reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.999446 - Outpatient facility required to designate employee or enter into contract for overseeing and managing program; qualifications and duties of employee or contractor

Current through June 11,
			 2024
1. Each outpatient
			 facility shall designate an employee or enter into a contract with a person to
			 oversee and manage all aspects of the program for the prevention and control of
			 infections and communicable diseases.
2. The person described in subsection 1:
(a) Must have completed specialized training
			 in the prevention and control of the development and transmission of infections
			 and communicable diseases; and
(b)
			 Shall ensure that the program for the prevention and control of infections and
			 communicable diseases for the outpatient facility:
(1) Complies with all applicable federal,
			 state and local laws;
(2) Is
			 consistent with the guidelines adopted by the holder of the permit pursuant to
			 NAC 449.999441; and
(3) Is reviewed
			 with all employees of the outpatient facility and all persons under contract
			 with the outpatient facility who work at the facility and have exposure to
			 patients at the facility within the first 10 days of employment and every 12
			 months thereafter, or more often if required pursuant to subsection 2 of NAC
			 449.999447.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.999447 - Mandatory training and evaluation of employees and other persons

Current through June 11, 2024
1. Each employee of an outpatient facility
			 and each person under contract with an outpatient facility who works at the
			 facility and has exposure to patients at the facility shall receive training
			 and must be evaluated by supervising staff on the employee's or contractor's
			 knowledge and skills concerning the program for the prevention and control of
			 infections and communicable diseases within the first 10 days of employment and
			 at least every 12 months thereafter.
2. An employee or person under contract with
			 the outpatient facility may be required to receive the training and evaluation
			 described in subsection 1 more often than every 12 months if a supervisor
			 determines that such training and evaluations are necessary to ensure that the
			 employee or contractor understands and will follow the policies and procedures
			 of the program for the prevention and control of infections and communicable
			 diseases.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 441A.120,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Program for the Prevention and Control of Infections and Communicable Diseases › Section 449.999448 - Establishment of additional policies and guidelines by holder of permit to ensure health and safety of patients; professional standards of practice; requirement of tuberculosis test for employees and persons under contract with outpatient facility

Current through June 11,
			 2024
In addition to the guidelines established
			 pursuant to NAC 449.999441, the holder of a permit to operate an outpatient
			 facility shall establish guidelines and maintain policies for the outpatient
			 facility which:
1. Ensure the health,
			 safety and well-being of patients of the outpatient facility;
2. Provide the professional standards of
			 practice for services provided by the outpatient facility and ensure that all
			 persons employed by the outpatient facility or under contract with the
			 outpatient facility comply with such professional standards; and
3. Require each person employed by the
			 outpatient facility or under contract with the outpatient facility to have a
			 skin test for tuberculosis in accordance with NAC 441A.375.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 441A.120,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.99945 - Definitions

Current through June 11, 2024
As used in
			 NAC 449.99945 to 449.999489, inclusive, unless the context otherwise requires,
			 the words and terms defined in NAC 449.999451 to 449.999457, inclusive, have
			 the meanings ascribed to them in those sections.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999451 - "Cluster" defined

Current through June 11,
			 2024
"Cluster" means a deficiency that involves the
			 same or similar kinds of care, treatment or services as one or more other
			 deficiencies.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999452 - "De minimis deficiency" defined

Current through June 11,
			 2024
"De minimis deficiency" means a deficiency
			 rated at a severity level of one or two and at a scope level of one or
			 two.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999453 - "Deficiency" defined

Current through June 11,
			 2024
1. "Deficiency"
			 means noncompliance with any state statute or regulation of the Board. The term
			 includes an incident concerning an outpatient facility where there are no
			 extenuating circumstances or where the facility has made an inappropriate
			 response to a complaint, including the failure to:
(a) Prevent an incident from occurring, if
			 the incident could have been avoided;
(b) Identify an incident;
(c) Take action to correct an incident before
			 the identification of the incident by the Bureau; or
(d) Implement a contingency plan if permanent
			 action to correct an incident has not been undertaken.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999454 - "Immediate and serious threat" and "immediate jeopardy" defined

Current through June 11, 2024
"Immediate
			 and serious threat" or "immediate jeopardy" means a situation in which
			 corrective action within 48 hours is necessary because the failure by an
			 outpatient facility to comply with a requirement of statute or regulation has
			 caused, or if uncorrected is likely to cause, serious injury or harm, or even
			 death, to a patient.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999455 - "Incident" defined

Current through June 11,
			 2024
"Incident" means an action, practice or
			 situation that appears to be inconsistent with a state statute or regulation of
			 the Board.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999456 - "Initial deficiency" defined

Current through June 11,
			 2024
"Initial deficiency" means the first occurrence
			 of a deficiency recorded by the Bureau, including, without limitation, any
			 deficiency found during a standard inspection, during an extended inspection or
			 in response to a complaint.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999457 - "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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999458 - Purpose of sanctions

Current through June 11,
			 2024
The purposes of administrative sanctions are
			 to:
1. Safeguard the rights, interests
			 and well-being of patients, including the protection of patients from actual or
			 potential harm resulting from deficiencies; and
2. Encourage and assist outpatient facilities
			 to comply with the requirements of the Division.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999459 - Grounds for denial, suspension or revocation of permit

Current
			 through June 11, 2024
In accordance with
			 NRS
			 449.447, the Division may deny an application
			 for a permit or may suspend or revoke a permit upon any of the following
			 grounds:
1. Offering to a patient a
			 service of general anesthesia, conscious sedation or deep sedation without a
			 permit, if a permit is required pursuant to
			 NRS 449.435 to
			 NRS 449.448,
			 inclusive, and NAC 449.99942.
2.
			 The failure or refusal of the holder of a permit to return an adequate plan of
			 correction to the Division within 10 days after the receipt of a statement of
			 deficiencies compiled pursuant to
			 NRS
			 449.446.
3. The failure or refusal of the entity to
			 whom a permit has been issued to comply with a directed plan of correction
			 issued by the Bureau.
4. The
			 failure or refusal to cooperate fully with an investigation or inspection by
			 the Bureau.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.99946 - Appeal of denial, suspension or revocation of permit or other sanction

Current through June 11, 2024
An applicant
			 or holder of a permit who is aggrieved by an action of the Division relating to
			 the denial, suspension or revocation of a permit or any other sanction assessed
			 pursuant to NAC 449.99945 to 449.999489, inclusive, may appeal pursuant to the
			 procedures set forth in NAC 439.300 to 439.395, inclusive.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999461 - Imposition of sanctions: Authority of Division and Bureau

Current through June 11, 2024
Administrative sanctions authorized by
			 NRS
			 449.447 may be imposed by the Division
			 through the Bureau.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999462 - Imposition of sanctions: Requirement for imposition; optional imposition; multiple sanctions; use of severity and scope factors for particular sanction

Current through June 11,
			 2024
1. The Bureau shall
			 impose at least one sanction listed in
			 NRS
			 449.447 upon an outpatient facility that has
			 a deficiency with a severity level of four or a combined severity and scope
			 score of six or more.
2. More than
			 one sanction may be imposed at the discretion of the Bureau.
3. The Bureau may impose sanctions if
			 deficiencies of a severity level of three or less or a combined severity and
			 scope score of less than six are identified.
4. If the Bureau chooses to impose a
			 particular sanction, it must be applied according to the severity and scope
			 factors established in NAC 449.999465 to 449.999468, inclusive.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999463 - Imposition of sanctions in emergencies: Notice; authority; exception to notice requirement

Current through June 11,
			 2024
1. Except as
			 otherwise provided in this section, the Bureau shall give notice pursuant to
			 the provisions of NAC 439.300 to 439.395, inclusive, before taking disciplinary
			 action against an outpatient facility.
2. If necessary to protect the public health
			 and safety, the Bureau may impose such sanctions as are necessary without
			 notice to the outpatient facility or by oral notice to the outpatient
			 facility.
3. If there is an
			 immediate and serious threat to the health and safety of patients served by an
			 outpatient facility, the provisions concerning notice contained in this section
			 govern.
4. The Bureau may suspend
			 the permit of an outpatient facility without notice or upon oral notice if the
			 Bureau finds that an emergency has caused a deficiency with a severity and
			 scope score of five or more which places one or more patients in immediate
			 jeopardy. For purposes of this subsection, "emergency" means any situation in
			 which an outpatient facility is unable to operate in a safe manner, including,
			 without limitation, due to a fire, flood, contagious infection, loss of
			 utilities or inappropriate transfer of patients.
5. 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999464 - Deficiencies: Basis for imposition of sanctions; reporting; presumption of de minimis deficiency

Current through June 11,
			 2024
1. The Bureau may
			 apply one or more sanctions on the basis of deficiencies found during
			 inspections or investigations of complaints conducted by the Bureau.
2. Deficiencies must be reported to the
			 outpatient facility by the Bureau. The notice to the outpatient 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.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999466 - 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 outpatient facility.
2. The basis for the assessment is the actual
			 or potential harm to patients as shown by:
(a) The frequency of the
			 deficiency;
(b) The number or
			 percentage of patients 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 › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999467 - 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. A
			 deficiency is of this scope if it involves 20 percent or less of the patients
			 sampled in an outpatient facility.
3. A deficiency is scope level two if the
			 Bureau identifies a pattern of incidents at the outpatient facility, including
			 any deficiencies involving patients who require particular kinds of care,
			 treatment or service. The number or percentage of patients 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 patients sampled in an
			 outpatient facility.
4. A
			 deficiency is of scope level three if it occurs in a sufficient number or
			 percentage of patients or staff or with sufficient regularity over time that it
			 may be considered systemic or pervasive in or by the outpatient facility. A
			 deficiency is also of this scope if it involves more than 50 percent of the
			 patients sampled in an outpatient facility.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999468 - 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 outpatient facility. The basis for the assessment must be the actual or
			 potential harm to patients.
2.
			 Deficiencies of severity level one concern requirements promulgated primarily
			 for administrative purposes. No harm is likely to occur to a patient. No
			 negative patient impact has occurred or is likely to occur. The ability of a
			 patient 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 patient. A potential for harm, as yet unrealized, exists. If continued
			 over time, a negative impact on one or more patients or a violation of one or
			 more patients' rights would occur or would be likely to occur or the ability of
			 one or more patients 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 an outpatient
			 facility that directly or indirectly threatens the health, safety, rights,
			 security, welfare or well-being of one or more patients. A negative impact on
			 the health, safety, rights, security, welfare or well-being of one or more
			 patients has occurred or can be predicted with substantial probability to
			 occur, or the ability of patients 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. 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 patient. 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999469 - Presumption when same deficiency found on subsequent inspection; imposition of sanction for subsequent deficiency

Current through June 11,
			 2024
If the same deficiency is found during a
			 subsequent inspection conducted to evaluate compliance with a plan of
			 correction, there is a rebuttable presumption that the deficiency continued
			 through the period between the inspection and the subsequent inspection. A
			 sanction may be imposed for a subsequent deficiency only if the subsequent
			 inspection is made and the deficiency is again actually found to be
			 present.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.99947 - Available sanctions

Current through June 11,
			 2024
The sanctions available for all outpatient
			 facilities include:
1. The assessment
			 of monetary penalties; and
2. The
			 denial, suspension or revocation of the permit for the outpatient
			 facility.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999471 - Determination of appropriate sanction: Procedure

Current through
			 June 11, 2024
To determine the appropriate sanction,
			 the Bureau shall follow the procedures set forth in NAC 449.99945 to
			 449.999489, inclusive.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999472 - 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 patients;
2. The severity of the
			 deficiency; and
3. The scope of the
			 deficiency.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999473 - 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
			 outpatient 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 patients who were offered a service of general anesthesia,
			 conscious sedation or deep sedation by the outpatient facility; and
4. The corrective and long-term compliance
			 outcomes desired.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999474 - Determination of appropriate sanction: Basis for selection; presumption for monetary penalties

Current through June 11,
			 2024
1. 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.
2. Absent evidence to
			 the contrary, monetary penalties are presumed to be the most effective
			 sanctions for deficiencies that do not cause an immediate and serious threat to
			 patients.
3. The Bureau may impose
			 a monetary penalty alone or in addition to other penalties.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999475 - Plan of correction: 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 outpatient 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 compiled
			 by the Division pursuant to
			 NRS
			 449.446. 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:
(a) Direct the
			 outpatient facility to resubmit a plan of correction;
(b) Develop a directed plan of correction
			 with which the outpatient facility must comply; or
(c) Revoke the outpatient facility's
			 permit.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999476 - Monetary penalties: Criteria for imposition; imposition of initial and daily penalties; exception for de minimis deficiency

Current through
			 June 11, 2024
1. Except
			 as otherwise provided in subsection 4, the Bureau may impose a monetary penalty
			 including interest thereon on any outpatient facility that is not in compliance
			 with a requirement of
			 NRS 449.435 to
			 449.448, inclusive,
			 and NAC 449.9994 to 449.999489, inclusive, 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 449.999479.
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. An outpatient facility
			 is not subject to a monetary penalty for a de minimis deficiency.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999477 - Monetary penalties: 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 accrues while the
			 outpatient 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999478 - Monetary penalties: Procedure for imposition; interest on total penalty assessed

Current through June 11,
			 2024
1. If the Bureau
			 imposes a monetary penalty, the penalty must be imposed as provided in NAC
			 449.999478 to 449.999482, inclusive.
2. In imposing the monetary penalty, the
			 total penalty assessed against any facility bears interest at the rate of 10
			 percent per annum on the unpaid balance of the penalty, beginning on the due
			 date.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999479 - Monetary penalties: 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 449.99948 and 449.999482.
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 outpatient 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 $1,000 per deficiency per day for each day the deficiency
			 continues.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.99948 - Monetary penalties: Increase in penalty for repeated deficiencies or falsely alleged compliance

Current through June 11,
			 2024
1. Penalties must
			 be increased for repeated deficiencies or if 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, not to exceed $1,000 per deficiency per day.
3. The Bureau may double the daily monetary
			 penalty, not to exceed $1,000 per deficiency per day, that was or could have
			 been assessed if the outpatient facility alleges compliance and the Bureau
			 finds during an inspection that, at the time compliance was alleged, the
			 deficiencies continued to exist.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999481 - Monetary penalties: Presumption regarding deficiencies identified on subsequent inspection

Current through June 11,
			 2024
There is a rebuttable presumption that
			 deficiencies identified on a subsequent inspection conducted to evaluate
			 compliance with a plan of correction were present on each day between the date
			 of the initial deficiency and the date the subsequent deficiency was found in
			 the subsequent inspection.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999482 - Monetary penalties: Reduction of penalty

Current through June
			 11, 2024
If an outpatient 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999483 - Monetary penalties: 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999484 - Monetary penalties: Date and period of computation; notice to outpatient facility

Current through June 11,
			 2024
1. Daily penalties
			 and interest must be computed after compliance has been verified or the
			 outpatient facility has been sent notice of termination of a permit. A daily
			 monetary penalty must end on the effective date of compliance or termination of
			 the permit of the outpatient facility.
2. If an outpatient facility achieves
			 compliance, the Bureau shall send a separate notice to the outpatient 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 › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999485 - Monetary penalties: Termination of daily penalties

Current
			 through June 11, 2024
1.
			 The daily accrual of a monetary penalty must end if the outpatient facility
			 demonstrates that deficiencies have been corrected and that the health, safety
			 and well-being of patients 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 permit of the outpatient facility.
3. If the outpatient facility can supply
			 credible evidence that substantial compliance with requirements was attained on
			 a date preceding that of the inspection, 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 by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999486 - Monetary penalties: Time for payment

Current through June 11,
			 2024
1. Initial monetary
			 penalty assessment payments are due within 15 days after the notice of the
			 penalty and must be paid irrespective of any administrative appeal.
2. The daily monetary penalty is due and must
			 be paid within 15 days after compliance is verified or termination of a permit
			 is effective and the outpatient facility is notified of the amount of the total
			 daily monetary penalty and interest due.
3. If the outpatient facility has appealed a
			 decision imposing a monetary penalty, the daily penalty is due and must be paid
			 after the final administrative decision is rendered and 15 days after the
			 outpatient facility has been notified of the amount of the total daily penalty
			 and interest due.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999487 - Recovery of expenses incurred by Bureau or Division for implementing and enforcing administrative penalties, bringing actions for enforcement and collecting monetary penalties

Current through June 11,
			 2024
Any expenses incurred by the Bureau or the
			 Division in implementing and enforcing administrative sanctions, bringing an
			 action in a course of competent jurisdiction for enforcement or collecting any
			 monetary penalty may be recovered from the outpatient facility, including,
			 without limitation, attorney's fees, filing fees, fees for service of notices
			 or process and all expenses of litigation recoverable as costs pursuant to
			 chapter 18 of NRS.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999488 - Failure to pay monetary penalty: Suspension of permit

Current
			 through June 11, 2024
1.
			 If the outpatient facility fails to pay a monetary penalty, the Division may
			 suspend the permit of the outpatient facility.
2. The Division shall, in accordance with the
			 requirements of NAC 439.345, provide notice of its intention to suspend the
			 permit of the outpatient facility.
3. If the outpatient facility fails to pay
			 the monetary penalty, including any expenses set forth in NAC 449.999487, in
			 collection of the penalty, within 10 days after receipt of the notice, the
			 Division shall suspend the permit of the outpatient facility. The suspension
			 must not be stayed during the pendency of any administrative appeal.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › OUTPATIENT FACILITIES: PERMIT FOR SERVICES OF GENERAL ANESTHESIA, CONSCIOUS SEDATION AND DEEP SEDATION › Administrative Sanctions › Section 449.999489 - Disposition of money collected

Current through June 11,
			 2024
Money collected by the Division as
			 administrative sanctions must be deposited into a separate fund and applied to
			 the protection of the health, safety, rights, welfare and well-being of
			 patients.
Added to NAC by Bd. of Health by
			 R179-09, eff. 7-22-2010
NRS
			 449.447,
			 449.448
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › STAR RATINGS OF CERTAIN HEALTH CARE FACILITIES › Section 449.99984 - Definitions

Current through June 11, 2024
As used in
			 NAC 449.99984 to
			 449.999848, inclusive, unless the
			 context otherwise requires, the words and terms defined in NAC
			 449.999842 and
			 449.999844 have the meanings
			 ascribed to them in those sections.
Added to NAC by Div. of
			 Pub. & Behavioral Health by R156-18, eff.
			 1/30/2019
NRS
			 449.2425
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › STAR RATINGS OF CERTAIN HEALTH CARE FACILITIES › Section 449.999842 - "Deficiency" defined

Current through June 11,
			 2024
"Deficiency" means a violation of
			 NRS
			 449.241 to
			 449.2428, inclusive, as
			 determined by the Division pursuant to an inspection conducted pursuant to
			 NRS
			 449.132 or an investigation conducted
			 pursuant to NRS
			 449.0307.
Added to NAC by Div. of
			 Pub. & Behavioral Health by R156-18, eff.
			 1/30/2019
NRS
			 449.2425
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › STAR RATINGS OF CERTAIN HEALTH CARE FACILITIES › Section 449.999844 - "Facility" defined

Current through June 11,
			 2024
"Facility" means a health care facility
			 located in a county whose population is 100,000 or more and which is licensed
			 to have more than 70 beds.
Added to NAC by Div. of
			 Pub. & Behavioral Health by R156-18, eff.
			 1/30/2019
NRS
			 449.2425
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › STAR RATINGS OF CERTAIN HEALTH CARE FACILITIES › Section 449.999846 - Criteria for assignment of ratings; issuance of placard with rating

Current through June 11, 2024
After each
			 inspection or investigation described in paragraph (a) of subsection 1 of
			 NRS
			 449.2425, the Division will:
1. Assign to the facility that was inspected
			 or investigated a rating of:
(a) Five stars if
			 the Division determined from the inspection or investigation that the facility
			 has no deficiencies.
(b) Four stars
			 if the Division determined from the inspection or investigation that the
			 facility has at least one deficiency designated as severity level one and no
			 deficiencies designated as severity level two, three or four pursuant to NAC
			 449.99861.
(c) Three stars if the Division determined
			 from the inspection or investigation that the facility has at least one
			 deficiency designated as severity level two and no deficiencies designated as
			 severity level three or four pursuant to NAC
			 449.99861.
(d) Two stars if the Division determined from
			 the inspection or investigation that the facility has at least one deficiency
			 designated as severity level three and no deficiencies designated as severity
			 level four pursuant to NAC
			 449.99861.
(e) One star if the Division determined from
			 the inspection or investigation that the facility has at least one deficiency
			 designated as severity level four pursuant to NAC
			 449.99861.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › STAR RATINGS OF CERTAIN HEALTH CARE FACILITIES › Section 449.999848 - Follow-up inspections and appeals

Current through June 11,
			 2024
1. A facility may
			 request a follow-up inspection or an appeal within 30 days after an
			 investigation or inspection described in paragraph (a) of subsection 1 of
			 NRS
			 449.2425 by submitting, in the form
			 prescribed by the Division, a request for a follow-up inspection or appeal, as
			 applicable.
2. A request for an
			 appeal made pursuant to subsection 1 must:
(a)
			 Specify each finding of a violation to be appealed, as identified by the number
			 ascribed to the violation by the Division in the statement of deficiencies
			 provided to the facility;
(b) State
			 the reasons that the facility is disputing the finding of a
			 violation;
(c) Include any evidence
			 to support reversing the finding of the Division; and
(d) Be submitted separately from the plan of
			 correction submitted to the Bureau pursuant to NAC
			 449.9987.
Nevada Administrative Code › Chapter 449A - Registry of Advance Directives for Health Care › Section 449A.600 - Definitions

Current through June 11, 2024
As used in NAC 449A.600 to
			 449A.705, inclusive, unless the
			 context otherwise requires, the words and terms defined in NAC
			 449A.605 to
			 449A.660, inclusive, have the
			 meanings ascribed to them in those sections.
(Added to NAC by Sec'y of
			 State by R006-08, eff. 4-17-2008) - (Substituted in revision for NAC
			 449.9998)
NRS
				449A.739
Nevada Administrative Code › Chapter 449A - Registry of Advance Directives for Health Care › Section 449A.605 - "Advance directive" defined

Current through June 11, 2024
"Advance directive" has the meaning ascribed to it in
			 NRS
			 449A.703.
(Added to NAC by Sec'y of
			 State by R006-08, eff. 4-17-2008) - (Substituted in revision for NAC
			 449.99981)
NRS
				449A.739
Nevada Administrative Code › Chapter 449A - Registry of Advance Directives for Health Care › Section 449A.610 - "Advance directive locator" defined

Current through June 11, 2024
"Advance directive locator" means a document in the format
			 prescribed by the Secretary of State that specifies the physical location of a
			 person's advance directive.
(Added to NAC by Sec'y of
			 State by R006-08, eff. 4-17-2008) - (Substituted in revision for NAC
			 449.999811)
NRS
				449A.739
Nevada Administrative Code › Chapter 449A - Registry of Advance Directives for Health Care › Section 449A.615 - "Agent" defined

Current through June 11, 2024
"Agent" has the meaning ascribed to it in
			 NRS
			 132.045.
(Added to NAC by Sec'y of
			 State by R006-08, eff. 4-17-2008) - (Substituted in revision for NAC
			 449.999812)
NRS
				449A.739
Nevada Administrative Code › Chapter 449A - Registry of Advance Directives for Health Care › Section 449A.620 - "Authorization to change form" defined

Current through June 11, 2024
"Authorization to change form" means a document in the format
			 prescribed by the Secretary of State that notifies the Secretary of State of
			 the intent of a registrant or the agent of a registrant:
1. To amend, suspend or revoke an advance
		  directive or advance directive locator filed in the Registry; or
2. To remove or delete the registrant's file
		  in the Registry.
(Added to NAC by Sec'y of
			 State by R006-08, eff. 4-17-2008) - (Substituted in revision for NAC
			 449.999813)
NRS
				449A.739