specialized training
			 in the prevention and control of the development and transmission of infections
			 and communicable diseases; and
(b)
			 Shall ensure that the program for the prevention and control of infections and
			 communicable diseases for the ambulatory surgical center:
(1) Complies with all applicable federal,
			 state and local laws;
(2) Is
			 consistent with the guidelines adopted by the governing body pursuant to NAC
			 449.98451; and
(3) Is reviewed with
			 all employees of the ambulatory surgical center and all persons under contract
			 with the ambulatory surgical center who work at the center and have exposure to
			 patients at the center within the first 10 days of employment and every 12
			 months thereafter, or more often if required pursuant to subsection 2 of NAC
			 449.98457.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.98457 - Mandatory training and evaluation of employees and other persons

Current through June 11, 2024
1. Each employee of an ambulatory surgical
			 center and each person under contract with an ambulatory surgical center who
			 works at the center and has exposure to patients at the center shall receive
			 training and be evaluated by supervising staff on his or her knowledge and
			 skills concerning the program for the prevention and control of infections and
			 communicable diseases within the first 10 days of employment and at least every
			 12 months thereafter.
2. An
			 employee or person under contract with the ambulatory surgical center may be
			 required to receive the training and evaluation described in subsection 1 more
			 often than every 12 months if his or her supervisor determines that such
			 training and evaluations are necessary to ensure that the employee or person
			 understands and will follow the policies and procedures of the program for the
			 prevention and control of infections and communicable diseases.
Added to NAC by Bd. of Health by
			 R096-08, 8-26-2008, eff. 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Personnel › Section 449.9855 - Policies and requirements for personnel

Current through June 11,
			 2024
1. An ambulatory
			 surgical center shall have written policies for the personnel employed at the
			 center. These policies must be provided to each employee in the form of a
			 manual and must include provisions concerning hours of work, grievances in
			 connection with termination, vacation, sick leave and leaves of
			 absence.
2. Each employee of the
			 center must:
(a) Have a skin test for
			 tuberculosis in accordance with NAC 441A.375. A record of each test must be
			 maintained at the center.
(b)
			 Within 10 days after the date of his or her employment, and periodically
			 thereafter, be instructed in the control of infections, the prevention of
			 fires, the safety of the patients, preparation in case of disaster, and the
			 policies and procedures of the center.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Personnel › Section 449.9865 - Medical staff

Current through June 11,
			 2024
1. The medical
			 staff of an ambulatory surgical center is answerable to the governing body for
			 the quality of medical care provided to patients and for the ethical and
			 professional practices of its members.
2. The governing body, or a person or
			 committee designated by the governing body, shall appoint the members of the
			 medical staff and grant, deny and withdraw the privileges to be accorded
			 members of the medical staff as it deems appropriate. Appointments to the
			 medical staff must be made in writing and must be documented in the records of
			 the center.
3. Each member of the
			 medical staff must be qualified for the position to which the member is
			 appointed and the privileges which he or she is accorded.
4. A roster of the surgical privileges of
			 each member of the medical staff must be kept in the files of the operating
			 room, specifying the privileges accorded him or her.
5. A member of the medical staff shall not
			 perform a surgical procedure or provide a treatment for which the member has
			 not been granted privileges.
6. The
			 governing body shall establish procedures for disciplining a member of the
			 medical staff who fails to comply with the policies and procedures of the
			 center, including, without limitation, disciplining a member of the medical
			 staff for performing a surgery for which the member has not been granted
			 privileges.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R181-09,
			 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Personnel › Section 449.988 - Nursing staff

Current through June 11,
			 2024
1. Each ambulatory
			 surgical center must have a department of nursing under the direction of a
			 chief nurse who is a registered nurse.
2. A sufficient number of members of the
			 nursing staff must be on duty at all times to ensure that proper care is
			 provided to each patient. A sufficient number of registered nurses must be on
			 duty at all times to ensure the immediate availability of a registered nurse
			 for the care of any patient. A person who is not a registered nurse may be
			 assigned to care for a patient to the extent consistent with his or her
			 education, experience and authorized scope of practice.
3. A surgical technician or licensed
			 practical nurse may be permitted to serve as a scrub technician only under the
			 direct supervision of a registered nurse.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.9885 - Medical records: Maintenance

Current through June 11,
			 2024
1. An employee
			 shall oversee the completion, filing and retention of each medical
			 record.
2. Records must be
			 maintained for each patient admitted for care in the center in accordance with
			 accepted professional principles.
3. Only authorized personnel may have access
			 to medical records. Information contained in a medical record must not be
			 released without the written consent of the patient or his or her guardian
			 except:
(a) As required by law;
(b) Under a contract involving a third-party
			 payor; or
(c) As otherwise provided
			 by the agreement on admission.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.989 - Medical records: Contents

Current through June 11,
			 2024
The medical record of each patient must be
			 complete, authenticated, accurate and current, and must include the following
			 information:
1. A complete
			 identification of the patient, including information on his or her next of kin
			 and on the person or agency legally or financially responsible for him or
			 her.
2. A statement concerning the
			 admission and diagnosis of the patient.
3. The medical history of the
			 patient.
4. Documentation that the
			 patient has been given a:
(a) Physical
			 examination, which must include a medical history of the patient, conducted by
			 a physician within the 30 days immediately preceding the date of the patient's
			 surgery; and
(b) Presurgical
			 evaluation conducted by a physician or a podiatric physician licensed pursuant
			 to chapter 635 of NRS, as applicable, on the day of the patient's surgery or
			 within the 7 days immediately preceding the date of the patient's
			 surgery.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.990 - Medication and treatment

Current through June 11,
			 2024
1. Any medication
			 or treatment may be given only upon the written or oral order of a person
			 lawfully authorized to prescribe that medication or treatment. This order must
			 be authenticated by the prescriber and the person administering the medication.
			 An oral order must be recorded and authenticated within 24 hours after it is
			 given.
2. Medications prepared by
			 one nurse may not be administered by another nurse.
3. At the time the medication is
			 administered, the patient must be identified and the medication must be
			 identified as being ordered for that patient and recorded in the medical record
			 of the patient.
4. Intravenous
			 medications or fluids may be administered only by persons who have been
			 specially trained and are authorized for that duty.
5. Any suspected adverse reaction to a
			 medication must be reported by members of the nursing staff to the physician
			 attending the patient. The nursing staff shall document the reaction in the
			 medical record of the patient.
6.
			 All medications must be prepared and administered in a safe and effective
			 manner in accordance with the program for the prevention and control of
			 infections and communicable diseases adopted pursuant to NAC 449.98452 and in
			 accordance with the manufacturer's instructions.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R096-08, 8-26-2008, eff.
			 10-25-2008
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.9902 - Emergency equipment and supplies

Current through June 11,
			 2024
1. An ambulatory
			 surgical center must be equipped with:
(a) A
			 cardiac defibrillator;
(b) A
			 tracheostomy or cricothyroidotomy set;
(c) A mobile cart which contains the
			 equipment and supplies specified by the medical staff pursuant to subsection
			 3;
(d) If the ambulatory surgical
			 center provides services to pediatric patients who are less than 9 years of
			 age, the equipment and supplies specified by the medical staff pursuant to
			 subsection 3 needed to treat a pediatric patient during an emergency;
(e) If general anesthesia is provided at the
			 ambulatory surgical center or if the center offers to patients a triggering
			 agent for malignant hyperthermia, a mobile cart which contains the equipment
			 and supplies specified by the medical staff pursuant to subsection 3 needed to
			 treat a patient with malignant hyperthermia;
(f) In addition to the mobile cart required
			 by paragraph (e), if general anesthesia is provided at the ambulatory surgical
			 center, the equipment and supplies specified by the medical staff pursuant to
			 subsection 3 needed to manage a difficult airway of a patient; and
(g) Such other emergency medical equipment
			 and supplies as are specified by the members of the medical staff pursuant to
			 subsection 3.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.9905 - Pharmacist employed by or contracted with center; records, storage and administration of drugs; center required to obtain license to operate pharmacy

Current through June 11, 2024
1. A pharmacist employed by or contracted
			 with an ambulatory surgical center pursuant to NAC 639.4996 is responsible for
			 all matters pertaining to the use of drugs in the ambulatory surgical
			 center.
2. Records of all
			 transactions must be in writing and maintained in accordance with the
			 provisions of state and federal law so the receipt and disposition of any drug
			 may be readily traced.
3. Drugs
			 requiring refrigeration must be stored in a locked refrigerator or a
			 refrigerator in a locked room.
4.
			 In the absence of a full-time pharmacist, the director of nursing must be
			 designated in writing as responsible for the control of dangerous drugs and
			 controlled substances. Controlled substances as described in chapter 453 of NRS
			 must be stored in a storage area with two locks. If a box is used, it must be
			 securely fastened and immovable. The keys or combinations to the locks must be
			 accessible only to licensed health care professionals.
5. All drugs must be logged into and checked
			 out of stock only by a licensed health care professional.
6. The ambulatory surgical center shall
			 obtain a license to operate a pharmacy pursuant to chapter 639 of
			 NRS.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R096-08, 8-26-2008, eff. 10-25-2008;
			 R181-09, 10-4-2013
NRS
			 441A.120,
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.991 - Laboratory services

Current through June 11,
			 2024
1. Laboratory
			 services must be provided to meet the needs of patients and must be available
			 to each center at all times.
2. If
			 the ambulatory surgical center has its own laboratory, it must be a licensed
			 clinical laboratory under the provisions of chapter 652 of NRS.
3. If the ambulatory surgical center
			 contracts with a laboratory for its services, that laboratory must be certified
			 in accordance with the Clinical Laboratory Improvement Amendments of 1988,
			 Public Law No. 100-578.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.992 - Pathological services

Current through June 11,
			 2024
1. Pathology
			 services must be provided by a staff pathologist or by a pathologist used as a
			 consultant by the ambulatory surgical center. The pathologist must be licensed
			 to practice in this State.
2. All
			 material removed from a patient during surgery must be clearly labeled and
			 examined microscopically as required by a pathologist. In the absence of a
			 staff pathologist, written arrangements must be made to send tissues to a
			 pathologist outside the center.
3.
			 A list of tissues that do not routinely require microscopic examination must be
			 approved by a pathologist and made available to the laboratory and the members
			 of the medical staff.
4. Reports of
			 examinations of tissues must be signed, which may include an electronic
			 signature, by the examining pathologist. The original report must be filed in
			 the medical record of the patient.
Added to NAC by Bd. of Health,
			 eff. 12-15-88; A by R049-99, 9-27-99; R181-09,
			 10-4-2013
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › SURGICAL CENTERS FOR AMBULATORY PATIENTS › Medical Records, Services and Facilities › Section 449.9925 - Blood and derivatives of blood: Procurement, storage, transfusion and administration; policies and procedures; reporting of adverse reaction

Current through June 11, 2024
1. If the ambulatory surgical center provides
			 its own service for blood transfusions through its medical laboratory as
			 defined in
			 NRS
			 652.060:
(a) Any arrangement for the procurement,
			 safekeeping or transfusion of blood or derivatives of blood must be under the
			 supervision of a pathologist;
(b)
			 Any reaction to a transfusion of blood must be investigated;
(c) The storage equipment for blood and
			 derivatives of blood must be protected by an alarm system which must be tested
			 each month and the temperature continuously monitored to verify its
			 operation;
(d) Samples of the blood
			 of any patient receiving a transfusion and of each unit of blood used in the
			 center must be retained in accordance with the written policy of the laboratory
			 for at least 7 days for further testing in the event of a reaction to the
			 transfusion; and
(e) Blood and
			 derivatives of blood that have exceeded their expiration date must not be used
			 and must be disposed of as biohazardous waste.