reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99826 - "Immediate family" defined

Current through June 11,
			 2024
"Immediate family" means the spouse, parent,
			 child or sibling of a recipient.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99827 - "Initial deficiency" defined

Current through June 11,
			 2024
1. "Initial
			 deficiency" means the first occurrence of a deficiency recorded by the
			 Bureau.
2. The term includes any
			 deficiency found during a standard survey, during an extended survey or in
			 response to a complaint.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99828 - "Major deficiency" defined

Current through June 11,
			 2024
"Major deficiency" means a deficiency with a
			 combined severity and scope rating of five or more.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99829 - "Medicaid facility" defined

Current through June 11,
			 2024
"Medicaid facility" means a facility that has
			 entered into an agreement to provide care, services or treatment paid under the
			 joint federal-state Medicaid program described in
			 42 U.S.C.
			 §§
										1396 et seq.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.9983 - "Medicare facility" defined

Current through June 11,
			 2024
"Medicare facility" means a facility that has
			 entered into an agreement to provide care, services or treatment paid by
			 Medicare pursuant to
			 42 U.S.C. §§
										1395 et seq.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99832 - "Monitor" defined

Current through June 11,
			 2024
"Monitor" means to observe, advise or supervise
			 a facility on an as-needed basis to ensure compliance with the plan of
			 correction for the facility
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99833 - "New admission" defined

Current through June 11,
			 2024
"New admission" means a person who is admitted
			 to the facility on or after the effective date of a ban on admissions and who
			 has not been admitted before or, if previously admitted, has been discharged or
			 left the facility voluntarily more than 30 days before the effective date of
			 the ban.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99834 - "Particular kinds of care, treatment or services" defined

Current
			 through June 11, 2024
"Particular kinds of care,
			 treatment or services" includes discrete areas such as bowel and bladder
			 training, catheter care, restraints, injections, parenteral fluid
			 administration, tube feedings, gastrostomy care, colostomy care, ileostomy
			 care, respiratory therapy, tracheostomy care, suctioning, physical therapy and
			 occupational therapy.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99835 - "Plan of correction" defined

Current through June 11,
			 2024
"Plan of correction" means a plan developed by
			 the facility and approved by the Bureau that:
1. Describes the actions to be taken by the
			 facility to correct one or more deficiencies; and
2. Specifies the date by which those
			 deficiencies will be corrected.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99836 - "Provider agreement" defined

Current through June 11,
			 2024
"Provider agreement" means an agreement between
			 a facility and:
1. The Centers for
			 Medicare and Medicaid Services, if the facility is a Medicare facility;
			 or
2. The Division of Health Care
			 Financing and Policy, if the facility is a Medicaid facility.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99837 - "Repeated deficiency" defined

Current through June 11,
			 2024
"Repeated deficiency" means a deficiency found
			 by the Bureau again within 18 months, including one found at a follow-up
			 survey, an investigation of a complaint or the next annual survey.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99838 - "Resurvey" defined

Current through June 11,
			 2024
"Resurvey" means a subsequent survey conducted
			 to evaluate compliance with a plan of correction.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99839 - "Severity and scope score" defined

Current through June 11,
			 2024
"Severity and scope score" means the sum of the
			 numerical levels of severity and scope assigned to a deficiency.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.9984 - "Subsequent deficiency" defined

Current through June 11,
			 2024
"Subsequent deficiency" means a deficiency
			 found on a resurvey.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99841 - "Temporary management" defined

Current through June 11,
			 2024
"Temporary management" means the temporary
			 appointment by the Bureau or by a court of competent jurisdiction of a manager
			 or administrator with authority to operate the facility and to hire, terminate
			 or reassign staff, obligate money of the facility, alter procedures and manage
			 the facility to correct the deficiencies found during a survey or visit
			 identifying the deficiencies.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99843 - Purposes of administrative sanctions

Current through June 11,
			 2024
The purposes of administrative sanctions are
			 to:
1. Safeguard the rights, interests
			 and well-being of recipients, including the protection of recipients from
			 actual or potential harm resulting from deficiencies;
2. Encourage and assist facilities to comply
			 with the requirements of the Division, including those imposed by federal
			 law;
3. Promote the efficient use
			 of resources to ensure appropriate care, treatment and services for recipients;
			 and
4. Protect Medicare
			 beneficiaries and Medicaid recipients against health care of substandard
			 quality.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › General Provisions › Section 449.99844 - Interpretation of provisions in accordance with federal standards

Current through June 11, 2024
With respect
			 to facilities governed by the federal Medicare or Medicaid criteria, the
			 provisions of NAC 449.9982 to 449.99939, inclusive, must be interpreted in
			 accordance with applicable federal standards.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.9985 - Authority of Division and Bureau

Current through June 11,
			 2024
Administrative sanctions authorized by
			 NRS
			 449.163 must be imposed by the Division
			 through the Bureau.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99851 - Requirement for imposition; optional imposition

Current through
			 June 11, 2024
At least one administrative sanction
			 must be imposed for each deficiency in any facility with a severity level of
			 four and for each deficiency in any facility with a combined severity and scope
			 score of six or more. The Bureau may impose sanctions if deficiencies of a
			 severity level three or less or a combined severity and scope score of less
			 than six are identified.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99852 - Requirement for imposition; multiple sanctions

Current through
			 June 11, 2024
The Bureau must impose at least one of
			 the sanctions listed in NAC 449.99863 upon any facility that has a deficiency
			 with a severity level of four or a combined severity and scope score of six or
			 more. More than one of these sanctions may be imposed in the discretion of the
			 Bureau.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99853 - Imposition of one or more sanctions; criteria for imposition of particular sanction

Current through June 11,
			 2024
The Bureau may apply one or more sanctions as
			 provided in NAC 449.99863 and 449.99935. If the Bureau chooses to impose a
			 particular sanction, it must be applied according to the severity and scope
			 factors established in NAC 449.99858 to 449.99861, inclusive.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99854 - Imposition in lieu of or in addition to recommendation to terminate provider agreement; duration of sanctions

Current through June 11,
			 2024
1. The Bureau may
			 apply one or more of the sanctions specified in NAC 449.99863 in lieu of or in
			 addition to a recommendation to the Division of Health Care Financing and
			 Policy or the Centers for Medicare and Medicaid Services to terminate a
			 provider agreement.
2. Sanctions
			 applied pursuant to NAC 449.9982 to 449.99939, inclusive, may be imposed until
			 substantial compliance is achieved or, if compliance is not achieved, until the
			 day before termination of the license or provider agreement becomes
			 effective.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99855 - Imposition in emergencies: Authority; notice

Current through
			 June 11, 2024
1. If
			 necessary to protect the public health and safety, the Bureau may impose such
			 sanctions as are necessary without notice to the facility or by oral notice to
			 the facility.
2. If there is an
			 immediate and serious threat to the health and safety of recipients served by a
			 facility, the Bureau may appoint a temporary manager to remove the threat. A
			 temporary manager may also be appointed without prior written notice on an
			 emergency basis if a facility violates any ban on admissions. If there is an
			 immediate and serious threat to the health and safety of recipients, the times
			 provided for notice contained in this subsection govern. In all other respects,
			 the provisions governing temporary management found in NAC 449.99915 to
			 449.99921, inclusive, apply.
3. The
			 Bureau may, in an emergency, impose a ban on admissions, a limitation on
			 occupancy of a residential facility or may suspend the license of a facility
			 without notice or upon oral notice as provided in this section.
4. In any case where sanctions are imposed
			 without written notice, the Bureau shall provide written notice that complies
			 with the requirements of NAC 439.345 within 48 hours after the imposition of
			 the sanctions.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R044-97, 10-30-97
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99856 - Deficiencies: Basis for imposition of sanctions; reporting; presumption of de minimis deficiency

Current through June 11,
			 2024
1. Except as
			 otherwise provided in section 4, the Bureau may apply one or more sanctions on
			 the basis of deficiencies found during surveys or investigations of complaints
			 conducted by the Bureau.
2.
			 Deficiencies must be reported to the facility and, if applicable, to the
			 Centers for Medicare and Medicaid Services. The notice to the facility must
			 specify the deficiencies found and the severity and scope score for each
			 deficiency determined by the Bureau.
3. Any deficiency for which a severity and
			 scope score is not specified is presumed to be a de minimis
			 deficiency.
4. A notice of
			 deficiencies is confidential until 14 days after the date on which the notice
			 is sent to the facility.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002; A by
			 R048-22A,
			 eff. 12/29/2022
NRS
			 439.200,
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99857 - Classifications of severity and scope of deficiencies: Use

Current
			 through June 11, 2024
In determining the sanctions
			 to be imposed, the Bureau shall consider the severity and scope of the
			 deficiencies according to the classifications of severity and scope described
			 in NAC 449.99858 to 449.99861, inclusive.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99859 - Scope of deficiencies: Use of scope scale; basis for assessment

Current through June 11, 2024
1. The scope scale must be used to assess the
			 scope of a particular deficiency in or by the facility.
2. The basis for the assessment is the actual
			 or potential harm to recipients as shown by:
(a) The frequency of the
			 deficiency;
(b) The number or
			 percentage of recipients affected;
(c) The number or percentage of staff
			 involved; and
(d) The pattern or
			 lack of pattern of the deficiencies.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.9986 - Scope of deficiencies: Criteria for evaluation

Current through
			 June 11, 2024
1. The
			 scope of the deficiencies must be evaluated using the criteria prescribed in
			 this section.
2. A deficiency of
			 scope level one consists of one or an isolated number of unrelated incidents in
			 the sample surveyed. A deficiency is of this scope if it involves 20 percent or
			 less of the recipients sampled in a facility.
3. A deficiency is scope level two if the
			 Bureau identifies a pattern of incidents at the facility, including any
			 deficiencies involving recipients who require particular kinds of care,
			 treatment or service. The number or percentage of recipients or staff involved
			 in the incidents or the repeated occurrences of incidents in short succession
			 may also establish a pattern by indicating a reasonable degree of
			 predictability of similar incidents. A deficiency is also of this scope if it
			 involves more than 20 percent but not more than 50 percent of the recipients
			 sampled in a facility.
4. A
			 deficiency is of scope level three if it occurs in a sufficient number or
			 percentage of recipients or staff or with sufficient regularity over time that
			 it may be considered systemic or pervasive in or by the facility. A deficiency
			 is also of this scope if it involves more than 50 percent of the recipients
			 sampled in a facility.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99861 - Severity of deficiencies: Use of severity scale; basis for assessment; criteria for evaluation

Current through June 11,
			 2024
1. The severity
			 scale must be used to assess the severity of a particular deficiency pertaining
			 to the facility. The basis for the assessment must be the actual or potential
			 harm to recipients.
2. Deficiencies
			 of severity level one concern requirements promulgated primarily for
			 administrative purposes. No harm is likely to occur to a recipient. No negative
			 recipient impact has occurred or is likely to occur. The ability of a recipient
			 to achieve the highest practicable physical, mental or psychosocial well-being
			 has not been and is not likely to be compromised.
3. Deficiencies of severity level two
			 indirectly threaten the health, safety, rights, security, welfare or well-being
			 of a recipient. A potential for harm, as yet unrealized, exists. If continued
			 over time, a negative impact on one or more recipients or a violation of one or
			 more recipients' rights would occur or would be likely to occur or the ability
			 of one or more recipients to achieve the highest practicable physical, mental
			 or psychosocial well-being would be, or would likely be, compromised.
4. Deficiencies of severity level three
			 create a condition or incident in the operation or maintenance of a facility
			 that directly or indirectly threatens the health, safety, rights, security,
			 welfare or well-being of one or more recipients. A negative impact on the
			 health, safety, rights, security, welfare or well-being of one or more
			 recipients has occurred or can be predicted with substantial probability to
			 occur or the ability of recipients to achieve the highest practicable physical,
			 mental or psychosocial well-being has been or is about to be compromised and
			 requires intervention and correction of the deficiency. Violation of a partial
			 or complete ban on admissions imposed on a facility, violation of a limitation
			 on occupancy of a residential facility or failure to implement a directed plan
			 of correction is presumed to be a deficiency of this level of
			 severity.
5. Deficiencies of
			 severity level four create a condition or incident that has resulted in or can
			 be predicted with substantial probability to result in death or serious harm to
			 a recipient. As used in this subsection, "serious harm" includes serious mental
			 harm, serious impairment of bodily functions, serious dysfunction of any bodily
			 organ or part, life-threatening harm or death.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99862 - Presumption when same deficiency found on resurvey; imposition of sanction for subsequent deficiency

Current through June 11,
			 2024
If the same deficiency is found on a resurvey,
			 there is a rebuttable presumption that the deficiency continued through the
			 period between the survey and resurvey. A sanction may be imposed for a
			 subsequent deficiency only if the resurvey is made and the deficiency is again
			 actually found to be present.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99863 - Available sanctions

Current through June 11,
			 2024
The sanctions available for all facilities
			 include:
1. The imposition of a plan
			 of correction as directed by the Bureau;
2. The issuance of a provisional license as
			 provided by
			 NRS
			 449.091;
3. The imposition of a limitation on the
			 occupancy of a residential facility;
4. The imposition of a ban on
			 admissions;
5. Monitoring of the
			 facility by the Bureau;
6. The
			 assessment of monetary penalties;
7. The requirement that the facility be
			 managed temporarily by a person appointed by the Bureau; and
8. The denial, suspension or revocation of
			 the license of the facility or an endorsement on a license, if
			 applicable.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R119-10, 1-13-2011
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99864 - Determination of appropriate sanction: Procedure

Current through
			 June 11, 2024
To determine the appropriate sanction,
			 the Bureau shall follow the procedure set forth in NAC 449.99864 to 449.99867,
			 inclusive.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99865 - Determination of appropriate sanction: Initial assessment

Current
			 through June 11, 2024
The Bureau shall initially
			 assess individual deficiencies or clusters of deficiencies according to the
			 following initial factors:
1. The
			 presence or absence of an immediate and serious threat to the health and safety
			 of residents;
2. The severity of
			 the deficiency; and
3. The scope of
			 the deficiency.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99866 - Determination of appropriate sanction: Consideration of secondary factors

Current through June 11, 2024
After the
			 initial assessment, the Bureau shall consider the following secondary factors
			 in determining the sanction to impose:
1. The relationship of one deficiency or
			 cluster or pattern of deficiencies to other deficiencies;
2. The history of previous compliance by the
			 facility generally and specifically with reference to the deficiencies in
			 issue;
3. Whether the deficiencies
			 are directly related to the care, services or treatment received by persons
			 from the facility; and
4. The
			 corrective and long-term compliance outcomes desired.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Imposition: Generally › Section 449.99867 - Determination of appropriate sanction: Basis for selection; presumption

Current through June 11, 2024
The
			 selection of a sanction must be based upon the nature of the deficiencies or
			 cluster of deficiencies and the sanction most likely to correct those
			 deficiencies. Absent evidence to the contrary, restrictions upon service and
			 monetary penalties are presumed to be the most effective sanctions for
			 deficiencies that do not cause an immediate and serious threat to
			 recipients.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Plan of Correction › Section 449.9987 - Development and submission of plan; authority of Bureau when plan is not acceptable; effect of failure to submit plan

Current through June 11,
			 2024
1. The facility
			 shall develop a plan of correction for each deficiency and submit the plan to
			 the Bureau for approval within 10 days after receipt of the statement of
			 deficiencies. The plan of correction must include specific requirements for
			 corrective action, which must include times within which the deficiencies are
			 to be corrected.
2. If the plan is
			 not acceptable to the Bureau, the Bureau may direct the facility to resubmit a
			 plan of correction or the Bureau may develop a directed plan of correction with
			 which the facility must comply.
3.
			 Failure to submit the plan of correction to the Bureau within 10 days
			 constitutes a separate deficiency subject to monetary penalties with severity
			 and scope rated at the same levels as the highest deficiency identified on the
			 notice of deficiencies.
4. Except
			 as otherwise provided in this subsection, a plan of correction that has not
			 been approved by the Bureau is confidential. The Bureau may provide such a plan
			 of correction to any entity within the Department of Health and Human Services
			 or the Centers for Medicare and Medicaid Services of the United States
			 Department of Health and Human Services. If the Bureau develops a directed plan
			 of correction pursuant to subsection 2, the unapproved plan of correction
			 submitted by the facility pursuant to subsection 1 and the directed plan of
			 correction cease to be confidential 14 days after the date on which the Bureau
			 sends the directed plan of correction to the facility.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by
			 R048-22A,
			 eff. 12/29/2022
NRS
			 439.200,
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Limitation on Occupancy of Residential Facility › Section 449.99875 - Purpose and scope of limitation; imposition in addition to partial ban on admissions

Current through June 11,
			 2024
1. A limitation on
			 the occupancy of a residential unit must be imposed by the Bureau to safeguard
			 the health, safety and well-being of residents currently receiving care,
			 treatment or services and to prevent the admission of persons who cannot
			 adequately be served by the facility. If a limitation on occupancy is imposed,
			 the limitation applies regardless of the source of payment. The Bureau may
			 limit the occupancy of a facility to the number of beds occupied at the time
			 the deficiency occurred. If such a limitation is imposed, priority in new
			 admissions must be given to immediate relatives of persons presently occupying
			 the facility.
2. If the facility
			 contains separately identifiable units and the deficiencies are confined to one
			 or more discrete units, the limitation on occupancy may be limited to those
			 units.
3. A limitation on occupancy
			 may be imposed in addition to a partial ban on admissions if the facility is
			 unable to provide adequate care, treatment or services for persons needing a
			 discrete kind or type of care.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Limitation on Occupancy of Residential Facility › Section 449.99876 - Criteria for imposition

Current through June 11,
			 2024
1. If the Bureau
			 imposes a limitation on the occupancy of a residential facility, the limitation
			 must be imposed as provided in this section.
2. For deficiencies with a combined severity
			 and scope score of six or more, a limitation on occupancy must be
			 imposed.
3. For deficiencies with a
			 severity and scope score of less than six, a limitation on occupancy may be
			 imposed if the deficiencies involve direct recipient care, services or
			 treatment or the ability of residents to exit the facility safely in case of a
			 fire or other emergency.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Limitation on Occupancy of Residential Facility › Section 449.99877 - Duration and termination of limitation

Current through June 11,
			 2024
A limitation on occupancy:
1. Must be imposed for not less than 72
			 hours.
2. Must be terminated if the
			 facility demonstrates that substantial improvements have been made to correct
			 the deficiencies and that the health, safety and well-being of recipients are
			 adequately safeguarded.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Limitation on Occupancy of Residential Facility › Section 449.99878 - Notice of limitation: General requirements; effect of noncompliance

Current through June 11, 2024
1. If a limitation on occupancy is imposed, a
			 notice of the limitation must be posted at all public entrances to the facility
			 within 48 hours after the facility receives notice of the limitation. Each
			 notice must be not less than 15 inches by 20 inches in size and include:
(a) The words "NOTICE OF LIMITATION ON
			 OCCUPANCY" printed in boldface type not less than 1 1/2 inches in
			 size;
(b) A statement specifying
			 the number of residents the facility is authorized to serve;
(c) A statement identifying a member of the
			 staff of the facility who will provide additional information relating to the
			 limitation on occupancy; and
(d)
			 The telephone number of the Bureau.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Ban on Admissions › Section 449.9988 - Purpose and scope of ban

Current through June 11,
			 2024
1. A ban on
			 admissions may be imposed by the Bureau on a residential or nonresidential
			 facility to safeguard the health, safety and well-being of recipients receiving
			 care, treatment or services and to prevent the admission of persons who cannot
			 adequately be served by the facility. If a ban is imposed, it applies to all
			 new admissions, regardless of the source of payment.
2. An immediate family member of a resident
			 of a residential facility is not a new admission for the purposes of a ban on
			 admissions unless the deficiencies are such that the health, safety or
			 well-being of the immediate family member will be directly
			 jeopardized.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Ban on Admissions › Section 449.99881 - Criteria for imposition

Current through June 11,
			 2024
1. If the Bureau
			 imposes a ban on admissions, the ban must be imposed as provided in this
			 section.
2. For deficiencies of
			 severity level four and scope level two or more, a ban on all new admissions
			 must be imposed.
3. For
			 deficiencies of severity level three and scope level three, a ban on all new
			 admissions must be imposed.
4. For
			 deficiencies of severity level three and scope level two, a complete or partial
			 ban on admissions may be imposed. If the deficiency is related to a discrete
			 type of care, treatment or services, the ban may be limited to new admissions
			 requiring the care, treatment or services for which the deficiency is
			 found.
5. For deficiencies with a
			 severity level of three or four and a scope level of one, the Bureau may impose
			 a partial ban on admissions, limited to persons needing the care, treatment or
			 services affected by the deficiency.
6. For deficiencies with a severity level of
			 two and a scope level of three, a ban on admissions may be imposed if the
			 deficiencies directly affect the care, treatment or services furnished to
			 recipients. The ban may be limited to those persons requiring the kind or type
			 of services affected by the deficiencies.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Ban on Admissions › Section 449.99882 - Duration and termination of ban

Current through June 11,
			 2024
A ban on admissions:
1. Must be imposed for not less than 72
			 hours.
2. Must be terminated if the
			 facility demonstrates that substantial improvements have been made to correct
			 the deficiencies and that the health, safety and well-being of recipients are
			 adequately safeguarded.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Ban on Admissions › Section 449.99883 - Notice of ban: General requirements; effect of noncompliance

Current through June 11, 2024
1. If a ban on admissions is imposed, a
			 notice of the ban must be posted at all public entrances to the facility within
			 48 hours after the facility receives notice of the ban. Each notice must be not
			 less than 15 inches by 20 inches in size and include:
(a) The words "NOTICE OF BAN ON ADMISSIONS"
			 printed in boldface type not less than 1 1/2 inches in size;
(b) A statement identifying a member of the
			 staff of the facility who will provide additional information relating to the
			 ban on admissions; and
(c) The
			 telephone number of the Bureau.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monitoring of Facility › Section 449.99885 - Authority of Bureau

Current through June 11,
			 2024
1. The Bureau may
			 monitor the implementation of the plan of correction of the facility to
			 determine whether the facility carries out the plan of correction.
2. The Bureau may also monitor the facility
			 if the scope of the deficiencies identified is difficult to evaluate on a
			 single visit. Such deficiencies include, without limitation, violations of
			 recipients' rights, inappropriate use of restraints and cases in which the
			 Bureau has reason to question the ongoing compliance of the facility with the
			 requirements of federal or state law.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99895 - Imposition by Bureau; purpose; applicable criteria

Current
			 through June 11, 2024
The Bureau may impose a
			 monetary penalty alone or in addition to other penalties. The purpose of a
			 monetary penalty is to provide a fund for protecting the health, safety,
			 rights, welfare and well-being of recipients and the property of residents in
			 facilities and to deter future deficiencies. If a monetary penalty is imposed,
			 the criteria in NAC 449.99896 must be applied.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99896 - Criteria for imposition; imposition of initial and daily penalties

Current through June 11, 2024
1. Except as otherwise provided in subsection
			 4 of this section, the Bureau may impose a monetary penalty including interest
			 thereon on any facility that is not in compliance with any participation
			 requirement, regardless of whether the deficiency constitutes an immediate and
			 serious threat.
2. If a monetary
			 penalty is imposed, the initial amount of the penalty must be based on the
			 severity and scope score of the deficiency and must be imposed as provided in
			 NAC 449.99899.
3. In addition to
			 the initial monetary penalty, the Bureau may impose a monetary penalty for each
			 day of noncompliance from the date the noncompliance occurs or is identified
			 until compliance is verified.
4. A
			 facility is not subject to a monetary penalty for a de minimis
			 deficiency.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99897 - Imposition of initial penalty pending hearing or appeal; stay of payment of penalties pending appeal

Current through June 11,
			 2024
1. The Bureau shall
			 impose an initial monetary penalty pending a hearing or appeal. The payment of
			 the initial penalty must not be stayed during the pendency of any
			 administrative appeal.
2. The
			 payment of any daily monetary penalties or interest that accrue while the
			 facility has a hearing pending on the initial determination of deficiencies
			 leading to the imposition of sanctions must be stayed pending the
			 appeal.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99898 - Procedure for imposition; interest on total penalty assessed

Current through June 11, 2024
If the
			 Bureau imposes a monetary penalty, the penalty must be imposed as provided in
			 NAC 449.99899 to 449.99908, inclusive. In imposing the monetary penalty, the
			 total penalty assessed against any facility bears interest at the rate of 10
			 percent per annum.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99899 - Determination of amount of penalties

Current through June 11,
			 2024
1. In determining
			 the amount of an initial monetary penalty, the Bureau shall consider the
			 severity alone if the severity level is four. In determining the amount of the
			 monetary penalty where the severity level is less than four, both severity and
			 scope must be considered. In determining whether to impose a daily monetary
			 penalty, the Bureau shall consider the severity and scope and the factors
			 indicated for increased and decreased penalties provided in NAC 449.99902 and
			 449.99904.
2. For initial
			 deficiencies with a severity level of four, an initial monetary penalty of
			 $1,000 per deficiency must be imposed.
3. For initial deficiencies rated with a
			 severity level of three and a scope level of three, a monetary penalty of $800
			 per deficiency must be imposed.
4.
			 For initial deficiencies with a severity level of three and a scope level of
			 two or less, an initial monetary penalty of $400 per deficiency must be
			 imposed.
5. For initial
			 deficiencies with a severity level of two and a scope level of three, an
			 initial monetary penalty of $200 per deficiency may be imposed. The payment of
			 this monetary penalty must be suspended if the facility has corrected the
			 deficiencies within the time specified in the plan of correction approved by
			 the Bureau.
6. In addition to any
			 monetary penalty imposed pursuant to this section, the Bureau may impose a
			 monetary penalty of not more than $10 per recipient per day for each day the
			 deficiency continues.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.998995 - Use of initial monetary penalty to correct deficiency

Current through June 11, 2024
1. A facility may submit to the Bureau a
			 request to use all or a portion of an initial monetary penalty imposed upon the
			 facility pursuant to NAC
			 449.99899 to correct the
			 deficiency for which the penalty was imposed in lieu of paying the penalty to
			 the Bureau. The Bureau may approve such a request if the deficiency results
			 from the facility's first violation of a particular provision of law or
			 regulation.
2. If the Bureau
			 approves a request pursuant to subsection 1, the facility must:
(a) Adhere to any requirements prescribed in
			 a plan of correction approved pursuant to NAC
			 449.9987 concerning the use of
			 the monetary penalty;
(b) Complete
			 all corrections for which the monetary penalty is used not later than 1 year
			 after the date on which the request was approved;
(c) Submit to the Bureau proof satisfactory
			 to the Bureau that the monetary penalty was used to make corrections for which
			 the use of the monetary penalty was approved by the Bureau pursuant to
			 subsection 1; and
(d) Remit to the
			 Bureau any portion of the monetary penalty that is not used to correct the
			 deficiency.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.999 - Limitation on principal amount of total daily penalty

Current
			 through June 11, 2024
In no event may the principal
			 amount of the total daily monetary penalty assessed against any facility exceed
			 $1,000 per deficiency per day.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99901 - Daily penalty: Computation according to number of recipients

Current through June 11, 2024
If a
			 monetary penalty is assessed on a daily basis according to the number of
			 recipients and the number of recipients fluctuates, the penalty must be
			 computed on the basis of the average daily number of recipients during the 3
			 months preceding the imposition of the penalty.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99902 - Increase in penalty for repeated deficiencies or false compliance

Current through June 11, 2024
1. Penalties must be increased if
			 deficiencies are repeated or compliance is falsely alleged.
2. For each repeat deficiency present within
			 18 months after an initial deficiency, the monetary penalty must be computed at
			 the rate of one and one-half times the rate that was or could have been
			 assessed initially for a deficiency of that severity and scope.
3. The Bureau may double the daily monetary
			 penalty that was or could have been assessed if the facility alleges compliance
			 and the Bureau finds on a survey that at the time compliance was alleged the
			 deficiencies continued to exist.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99903 - Presumption regarding deficiencies identified on resurvey

Current
			 through June 11, 2024
There is a rebuttable
			 presumption that deficiencies identified on a resurvey were present on each day
			 between the date of the initial deficiency and the date of the resurveyed
			 deficiency.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99904 - Reduction of penalty

Current through June 11,
			 2024
If a facility against which a monetary penalty
			 is imposed:
1. Waives the right to a
			 hearing;
2. Corrects the
			 deficiencies that were the basis for the sanction; and
3. Pays the monetary penalty within 15 days
			 after receipt of the notice of the penalty,
the penalty must be reduced
			 by 25 percent and no interest may be charged.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99905 - Daily penalty: Effective beginning date

Current through June
			 11, 2024
The effective beginning date of a daily
			 monetary penalty is:
1. In the case of
			 an immediate and serious threat, the date the deficiency occurred; or
2. In any other case, the day the deficiency
			 is identified.
Added to NAC by Bd. of Health,
			 eff. 8-1-91
NRS
			 449.0302,
			 449.165
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99906 - Daily penalty: Date and period of computation; notice to facility

Current through June 11, 2024
1. Daily penalties and interest must be
			 computed after compliance has been verified or the provider has been sent
			 notice of termination of a license or provisional license. A daily monetary
			 penalty must end on the effective date of compliance or termination of the
			 license of the facility.
2. If a
			 provider achieves compliance, the Bureau shall send a separate notice to the
			 facility containing:
(a) The amount of the
			 penalty per day;
(b) The number of
			 days involved;
(c) The due date of
			 the penalty; and
(d) The total
			 amount due.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › ADMINISTRATIVE SANCTIONS › Monetary Penalties › Section 449.99907 - Termination of daily penalties; failure of Medicaid facility to remove immediate and serious threat after appointment of temporary management

Current through June 11, 2024
1. The daily accrual of a monetary penalty
			 must end if the facility demonstrates that substantial improvements have been
			 made to correct the deficiencies and that the health, safety and well-being of
			 recipients are adequately protected and safeguarded.
2. A monetary penalty may be imposed on a
			 daily basis for not longer than 6 months, after which the Bureau shall deny,
			 suspend or revoke the license of the facility and, if the facility is a
			 Medicaid facility and major deficiencies remain, request the Division of Health
			 Care Financing and Policy to terminate the Medicaid provider agreement of the
			 facility.
3. If a deficiency in a
			 Medicaid facility presents an immediate and serious threat and continues to
			 exist on the 23rd day after the appointment of temporary management, the Bureau
			 shall request the Division of Health Care Financing and Policy to terminate the
			 Medicaid provider agreement of the facility.
4. If the provider can supply credible
			 evidence that substantial compliance with participation requirements was
			 attained on a date preceding that of the survey, monetary penalties accrue only
			 until that date of correction for which there is credible evidence. As used in
			 this subsection, "credible evidence" means actual documentation that compliance
			 has been achieved.
Added to NAC by Bd. of Health,
			 eff. 8-1-91; A by R051-02, 7-24-2002
NRS
			 449.0302,
			 449.165