reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5445 - Social services

Current through June 11,
				2024
1. Each facility
				shall provide social services to each patient of the facility and to the
				provider of care for the patient, if required. The facility shall ensure that
				the social services support and maximize the adjustment, social functioning and
				rehabilitation of each patient of the facility.
2. The social worker shall:
(a) Conduct a psychosocial evaluation of each
				patient of the facility;
(b)
				Participate in a team review of the progress of the patient in accordance with
				the provisions of NAC 449.541;
(c)
				Recommend changes in the treatment of the patient based on the psychosocial
				requirements of the patient;
(d)
				Except as otherwise provided in subsection 7, provide casework and group work
				services to the patient and, if needed, to members of his or her family
				concerning the problems associated with treating end-stage renal
				disease;
(e) Except as otherwise
				provided in subsection 7, identify public agencies that may provide social
				services for the patient or other resources that are available to the patient
				and assist the patient and each member of his or her family in the use of those
				resources; and
(f) Participate in
				activities conducted at the facility to ensure the quality of the
				facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.546 - Patient care: Advanced practice registered nurses and physician assistants; medical emergencies

Current through June 11,
				2024
1. If an advanced
				practice registered nurse or a physician assistant provides treatment for a
				patient of a facility, the facility shall ensure that there is evidence of
				communication with the treating physician of the patient if the advanced
				practice registered nurse or physician assistant changes any order for
				treatment in accordance with the provisions of chapter 630 or 632 of
				NRS.
2. An advanced practice
				registered nurse or a physician assistant specified in subsection 1 may not
				replace the treating physician of the patient concerning:
(a) Participation in planning for the care of
				the patient; or
(b) Activities
				conducted at the facility to ensure the quality of the facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5465 - Patient care: Licensed practical nurses and dialysis technicians

Current through June 11, 2024
1. The provisions of NAC 449.501 to 449.5795,
				inclusive, do not prohibit a licensed practical nurse from practicing in
				accordance with the regulations adopted by the State Board of Nursing. If a
				licensed practical nurse acts in the capacity of a licensed practical nurse
				during the treatment of a patient of a facility, the licensed practical nurse
				must be certified to give intravenous injections by a board that is approved by
				the State Board of Nursing.
2. A
				member of the staff of a facility who acts in the capacity of a dialysis
				technician at the facility must be qualified in accordance with the provisions
				of NAC 449.5705 to 449.5775, inclusive. If the facility determines that the
				member of the staff is not qualified pursuant to those provisions, the facility
				shall not allow the member of the staff to act in the capacity of a dialysis
				technician until the member of the staff becomes qualified pursuant to those
				provisions.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.547 - Self-dialysis: Provision of training and certain services

Current
				through June 11, 2024
1.
				If a facility provides training to a patient of the facility concerning the
				performance of dialysis by the patient, a licensed nurse who has at least 12
				months of experience in the applicable dialysis modality, including
				hemodialysis or peritoneal dialysis, must be responsible for training the
				patient and each member of the family of the patient who intends to assist the
				patient in conducting the dialysis. The licensed nurse shall supervise all
				other members of the staff of the facility who assist in providing that
				training.
2. If a patient of a
				facility performs dialysis for himself or herself at the patient's residence,
				the facility shall provide the following services to the patient:
(a) A yearly physical examination;
(b) Monthly communication from a member of
				the staff of the facility by:
(1)
				Telephone;
(2) Visits to the
				facility by the patient; or
(3)
				Visits to the patient's residence by a member of the staff;
(c) A visit to the facility at
				least once every 3 months;
(d)
				Communication with the appropriate member of the interdisciplinary team that is
				established for the patient pursuant to the provisions of NAC
				449.541;
(e) Routine laboratory
				work in accordance with the policy of the facility; and
(f) A method by which the patient may contact
				a member of the staff of the facility, including the primary physician of the
				patient, at any time if an emergency concerning the condition of the patient
				occurs.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5475 - Continuous ambulatory peritoneal dialysis

Current through June
				11, 2024
If a facility provides continuous ambulatory peritoneal
				  dialysis for a patient of the facility, the facility shall provide the
				  following services to the patient:
1.
				Consultation with a registered nurse, social worker and licensed
				dietitian;
2. A system for
				maintaining a record of treatment that ensures continuity of care for the
				patient; and
3. Ordering of
				supplies on a continual basis.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001; A by R090-12,
				  12-20-2012
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.549 - Continuous cycling peritoneal dialysis

Current through June 11,
				2024
If a facility provides continuous cycling peritoneal dialysis
				  to a patient of the facility, the facility shall provide the following services
				  to the patient:
1. Surveillance of the
				patient's home adaptation, including provisions for visits to his or her
				residence;
2. Consultation with a
				registered nurse, social worker and licensed dietitian;
3. A system for maintaining a record of
				treatment that ensures continuity of care for the patient;
4. Installation and maintenance of the
				equipment required to perform the dialysis; and
5. Ordering of supplies on a continual
				basis.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001; A by R090-12,
				  12-20-2012
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5495 - Patient services by contract; laboratory

Current through June
				11, 2024
1. If a
				facility provides services to a patient of the facility by contract, the
				facility remains responsible for supervising the treatment of the patient and
				providing adequate care for the patient in accordance with the provisions of
				NAC 449.501 to 449.5795, inclusive.
2. If a facility maintains a laboratory for
				use by the facility, the laboratory must be licensed in accordance with the
				provisions of chapter 652 of NRS.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.550 - Governing body

Current through June 11,
				2024
1. Each facility
				shall establish a governing body that is legally responsible for developing and
				carrying out the policies of the facility regarding the management and
				operation of the facility.
2. The
				policies established and carried out pursuant to the provisions of subsection 1
				must include, without limitation:
(a) The
				governance of the governing body;
(b) The care and safety of the patients of
				the facility;
(c) The general
				operation of the facility; and
(d)
				The protection of the personal and property rights of each patient of the
				facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.5505 - Medical director

Current through June 11,
				2024
1. The medical
				director of a facility:
(a) Must be certified
				in nephrology or pediatric nephrology or be eligible for that certification by
				a board that is approved by the American Medical Association; or
(b) During the 5 years immediately preceding
				July 1, 2001, must have served for at least 12 months as the director of a
				dialysis program.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.552 - Physicians

Current through June 11, 2024
1. Each patient of a facility must be under
				the care of a physician who is a member of the medical staff of the
				facility.
2. If a patient of the
				facility receives pediatric dialysis at the facility, the treatment provided to
				the patient must be supervised by a pediatric nephrologist or a pediatrician.
				If a pediatric nephrologist is not available to serve as the primary physician
				for the patient, an adult nephrologist may serve as the primary physician for
				the patient if a direct patient evaluation is prepared by a pediatric
				nephrologist or a pediatrician at the initiation of care for the patient and
				annually until the patient reaches 6 years of age.
3. Each patient who receives treatment at the
				facility must be evaluated at least once each month by a physician who is a
				member of the medical staff of the facility. If a patient of the facility
				performs dialysis for himself or herself at the patient's residence, the
				patient must be examined by such a physician at least once every 3 months. The
				record of any examination conducted pursuant to the provisions of this
				subsection must include evidence of:
(a) A
				monthly assessment concerning any new or recurrent problems; and
(b) A review of the adequacy of the treatment
				provided to the patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.5525 - Orientation program for new employees; continuing education

Current through June 11, 2024
1. Each facility shall develop and carry out
				a program to orient and familiarize each new employee of the facility with:
(a) The policies and operation of the
				facility; and
(b) The
				responsibilities of the position for which the employee is employed by the
				facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.553 - Medical staff: Generally

Current through June 11,
				2024
1. Each physician
				who is a member of the medical staff of a facility must be licensed to practice
				medicine in this State.
2. The
				membership of the medical staff of a facility may include a nephrologist or any
				other physician who has training or demonstrated experience in providing care
				for a patient who is diagnosed with end-stage renal disease.
3. If a facility employs an advanced practice
				registered nurse or a physician assistant:
(a) The advanced practice registered nurse
				must be qualified in accordance with the provisions of chapter 632 of NRS;
				and
(b) The physician assistant
				must be qualified in accordance with the regulations adopted by the Board of
				Medical Examiners.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.5535 - Nurses

Current through June 11, 2024
1. Each nurse employed by a facility must be
				licensed to practice nursing in this State.
2. Except as otherwise provided in subsection
				3, each nurse of a facility who is assigned charge responsibilities must:
(a) Be a registered nurse; and
(b) Have at least 6 months of experience as a
				nurse in performing hemodialysis or in providing nursing care for a patient
				with permanent kidney failure. The experience required pursuant to the
				provisions of this paragraph must be obtained within the 2 years immediately
				preceding the date on which the nurse is assigned charge responsibilities by
				the facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.555 - Dietitians

Current through June 11, 2024
Each dietitian employed by a facility must be a licensed
				  dietitian.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001; A by R090-12,
				  12-20-2012
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.5555 - Social workers

Current through June 11,
				2024
Each social worker employed by a facility must:
1. Be licensed as a social worker in this
				State and hold a master's degree in social work from a graduate school of
				social work that is accredited by the Council on Social Work Education;
				or
2. Have worked for at least 2
				years as a social worker, 1 year of which was in a facility or transplantation
				program before September 1, 1976, and have established a consultative
				relationship with a social worker who has a master's degree in social work from
				a graduate school of social work that is accredited by the Council on Social
				Work Education.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.556 - Staff responsible for operating water treatment system

Current through June 11, 2024
1. Each member of the staff of a facility who
				is responsible for operating the water treatment system of the facility must
				demonstrate to the satisfaction of the Bureau that he or she understands the
				risks to patients of exposure to water that has not been treated by the water
				treatment system. The facility shall, for each of those members, prepare and
				maintain at the facility a written record of the training provided to those
				members concerning the safe operation of the water treatment system of the
				facility.
2. A facility shall not
				allow a person to repair or replace any component of the water treatment system
				of the facility unless the person is qualified to repair or replace the
				component pursuant to the provisions of NAC 449.5565. If the facility allows a
				person who is qualified pursuant to those provisions to repair or replace any
				component of the water treatment system of the facility, the facility shall
				prepare and maintain at the facility a written record of the training,
				education and experience of the person.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Administration and Personnel › Section 449.5565 - Staff that repairs or maintains equipment used to provide care to patients

Current through June 11, 2024
A facility shall not allow a member of the staff of the
				  facility to repair or maintain any equipment of the facility that is used to
				  provide care to a patient of the facility unless the member has completed a
				  course of instruction and demonstrated competency in repairing or maintaining
				  that equipment. The course must include instruction in the following
				  subjects:
1. The prevention of the
				transmission of hepatitis through any equipment that is used for
				dialysis;
2. The requirements for
				safety of systems that are used to deliver dialysate;
3. The control of bacteria;
4. Standards for water quality; and
5. The repair and maintenance of equipment
				used for dialysis or other equipment used by the facility to provide care to a
				patient of the facility.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.558 - Preparation and maintenance

Current through June 11,
				2024
1. Each facility
				shall establish a system for preparing and maintaining a clinical record for
				each patient of the facility. The system must be developed to ensure that the
				care provided to each patient of the facility is:
(a) Completely and accurately
				documented;
(b) Readily available
				for retrieval by the facility; and
(c) Systematically organized to facilitate
				the compilation and retrieval of information.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.5585 - Additional requirements

Current through June 11,
				2024
1. In addition to
				the provisions of NAC 449.558, the clinical record of each patient of a
				facility must include:
(a) An accurate
				assessment of the progress of the patient, including all changes in the medical
				status of the patient;
(b) The
				results of each diagnostic test concerning the patient that is requested by the
				attending nephrologist;
(c)
				Consultation reports; and
(d) All
				unusual occurrences concerning the care and treatment of the patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.559 - Medical history and physical examination

Current through June
				11, 2024
Each facility shall prepare a medical history of each patient
				  of the facility and conduct a physical examination of the patient. The medical
				  history and physical examination must be completed within 30 days before the
				  patient is admitted to the facility or within 2 weeks after he or she is
				  admitted to the facility. Before the patient receives his or her first
				  treatment at the facility, the physician for the patient must notify the charge
				  nurse for the facility of the diagnoses, medications, hepatitis status,
				  allergies and prescription for dialysis of the patient. All information
				  provided by the physician to the charge nurse pursuant to the provisions of
				  this section must be included in the clinical record of the patient.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.5595 - Transient patients

Current through June 11,
				2024
1. The clinical
				record of each transient patient of a facility must include:
(a) Each order for the treatment of the
				patient at the treating facility;
(b) Each laboratory report ordered by the
				treating facility concerning the patient that is prepared within 30 days after
				receiving treatment at the treating facility, including hepatitis B antigen
				status;
(c) The most recent patient
				care plan and treatment records received from the home facility of the patient;
				and
(d) All records received from
				the home facility concerning the care and treatment of the patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.561 - Discharge or transfer of patients; removal of records

Current
				through June 11, 2024
1.
				If a patient of a facility is discharged from the facility, the facility shall,
				within 30 days after the patient is discharged, prepare a discharge summary
				concerning the patient. The discharge summary must specify the disposition of
				the patient and include:
(a) A diagnosis of
				the patient or, if the patient has died, the cause of death;
(b) The date of the discharge or, if the
				patient has died, the date and location of his or her death;
(c) If the patient receives a kidney
				transplant or is relocated, information concerning the kidney transplant or
				relocation; and
(d) If the patient
				is discharged for a reason other than kidney transplantation or death, the
				reason for the discharge.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Clinical Records › Section 449.5615 - Cessation of operation of facility

Current through June 11,
				2024
If a facility ceases to operate, the facility shall:
1. Ensure the preservation of the clinical
				records of the facility; and
2. Not
				more than 30 days after the facility ceases to operate, notify the Bureau in
				writing of the location of the clinical records of the facility. The written
				notice must include the name and address of the custodian of the clinical
				records.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.570 - General qualifications; identification to be worn during training; provision of care; requirements to act as preceptor

Current through June
				11, 2024
1. A person may
				not act as a dialysis technician at a facility unless he or she is qualified in
				accordance with the provisions of NAC 449.5705 to 449.5775,
				inclusive.
2. If a dialysis
				technician receives training in any area of a facility in which treatment is
				provided to a patient of the facility, the dialysis technician shall, during
				the period in which he or she is located in that area, wear a tag or similar
				device that identifies the dialysis technician. The tag or similar device must
				be worn in a visible manner.
3.
				Until a dialysis technician becomes qualified in accordance with the provisions
				of NAC 449.5705 to 449.5775, inclusive, the dialysis technician may provide
				care to a patient of a facility only if the care is provided:
(a) As part of the training received by the
				dialysis technician at the facility; and
(b) Under the immediate supervision of a
				registered nurse or preceptor who is assigned for that purpose by the
				facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5705 - Qualification of technician determined to be qualified before July 1, 2001

Current through June 11, 2024
1. If a person completes an orientation
				program of a facility pursuant to the provisions of NAC 449.5525 and has been
				determined by the facility to be qualified to provide dialysis treatment before
				July 1, 2001, the person may qualify as a dialysis technician if he or she:
(a) Except as otherwise provided in
				subsection 2, passes the written examination specified in NAC 449.571 and
				demonstrates competency by obtaining a written list concerning his or her
				knowledge and skills prepared in accordance with the provisions of NAC
				449.5745; or
(b) Demonstrates to
				the satisfaction of an instructor or supervising nurse for the facility that
				the person is competent to assume the responsibilities of a dialysis technician
				and obtains from the instructor or supervising nurse a written list concerning
				his or her knowledge and skills prepared in accordance with the provisions of
				NAC 449.5745.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.571 - Program of training: Curriculum; duties of instructor; written examinations

Current through June 11,
				2024
1. Each program for
				training a dialysis technician provided by a facility must consist of a written
				curriculum that specifies the objectives for each portion of the
				course.
2. The written curriculum
				must include at least the following subjects:
(a) Introduction to dialytic therapies,
				including:
(1) The history of
				dialysis;
(2) Definitions and
				terminology;
(3) Communication
				skills;
(4) Ethics and
				confidentiality;
(5) The
				multidisciplinary process;
(6) The
				roles of the members of an interdisciplinary team established pursuant to the
				provisions of NAC 449.541; and
(7)
				Information concerning renal organizations and resources;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5715 - Program of training: Qualifications of instructors

Current
				through June 11, 2024
Each instructor who provides instruction pursuant to a
				  program of training specified in NAC 449.571 must be:
1. A physician who is qualified as a medical
				director in accordance with the provisions of NAC 449.5505;
2. A registered nurse who:
(a) Has at least 12 months of experience in
				performing hemodialysis obtained within the 2 years immediately preceding the
				date he or she begins instruction pursuant to the program; and
(b) Has provided to the facility a current
				written list concerning his or her knowledge and skills that is prepared
				pursuant to the provisions of NAC 449.5745;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.573 - Program of training: Certain persons authorized to provide instruction and serve as preceptor

Current through June 11,
				2024
If a licensed nurse or dialysis technician has at least 1
				  year of experience in performing hemodialysis and has filed with the facility a
				  current written list concerning his or her knowledge and skills prepared in
				  accordance with the provisions of NAC 449.5745, the licensed nurse or dialysis
				  technician may:
1. Assist in providing
				instruction to a dialysis technician at the facility; and
2. Serve as a preceptor at the
				facility.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5735 - Program of training: Required hours

Current through June 11,
				2024
1. Except as
				otherwise provided in subsection 2, each program of training specified in NAC
				449.571 must consist of at least 80 hours of education in the classroom and 200
				hours of directly supervised clinical training for each dialysis technician who
				is enrolled in the program.
2. A
				program of training for a dialysis technician who has experience in providing
				care directly to a patient of a facility may consist of not less than 80 hours
				of combined education in the classroom and clinical training if the dialysis
				technician demonstrates to the satisfaction of the facility that he or she is
				competent to provide that care.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.574 - Committee to review program of training

Current through June 11,
				2024
Each facility shall appoint a committee to review the
				  training provided pursuant to a program of training specified in NAC 449.571.
				  The membership of the committee must consist of at least the medical director,
				  supervising nurse and chief technician of the facility. The committee
				  shall:
1. Review the records of each
				dialysis technician enrolled in the program, including:
(a) The results of each examination taken by
				the dialysis technician pursuant to the provisions of NAC 449.571;
				and
(b) Each written list
				concerning the knowledge and skills of the dialysis technician prepared
				pursuant to the provisions of NAC 449.5745;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5745 - Written list concerning knowledge and skills

Current through June
				11, 2024
The supervising nurse or a registered nurse of a facility who
				  qualifies as an instructor for the facility shall complete a written list to
				  determine the knowledge and skills of each dialysis technician in performing
				  the following activities:
1.
				Assembling supplies required to provide treatment to a patient of the
				facility;
2. Preparing dialysate
				according to procedure and dialysis prescription;
3. Assembling and preparing the dialysis
				extracorporeal circuit;
4. Securing
				the correct dialyzer for the patient;
5. Installing and rinsing the dialyzer and
				all required tubing for the dialyzer;
6. Testing monitors and alarms, conductivity
				and, if applicable, testing for the presence or absence of residual
				sterilants;
7. Setting monitors and
				alarms in accordance with the protocols of the facility and the instructions of
				the manufacturer of the monitor or alarm;
8. Obtaining predialysis vital signs, weight
				and temperature of a patient of the facility in accordance with the protocols
				of the facility and, after obtaining that information, notifying the
				supervising nurse or registered nurse of all unusual findings;
9. Inspecting the dialysis access of the
				patient for patency and, after cannulation is performed and heparin is
				administered, initiating dialysis in accordance with the patient's
				prescription, observing universal precautions and reporting all unusual
				findings to the supervising nurse or registered nurse;
10. Adjusting the rate of the flow of blood
				in accordance with the protocols of the facility and the prescription of the
				patient;
11. Calculating and
				setting the dialysis machine to allow the removal of fluid at a rate
				established in accordance with the protocols of the facility and the
				prescription of the patient;
12.
				Monitoring the patient and equipment during treatment, responding appropriately
				to the requirements of the patient and to machine alarms, and reporting all
				unusual occurrences to the supervising nurse or registered nurse;
13. Changing the rate of the removal of
				fluid, placing the patient in the Trendelenburg position and administering
				replacement normal saline as directed by:
(a)
				The supervising nurse or registered nurse;
(b) An order of a physician; or
(c) The protocols of the facility;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.576 - Peritoneal dialysis: Additional activities required

Current
				through June 11, 2024
In addition to the written list required pursuant to the
				  provisions of NAC 449.5745, if a dialysis technician who is enrolled in a
				  course of training pursuant to the provisions of NAC 449.571 intends to provide
				  training or treatment for a patient of the facility who receives peritoneal
				  dialysis, each of the following activities must be completed satisfactorily by
				  the dialysis technician:
1. Assisting
				patients in ordering supplies;
2.
				Performing an exchange of dialysate by draining and refilling the peritoneal
				space with dialysate, including procedures for conducting a continuous
				ambulatory peritoneal dialysis exchange and the commencement or discontinuation
				of continuous cycling peritoneal dialysis;
3. Observing peritoneal effluent;
4. Recognizing and understanding the
				appropriate observations to report;
5. Collecting a specimen of
				dialysate;
6. Performing a change
				of transfer tubing; and
7. Setting
				up and operating the equipment required to conduct continuous cycling
				peritoneal dialysis.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5765 - Cannulation or administration of normal saline or heparin: Additional activities required

Current through June 11,
				2024
In addition to the written list required pursuant to the
				  provisions of NAC 449.5745, if a dialysis technician who is enrolled in a
				  course of training pursuant to the provisions of NAC 449.571 intends to
				  cannulate a dialysis access of a patient of the facility or administer normal
				  saline and heparin to that patient, each of the following activities must be
				  completed satisfactorily by the dialysis technician:
1. Cannulation, including:
(a) Inspecting the dialysis access of the
				patient for patency;
(b) Preparing
				the skin;
(c) Using aseptic
				techniques;
(d) Placing needles
				correctly;
(e) Establishing blood
				access;
(f) Replacing
				needles;
(g) Recognizing the
				circumstances under which a call for assistance may be required; and
(h) Securing needles;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.577 - Cannulation or administration of normal saline, heparin or lidocaine: Verification and documentation of competency required

Current through
				June 11, 2024
If a dialysis technician intends to cannulate a dialysis
				  access during the treatment of a patient of the facility or administer normal
				  saline, heparin or lidocaine, the medical director of the facility must, before
				  the dialysis technician performs those tasks at the facility, verify and
				  document whether the dialysis technician is competent to perform those
				  activities.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5775 - Documentation of successful completion of program of training; employment by another facility

Current through June 11,
				2024
1. A facility shall
				issue to each dialysis technician who successfully completes a program of
				training and receives an evaluation of his or her competency provided to him or
				her by the facility pursuant to the provisions of NAC 449.5705 to 449.5775,
				inclusive, a document indicating that the dialysis technician has successfully
				completed the program of training.
2. Each document issued pursuant to the
				provisions of subsection 1 must include a statement indicating that the program
				for which the document is issued satisfies the requirements of NAC 449.5705 to
				449.5775, inclusive.
3. A document
				issued pursuant to the provisions of subsection 1 may be accepted by any other
				facility that employs the dialysis technician. The document may be accepted
				only for 6 months after the date on which the document is issued. If the
				dialysis technician is employed by any other facility after that date, the
				dialysis technician shall obtain from the facility that employs the dialysis
				technician a written list concerning his or her knowledge and skills prepared
				in accordance with the provisions of NAC 449.5745.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.579 - Patient care: Technicians must demonstrate certain knowledge and competency

Current through June 11, 2024
A dialysis technician who provides care directly to a patient
				  of a facility must demonstrate knowledge of and competency to carry out the
				  responsibilities specified in NAC 449.5705 to 449.5775, inclusive.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Dialysis Technicians › Section 449.5795 - Prohibited acts

Current through June 11,
				2024
A dialysis technician of a facility shall not:
1. Initiate the provision of education for
				any patient of the facility;
2.
				Alter any treatment that is ordered for a patient of the facility, including
				shortening the period for providing treatment to the patient;
3. Administer any medication to a patient of
				the facility other than the administration of normal saline, heparin or
				lidocaine during the regular course of treatment for the patient;
4. Administer any blood or products of blood
				to a patient of the facility;
5.
				Perform a venipuncture other than a venipuncture at the point of access for
				dialysis;
6. Perform an arterial
				puncture; or
7. Accept the order of
				a physician.
Added to NAC by Bd. of
				  Health by R130-99, eff. 8-1-2001
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.6113 - Definitions

Current through June 11, 2024
As used in NAC
				  449.6113 to
				  449.61178, inclusive, and
				  sections 2 and 3 , unless the context otherwise requires:
1. "Licensed advanced practice registered
				nurse" means an advanced practice registered nurse who is licensed pursuant to
				chapter 632 of NRS to practice in a role as a nurse midwife by the State Board
				of Nursing.
2. "Licensed physician"
				means a physician licensed pursuant to chapter 630 or 633 of NRS.
3. "Maternal patient" means a woman admitted
				to an obstetric center in accordance with NAC
				449.61134 who has had a normal
				uncomplicated prenatal course, as determined by adequate prenatal care, and the
				prospect for a normal, uncomplicated birth, as defined by the criteria
				established by the American College of Obstetricians and Gynecologists and by
				reasonable and generally accepted clinical standards for maternal and fetal
				health.
4. "Obstetric care" means
				the care which is provided, in accordance with NAC
				449.6113 to
				449.61178, inclusive, and
				sections 2 and 3 immediately before, during and for not more than 24 hours
				after delivery to a maternal patient:
(a) Who
				has completed at least 37 weeks of gestation and not more than 42 weeks of
				gestation; and
(b) Whose condition
				is reasonably expected to result in a normal and uncomplicated vaginal
				birth.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.61132 - Authorized obstetric care

Current through June 11,
				2024
Obstetric care provided at an obstetric center must be
				  limited to:
1. Care provided
				immediately before, during and for not more than 24 hours after a vaginal birth
				to a maternal patient, if the care provided to the maternal patient does not
				include general or regional anesthesia; and
2. Assessment of a maternal patient before
				the completion of 36 weeks of gestation, for preterm labor or premature rupture
				of membranes and the initiation of appropriate treatment according to
				established written protocols.
Added to NAC by Bd. of
				  Health, eff. 7-19-96
NRS
					 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.61134 - Eligible maternal patients

Current through June 11,
				2024
A woman may be a maternal patient at an obstetric center
				  if:
1. She has completed at least 37
				weeks and not more than 42 weeks of gestation;
2. She has no major medical
				problems;
3. She has no previous
				history of major uterine wall surgery, cesarean section, or other obstetrical
				complications which are likely to recur;
4. She has parity of under six unless a
				justification for a variation is documented by the director for the obstetric
				center;
5. She is not less than 15
				years or more than 40 years of age and is not a nullipara, unless the director
				has reviewed the age and parity of the maternal patient and approves the
				admission of the maternal patient on a case-by-case basis;
6. She has no clinically significant signs or
				symptoms of:
(a) Pregnancy-induced
				hypertension;
(b) Polyhydramnios or
				oligohydramnios;
(c) Abruptio
				placenta;
(d)
				Chorioamnionitis;
(e) Multiple
				gestation;
(f) Intrauterine growth
				retardation;
(g) Meconium-stained
				amniotic fluid associated with signs of fetal intolerance of labor;
(h) Fetal intolerance of labor;
(i) Active substance use disorder;
(j) Placenta previa;
(k) Diabetes mellitus; or
(l) Anemia;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.61138 - Denial of application for or renewal of license; revocation or suspension of license

Current through June 11,
				2024
1. An application
				for a license or the renewal of a license may be denied if the facility,
				personnel or equipment fails to meet the requirements of NAC
				449.002 to
				449.99939, inclusive, and
				sections 2 and 3 or if cause or circumstance exists that may, in the opinion of
				the Division, threaten or have the potential to threaten the safety or health
				of the public.
2. A license may be
				revoked or summarily suspended in accordance with NAC
				449.002 to
				449.99939, inclusive, and
				sections 2 and 3 , and chapters 233B and 449 of NRS if the facility, personnel
				or equipment fails to meet the requirements of NAC
				449.002 to
				449.99939, inclusive, and
				sections 2 and 3 , or if cause or circumstance exists that may, in the opinion
				of the Division, threaten or have the potential to threaten the safety or
				health of the public.
3. An
				obstetric center shall maintain current accreditation by a nationally
				recognized organization approved by the Division. Within 6 months after initial
				licensure, an obstetric center shall submit to the Division proof of such
				accreditation. If the accreditation of an obstetric center becomes invalid for
				any reason, including, without limitation, lapse or revocation, the obstetric
				center shall immediately terminate operations.
Added to NAC by Bd. of
				  Health, eff. 7-19-96; A by R044-97, 10-30-97; A by
				  R059-16A,
				  eff. 12/21/2016
NRS
				  NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.6114 - Design, construction, equipment and maintenance of obstetric center: General requirements; prerequisites to approval for licensure

Current through June 11, 2024
1. An obstetric center must be designed,
				constructed, equipped and maintained in a manner that protects the health and
				safety of the patients and personnel of the obstetric center and members of the
				general public.
2. The Board hereby
				adopts by reference the chapter containing the specific requirements for
				freestanding birth centers contained in the
Guidelines for Design and
				Construction of Hospitals and Outpatient Facilities
in the form most
				recently published by the Facility Guidelines Institute, unless the Board gives
				notice that a revision is not suitable for this State pursuant to subsection 3.
				A copy of this publication may be obtained from the Facility Guidelines
				Institute at the Internet address
http://www.fgiguidelines.org/guidelines-main/
or by telephone at (800) 242-2626 for the price of $200.
3. The Board will review each revision of the
				publication adopted by reference pursuant to subsection 2 to ensure its
				suitability for this State. If the Board determines that a revision is not
				suitable for this State, the Board will hold a public hearing to review its
				determination within 6 months after the date of the publication of the revision
				and give notice of that hearing. If, after the hearing, the Board does not
				revise its determination, the Board will give notice within 30 days after the
				hearing that the revision is not suitable for this State. If the Board does not
				give such notice, the revision becomes part of the publication adopted by
				reference pursuant to subsection 2.
4. An obstetric center shall comply with all
				applicable:
(a) Federal and state
				laws;
(b) Local ordinances,
				including, without limitation, zoning ordinances;
(c) Environmental, health and local building
				codes;
(d) Fire and safety codes,
				including, without limitation, those codes relating to ingress and egress of
				occupants, placement of smoke alarms, fire extinguishers or sprinkler systems,
				and fire escape routes ; and
(e)
				Provisions of the publication adopted by reference in subsection 2, related to
				the design, construction and maintenance of the obstetric center. If there is a
				difference between state and local requirements, the more stringent
				requirements apply.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › PROVISION OF CERTAIN SPECIAL SERVICES › Obstetric Care › Section 449.61142 - Required facilities and services

Current through June 11,
				2024
1. An obstetric
				center shall provide:
(a) Services for labor,
				delivery, newborn and recovery care for not more than 24 hours after
				delivery.
(b) Areas for labor,
				delivery, newborn and recovery which are in a safe and clean environment in
				accordance with all applicable local, state and federal laws.
(c) Areas for:
(1) Maintenance and documentation of medical
				records of each maternal patient by physicians and nurses;
(2) Patient and family education;
(3) Treatment and examination of a maternal
				patient and newborn baby;
(4)
				Cleaning and storage of instruments and equipment which are located separately
				from the other areas of the obstetric center;
(5) Secure storage of drugs; and
(6) Family visitation.
(d) Simple nourishment for the maternal
				patient by providing:
(1) A separate area for
				appropriate storage of food which may be provided to the maternal patient by
				her family; or
(2) Food prepared or
				stored by the obstetric center. If food is prepared or stored by the obstetric
				center, the obstetric center must comply with all applicable local, state and
				federal laws relating to the preparation and storage of food by a medical
				facility.