reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR REFRACTIVE SURGERY › Section 449.4524 - Medical care of patients

Current through June 11,
			 2024
1. The
			 administrator of a facility shall ensure that:
(a) Only local anesthesia and oral medication
			 which is administered to a patient to relieve anxiety in the patient, if the
			 medication is not given in a dosage which is sufficient to induce in a patient
			 a controlled state of depressed consciousness or unconsciousness similar to the
			 state produced pursuant to the administration of general anesthesia, deep
			 sedation or conscious sedation, are used at the facility.
(b) An appropriate and current history,
			 including a list of current medications, dosages, physical examination and
			 pertinent preoperative diagnostic studies, is incorporated into the patient's
			 medical record before surgery.
(c)
			 Surgical procedures are performed only by an ophthalmologist licensed pursuant
			 to chapter 630 of NRS or a doctor of osteopathy licensed pursuant to chapter
			 633 of NRS.
(d) A preoperative
			 evaluation is conducted immediately before the surgical procedure by the
			 ophthalmologist, licensed pursuant to chapter 630 of NRS, or the doctor of
			 osteopathy, licensed pursuant to chapter 633 of NRS, who will be performing the
			 surgery.
(e) Emergency equipment
			 and medications as required by the policies and procedures established by the
			 facility pursuant to NAC 449.451 are available, and properly stored and
			 maintained at the facility.
(f)
			 Outdated medications are destroyed in accordance with the requirements of the
			 laws of this State and federal law.
(g) Protocols are established and implemented
			 for instructing patients in self-care after surgery, including, without
			 limitation, written instructions to be given at the time of
			 discharge.
(h) A follow-up
			 examination of a patient is conducted by an ophthalmologist licensed pursuant
			 to chapter 630 of NRS, a doctor of osteopathy licensed pursuant to chapter 633
			 of NRS or a collaborating optometrist as provided in
			 NRS
			 636.374 within 24 hours after the procedure.
			 Documentation of the results of this examination must be included as part of
			 the permanent medical record of the patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR REFRACTIVE SURGERY › Section 449.4526 - Application for indemnification for certain damages; claims against surety bond or substitute thereof

Current through June 11,
			 2024
1. A person who has
			 sustained damages as a result of the bankruptcy of or any breach of contract by
			 a facility may file an application for indemnification with the Administrator
			 of the Division. The Administrator of the Division shall return an incomplete
			 application to the applicant.
2. An
			 application filed pursuant to subsection 1 must include a copy of the court
			 order or settlement agreement which indicates a determination that the patient
			 sustained damages as a result of a breach of contract or bankruptcy of a
			 facility, proof of the identity of the patient or patient's legal
			 representative that is acceptable to the Division and a statement of the
			 patient or patient's legal representative which includes the following
			 information:
(a) A brief description of the
			 damages sustained by the patient as a result of the bankruptcy of or any breach
			 of contract by the facility;
(b)
			 The date that the damages were sustained and the amount of damages claimed;
			 and
(c) The name and address of the
			 facility in which the patient sustained damage.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › General Provisions › Section 449.501 - Definitions

Current through June 11, 2024
As used in NAC 449.501 to 449.5795, inclusive, unless the
				  context otherwise requires, the words and terms defined in NAC 449.502 to
				  449.519, inclusive, have the meanings ascribed to them in those
				  sections.
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 › General Provisions › Section 449.502 - "Advanced practice registered nurse" defined

Current through
				June 11, 2024
"Advanced practice registered nurse" has the meaning ascribed
				  to it in NAC 632.020.
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 › General Provisions › Section 449.504 - "Charge nurse" defined

Current through June 11,
				2024
"Charge nurse" has the meaning ascribed to it in NAC
				  632.033.
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 › General Provisions › Section 449.5045 - "Competency" defined

Current through June 11,
				2024
"Competency" means the demonstrated ability to carry out a
				  specified task or activity with reasonable skill and safety in accordance with
				  the prevailing standard of practice of the community in which the task or
				  activity is carried out.
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 › General Provisions › Section 449.505 - "Dialysis" defined

Current through June 11,
				2024
"Dialysis" means the method by which a dissolved substance is
				  removed from the body of a patient by diffusion, osmosis and convection from
				  one fluid compartment to another fluid compartment across a semipermeable
				  membrane.
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 › General Provisions › Section 449.5053 - "Dialysis technician" defined

Current through June 11,
				2024
"Dialysis technician" means a person, other than a registered
				  nurse or physician, who provides dialysis care under the direct supervision of
				  a registered nurse or 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 › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › General Provisions › Section 449.5055 - "Direct supervision" defined

Current through June 11,
				2024
"Direct supervision" means the supervision of a task or
				  activity that is provided by a qualified person who is present on the premises
				  of a facility during the period in which the task or activity is performed 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 › General Provisions › Section 449.5065 - "End-stage renal disease" defined

Current through June 11,
				2024
"End-stage renal disease" means a stage of renal impairment
				  that is irreversible and permanent and requires a kidney transplantation or
				  regular course of dialysis to preserve the life of the person who has the
				  disease.
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 › General Provisions › Section 449.507 - "Facility" defined

Current through June 11,
				2024
"Facility" means a facility for the treatment of irreversible
				  renal disease as defined in
				  NRS
				  449.0046.
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 › General Provisions › Section 449.508 - "Hemodialysis" defined

Current through June 11,
				2024
"Hemodialysis" means dialysis of the blood.
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 › General Provisions › Section 449.510 - "Immediate supervision" defined

Current through June 11,
				2024
"Immediate supervision" means the supervision of a task or
				  activity that is provided by a person who:
1. Is present on the premises of a facility
				during the period in which the task or activity is performed at the facility;
				and
2. Directly observes the task
				or activity.
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 › General Provisions › Section 449.511 - "Intermediate level disinfection" defined

Current through June 11,
				2024
"Intermediate level disinfection" means to treat a surface
				  using a chemical germicide or other disinfectant that, when used in accordance
				  with the instructions of the manufacturer of the chemical germicide or other
				  disinfectant or the guidelines established by the facility concerning the
				  chemical germicide or other disinfectant, inactivates microorganisms other than
				  bacterial endospores, including, without limitation:
1. Viruses;
2. Fungi; and
3. Bacteria that are actively growing,
				including tubercle bacteria.
The term includes any bleach or any disinfectant that
				  consists of 70 percent or more of ethanol or isopropanol.
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 › General Provisions › Section 449.513 - "Licensed practical nurse" defined

Current through June 11,
				2024
"Licensed practical nurse" means a nurse who may collect data
				  and perform a skill, intervention or other duty in accordance with the
				  provisions of NAC 632.242.
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 › General Provisions › Section 449.516 - "Product water" defined

Current through June 11,
				2024
"Product water" means the effluent that is obtained from the
				  final component of the water treatment system of a 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 › General Provisions › Section 449.517 - "Supervision" defined

Current through June 11,
				2024
"Supervision" means the guidance and direction provided by a
				  qualified person for the accomplishment of a task or activity, including the
				  initial direction and periodic inspection by that person of the actual
				  accomplishment of the task or activity.
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 › General Provisions › Section 449.519 - "Training" defined

Current through June 11,
				2024
"Training" means to learn a task or activity through
				  experience or instruction that is received during employment at a facility by a
				  person who is capable of learning that task or activity through education or
				  experience.
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 › Construction; Health and Safety › Section 449.520 - New construction or remodeling: Notification; increase in number of stations for which facility is licensed

Current through June 11,
				2024
1. A facility shall
				notify the Bureau in writing at least 30 days before beginning any
				construction, renovation or modification of the physical plant of the
				facility.
2. A facility must obtain
				the approval of the Bureau before increasing the number of stations for which
				the facility is licensed. If a facility intends to increase the number of those
				stations, the facility must, at least 30 days before the proposed date to
				increase the number of stations, submit to the Bureau an application for a new
				license. The application must be submitted on a form approved by the Bureau and
				include:
(a) Evidence satisfactory to the
				Bureau that:
(1) The facility has reviewed
				the availability of the members of the staff of the facility and, if necessary,
				has increased the number of positions on the staff to accommodate the proposed
				increase in the number of stations; and
(2) The water treatment system of the
				facility is sufficient to ensure the availability of water that is safe for the
				proposed increase in the number of stations; and
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5205 - New construction or remodeling: Submission of plans and specifications; minor changes; inspection

Current through June 11,
				2024
1. To determine
				compliance with the provisions of NAC 449.501 to 449.5795, inclusive, each
				facility may submit to the Bureau for its approval any plans and specifications
				concerning the construction of a new facility or any alteration, addition,
				conversion, modernization or renovation of an existing building of the
				facility. The plans and specifications must be submitted in accordance with the
				provisions of this section.
2. A
				facility may request the Bureau to review any minor alterations or remodeling
				changes to the facility that, as determined by the Bureau, do not:
(a) Alter any load-bearing partitions, change
				any functional operation or affect the fire safety of the facility;
				or
(b) Add any additional stations
				to the facility.
A request submitted pursuant to the provisions of this
				  subsection must be set forth in writing and include a brief description of the
				  minor alterations or changes proposed by the facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.522 - Construction, space and design; physical environment; restrictions for treatment of patients with hepatitis B

Current through June 11,
				2024
1. The Bureau shall
				consider a facility to be in compliance with the provisions of NAC 449.501 to
				449.5795, inclusive, relating to the construction, space or design of the
				facility if:
(a) The facility was licensed on
				or before July 1, 2001; and
(b) The
				existing construction of the facility does not have any deficiencies that are
				likely to cause serious injury, harm or impairment to the health and welfare of
				the members of the general public. If such a deficiency occurs, the facility
				must correct the deficiency before the facility may continue to
				operate.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5225 - Safety and comfort of patients during construction; imposition of more stringent design and space requirements

Current through June 11,
				2024
1. If any
				construction occurs in or near an area of the facility that is occupied by a
				patient of the facility, the facility shall ensure the safety and comfort of
				the patient during the construction.
2. A facility may impose more stringent
				design and space requirements than the requirements set forth in NAC 449.501 to
				449.5795, 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 › Construction; Health and Safety › Section 449.523 - Safety requirements

Current through June 11,
				2024
1. Each facility
				shall install a system for lighting the facility that is capable of providing
				sufficient illumination to allow safe evacuation from each building of the
				facility during an emergency at the facility. Each battery pack system used by
				the facility must be maintained and tested at least once each month. If a
				facility maintains a backup generator, the generator must be installed, tested
				and maintained in accordance with the instructions of the manufacturer of the
				generator. The facility shall document the testing of the generator at least
				once every 6 months.
2. A facility
				must not be located in or adjacent to a building that is considered a high
				hazard building and meets the requirements of group H of Volume I of the
Uniform Building Code
, 1997 edition, which is hereby adopted
				by reference. A copy of those provisions may be obtained from the International
				Conference of Building Officials, 5360 Workman Mill Road, Whittier, California
				90601, for the price of $67.50.
3.
				Each facility must be equipped with smoke detectors that are maintained in
				proper operating condition at all times. The smoke detectors must be tested in
				accordance with the specifications of the manufacturer of the smoke
				detectors.
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 › Construction; Health and Safety › Section 449.5235 - Maintenance and repair of equipment

Current through June 11,
				2024
1. Any equipment
				that is used by a facility, including any equipment used for backup, must be
				maintained free from any defect that may be hazardous to the patients or
				members of the staff of the facility or any visitors to the facility. Any
				maintenance or repair of the equipment must be performed by a member of the
				staff of the facility who is qualified to conduct the maintenance or repair or
				by contract personnel.
2. Each
				facility shall ensure that each person employed on the staff of the facility is
				able to identify any equipment that malfunctions and report the malfunction to
				the appropriate person for repair.
3. If any medical equipment of a facility
				malfunctions, the equipment:
(a) Must be
				removed immediately from service at the facility; and
(b) Must not be returned to service at the
				facility unless the malfunction is identified and corrected.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.525 - Water treatment system: General requirements

Current
				through June 11, 2024
1.
				The design for the water treatment system of a facility must be:
(a) Based on considerations of the source of
				water for the facility; and
(b)
				Prepared by a person who, as determined by the Bureau, has obtained education,
				training or experience in the design of dialysis systems.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5255 - Water treatment system: Chemical testing of product water; records

Current through June 11, 2024
1. Except as otherwise provided in this
				section, each facility shall, at least once every 6 months, conduct a chemical
				test of a sample of the product water of the water treatment system of the
				facility. The results of any test conducted pursuant to the provisions of this
				section must indicate that the quality of the product water satisfies the
				requirements relating to maximum level of chemical contaminants set forth in
				the
American National Standard,
Water Treatment
				Equipment for Hemodialysis Applications
, adopted by reference pursuant
				to the provisions of NAC 449.520.
2. A facility shall conduct a chemical test
				pursuant to the provisions of this section if substantial changes are made to
				the water treatment system or if the percent of rejection of a reverse osmosis
				system decreases 5 percent or more from the percent of rejection measured at
				the time the water sample for the preceding chemical test was taken. If a
				facility uses a water treatment system that is portable, the facility shall, at
				least once each year, conduct a chemical test of the product water in
				accordance with the provisions of this section.
3. The records maintained by a facility
				concerning the operation of the facility must include:
(a) The results of each test conducted
				pursuant to the provisions of this section and NAC 449.525 and 449.526;
				and
(b) Evidence satisfactory to
				the Bureau that the medical director of the facility reviewed the results of
				those tests and required corrective action to be taken if indicated by those
				results.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.526 - Water treatment system: Microbiological testing of product water

Current through June 11, 2024
1. Each facility shall, at least once each
				month or immediately after any repair or change is made to the water product
				treatment system of the facility, conduct a microbiological test of the product
				water. The results of any test conducted pursuant to the provisions of this
				section must indicate that the quality of the product water satisfies the
				requirements relating to hemodialysis systems set forth in the
American
				National Standard,
Water Treatment Equipment for Hemodialysis
				Applications
, adopted by reference pursuant to the provisions of NAC
				449.520.
2. Sample sites selected
				by the facility to conduct the test must include the beginning of the
				distribution piping, the product water in the reuse room of the facility and
				the end of the distribution piping. If the results of the test do not satisfy
				the requirements specified in subsection 1, the facility shall immediately
				disinfect and reculture the water treatment system. If, after the water
				treatment system is disinfected and recultured, the results of the test do not
				satisfy those requirements, the facility shall determine the source of the
				contamination by immediately reculturing:
(a)
				The sample sites;
(b) Each patient
				station of the facility;
(c) Each
				tank of the water treatment system that is used to store water;
(d) All water that is used to mix dialysate;
				and
(e) The product water obtained
				from the final component of the water treatment system.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5265 - Reuse of hemodialyzer; transport of used dialyzer

Current
				through June 11, 2024
1.
				If a facility reuses any hemodialyzer in providing treatment to a patient of
				the facility, the facility shall:
(a) Ensure
				that the reuse of the hemodialyzer is conducted in accordance with the
				provisions of the
American National Standard,
Water
				Treatment Equipment for Hemodialysis Applications
, adopted by
				reference pursuant to the provisions of NAC 449.520.
(b) Ensure that each transducer protector
				used during the treatment is:
(1) Replaced,
				if it becomes wet during the treatment; and
(2) Used only for one treatment.
(c) Ensure that, in any area of
				the facility in which the reuse occurs, the supply of water in that area
				incorporates a mechanism to prevent any chemical agents from flowing into the
				water distribution system of the facility.
(d) Ensure that any ventilation system
				installed in an area specified in paragraph (c):
(1) Is connected to an exhaust system that:
(I) Leads to the outside of the building in
				which the room is located; and
(II)
				Is separate from the exhaust system of the building;
(2) Has an exhaust fan that is located at the
				discharge end of the ventilation system;
(3) Has a system of exhaust ducts that is
				constructed of material that is noncombustible and resistant to corrosion;
				and
(4) Has an exhaust outlet that
				is located above the level of the roof of the building to which the exhaust
				outlet is attached, and if more than one exhaust outlet is installed, the
				facility shall ensure that each of those outlets is arranged in such a manner
				as to minimize any recirculation of exhaust air into the building.
(e) Adopt and comply with a policy
				that sets forth the criteria for reuse, including the number of reuses allowed
				by the facility.
(f) Ensure that
				access to an area of the facility specified in paragraph (c) is restricted to
				persons who are authorized by the facility to enter that area.
(g) Before providing treatment to the
				patient:
(1) Consider and address the health
				and safety of the patient if he or she is sensitive to disinfectant solution
				residuals;
(2) Provide to the
				patient information regarding the policy of reuse for the facility and the
				opportunity to submit and receive a response to questions concerning the reuse;
				and
(3) Obtain written consent for
				the reuse from the patient or legal representative of the patient.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.528 - Adoption of more stringent requirements for treatment of water and reuse of hemodialyzers

Current through June 11,
				2024
A facility may adopt more stringent requirements for the
				  treatment of water and the reuse of hemodialyzers than the requirements set
				  forth in NAC 449.525 to 449.5265, 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 › Construction; Health and Safety › Section 449.5285 - Sanitation: Precautions regarding blood and bodily fluids

Current
				through June 11, 2024
1.
				Any activity relating to the care of a patient of a facility must be provided
				in accordance with the provisions of
				29 C.F.R. §
										1910.1030(d)(1) -(3),
				relating to bloodborne pathogens.
2. Each member of the staff of the facility
				shall wash his or her hands immediately before and after each contact with a
				patient that may expose the member of the staff to any blood or fluids of the
				body of the patient. The location and arrangement of any area of the facility
				that is used for washing hands must permit ease of access and proper
				use.
3. A sink that is used for
				washing hands must be readily accessible in each area of the facility that is
				used to care for patients of the facility. Each fixture and lavatory located in
				that area must be trimmed with valves which may be operated without the use of
				hands. There must be sufficient clearance for the operation of blade-type
				handles, if those handles are used.
4. Provisions for drying hands must be
				included in any area of the facility that is used for washing hands.
5. If a patient of a facility or a member of
				the patient's family intends to assist a member of the staff of the facility in
				conducting a procedure that may cause the patient or member of the patient's
				family to come into contact with any blood or bodily fluids, the member of the
				staff of the facility shall, before the procedure is conducted:
(a) Explain to the patient or member of the
				patient's family the potential risks associated with blood and any products of
				blood; and
(b) Provide to the
				patient or member of the patient's family the appropriate equipment to protect
				the patient or member of the patient's family from those risks.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.529 - Sanitation: Control of infections; nonsmoking policy

Current
				through June 11, 2024
1.
				Each facility shall designate a person to monitor and coordinate the activities
				occurring at the facility concerning the control of infections at the
				facility.
2. Each facility shall
				develop and maintain a system to identify, monitor and record the occurrence of
				infections at the facility. The system must be reviewed as a part of the
				program to ensure the quality of the facility conducted pursuant to the
				provisions of NAC 449.540. The record maintained by a facility pursuant to the
				provisions of this subsection must include any trends, corrective actions and
				improvement actions taken by the facility.
3. Each facility shall establish and comply
				with a policy concerning nonsmoking 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 › Construction; Health and Safety › Section 449.5295 - Sanitation: Provision of sanitary environment; walls, floors and ceilings; blood spills

Current through June 11,
				2024
1. Each facility
				shall provide a sanitary environment that minimizes or prevents transmission of
				infectious diseases at the facility.
2. The base of each wall that is located in
				any area of a facility which is subject to frequent cleaning with water or any
				other liquid must be:
(a) Tightly sealed to
				the floor and the wall to ensure that the base of the wall is impervious to the
				water or other liquid; and
(b)
				Constructed without any voids that may harbor insects.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.531 - Sanitation: Disinfection of dialysis machines; culturing dialysate; cleaning of machines and equipment; handling of waste

Current through June
				11, 2024
1. Each
				facility shall periodically disinfect each active and backup dialysis machine
				in accordance with the policy of the facility concerning the disinfection of
				those machines. Any disinfection conducted pursuant to the provisions of this
				subsection must achieve at least intermediate level disinfection.
2. Each facility shall, at least once each
				month:
(a) Randomly collect a sample of
				dialysate from a dialysis machine that is used by the facility; and
(b) Conduct a culture of the sample.
The results of a culture conducted pursuant to the
				  provisions of this subsection must not exceed 2,000 colony forming units per
				  milliliter. A hemodialysis machine that is used by a patient of a facility at
				  his or her residence must be cultured at least once each month until results
				  not exceeding 2,000 colony forming units per milliliter are obtained for 3
				  consecutive months. If those results are obtained, quarterly samples must be
				  cultured.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5315 - Hepatitis B: Vaccinations for certain staff members; postvaccination screening; adoption of related provisions

Current through June 11,
				2024
1. If any member of
				the staff of a facility is susceptible to hepatitis B and has not been
				vaccinated for that disease, the facility shall offer vaccination for the
				disease to that member of the staff in accordance with the provisions of
				29 C.F.R. §
										1910.1030(f)(1) and (2),
				relating to bloodborne pathogens. If a member of the staff of a facility is
				vaccinated pursuant to the provisions of this subsection, a written record of
				the vaccination must be included in the health record of the member of the
				staff maintained by the facility.
2. Each facility shall establish and comply
				with a policy to conduct postvaccination screening of each member of the staff
				of the facility. The serologic screening must be conducted within 60 days after
				the final dose of vaccine is administered to the member of the staff of the
				facility. Any additional screening and follow-up must be based upon the results
				of the testing for the hepatitis B surface antigen.
3. The provisions of Appendices I and II of
				the
National Surveillance of Dialysis-Associated Diseases in the United
				States
, 1993 edition, are hereby adopted by reference. A copy of those
				provisions may be obtained free of charge from the Public Health Service,
				Centers for Disease Control and Prevention, National Center for Infectious
				Diseases, Hospital Infections Program, Mail Stop C01, Atlanta, Georgia 30333.
				If a facility determines pursuant to subsection 2 that a member of the staff of
				the facility is a responder as defined in Appendix II of those provisions, the
				facility shall not require the member of the staff to submit to further
				screening pursuant to subsection 2. If the facility determines that a member of
				the staff of the facility is a nonresponder as defined in that appendix, the
				facility shall ensure that the member of the staff is tested at least once
				every 6 months pursuant to that subsection.
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 › Construction; Health and Safety › Section 449.532 - Hepatitis B: Vaccinations for certain patients

Current through
				June 11, 2024
1. If
				advised by and with the consent of a patient's attending nephrologist, each
				facility shall offer hepatitis B vaccine to each patient who is susceptible to
				hepatitis B.
2. Each facility
				shall, upon request by a patient of the facility, make available to the patient
				a publication or other information concerning the risks and benefits of
				receiving the vaccine for hepatitis B.
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 › Construction; Health and Safety › Section 449.5325 - Hepatitis B surface antigen: Screening of patients; additional serologic screening

Current through June 11,
				2024
1. Each candidate
				for dialysis at a facility must, if practicable, be screened for the hepatitis
				B surface antigen before being admitted to the facility. The screening may be
				performed at any time within 30 days before the person is admitted to the
				facility.
2. Additional serologic
				screening must be based on the antigen or antibody status of the patient, as
				follows:
(a) If the patient tests negative
				for the hepatitis B surface antigen, the facility shall screen the patient at
				least once each month.
(b) If the
				patient tests positive for the hepatitis B surface antigen or anti-hepatitis B
				surface antigen, the facility may screen the patient less than once each month
				if the policy of the facility concerning the screening of that patient complies
				with the provisions of Appendices I and II of the
National Surveillance
				of Dialysis-Associated Diseases in the United States
, adopted by
				reference pursuant to the provisions of NAC 449.5315.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.534 - Hepatitis B surface antigen: Treatment of patients who test positive

Current through June 11, 2024
1. If a patient of a facility tests positive
				for the hepatitis B surface antigen, the facility shall provide treatment for
				the patient:
(a) On a machine that is
				dedicated for patients who test positive for the hepatitis B surface antigen;
				and
(b) In an area of the facility
				that includes:
(1) A sink for washing
				hands;
(2) A work area;
(3) An amount of equipment and supplies that
				is sufficient to care for the patient; and
(4) Sufficient space to prevent contamination
				of any other patient of the facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Construction; Health and Safety › Section 449.5345 - Tuberculosis: Screening of staff and patients

Current through June
				11, 2024
1. A facility
				shall screen each member of the staff of the facility to determine whether the
				member has tuberculosis. The facility shall screen each member of the staff:
(a) Upon commencement of employment at the
				facility or upon receiving privileges as a member of the medical staff of the
				facility; or
(b) Before the member
				of the staff has any physical contact with a patient of the facility.
The screening must be conducted in accordance with the
				  provisions of NAC 441A.375.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.540 - Program of quality assurance; recordation of accidents and incidents; reporting of certain events

Current through June 11,
				2024
1. Each facility
				shall:
(a) Conduct a systematic and
				comprehensive review of the facility and the care provided to each patient of
				the facility; and
(b) Adopt and
				comply with a program to ensure the quality of the facility. The program must
				be based on information concerning the facility provided to the facility by the
				End-Stage Renal Disease Network.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5405 - Rights of patients

Current through June 11,
				2024
1. In addition to
				the requirements set forth in
				NRS
				449.700 to
				449.730,
				inclusive, each facility shall adopt and comply with a policy which ensures
				that each patient of the facility is:
(a)
				Treated with respect, dignity and complete recognition of the individuality and
				personal requirements of the patient;
(b) Provided with sufficient privacy during
				treatment to ensure that any unwarranted exposure of the patient does not occur
				and to ensure confidentiality of the clinical record of that patient;
(c) Provided with a safe and comfortable
				environment for receiving any treatment provided by the facility;
(d) Provided with information concerning the
				patient's treatment in a manner which ensures that the patient or the legal
				representative of the patient understands that information;
(e) Informed by a physician of the medical
				status of the patient;
(f) Informed
				about all modalities and settings for the treatment of end-stage renal
				disease;
(g) Informed about and
				participates in, if requested by the patient, each aspect of care, including,
				without limitation, the right to refuse treatment and the medical consequences
				of refusing that treatment;
(h)
				Aware of any services that are available to the patient at the facility and the
				charges for those services; and
(i)
				Informed about any reuse of dialysis supplies by the facility, including
				hemodialyzers. If any brochures or other printed materials are used to describe
				the facility or any services provided by the facility, the facility shall
				ensure that the brochures or other printed materials include a statement
				specifying the policy of the facility concerning the reuse of those
				supplies.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.541 - Interdisciplinary teams; plans for care of patients

Current through
				June 11, 2024
1. Each
				facility shall establish and comply with a policy which specifies that the
				services provided to each patient of the facility are coordinated using an
				interdisciplinary team. The interdisciplinary team must consist of:
(a) The primary dialysis physician of the
				patient;
(b) A registered
				nurse;
(c) A social worker;
				and
(d) A licensed
				dietitian.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5415 - Preparations for emergencies and disasters

Current through June
				11, 2024
1. Each
				facility shall adopt a written procedure to be followed by each patient and
				member of the staff of the facility if any emergency occurs at the facility,
				including, without limitation, any fire, equipment failure, power outage,
				medical emergency or natural disaster that may threaten the health or safety of
				any patient or member of the staff of the facility or any member of the general
				public.
2. Each facility shall
				prepare a plan for obtaining emergency medical services that are available for
				use by the facility.
3. Each
				facility shall employ personnel who are qualified to operate emergency
				equipment at the facility and to provide emergency care at the facility. The
				personnel must be available to operate the emergency equipment and provide
				emergency care during each period in which treatment is provided to a patient
				of the facility. A charge nurse who is qualified to provide basic
				cardiopulmonary life support must be present at the facility and available in
				the treatment area during any period in which a patient of the facility is
				present in that area. Each member of the clinical staff of the facility must
				maintain current certification and competency in basic cardiopulmonary life
				support.
4. Each facility shall
				enter into an agreement with at least one hospital that provides acute dialysis
				service, inpatient care and other hospital services to the patients of the
				facility. The agreement must include:
(a)
				Documentation from the hospital indicating that the patients of the facility
				will be accepted and treated during any emergency that occurs at the facility;
				and
(b) Reasonable assurances that:
(1) The transfer or referral of a patient
				will occur between the hospital and the facility if the transfer or referral is
				determined to be medically appropriate by the attending physician of the
				patient;
(2) The exchange of
				medical and other information necessary or useful in the care and treatment of
				the patient transferred will occur within 1 working day after the transfer or
				referral of the patient; and
(3)
				All personal property belonging to and transferred with the patient will be
				accounted for and protected from theft, loss or damage.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.543 - Pharmaceutical services

Current through June 11,
				2024
1. Each facility
				shall provide pharmaceutical services in accordance with accepted professional
				principles and any applicable federal and state statutes and
				regulations.
2. Medication may be
				administered to a patient of a facility only if the medication is ordered by:
(a) The patient's physician;
(b) A physician assistant; or
(c) An advanced practice registered
				nurse.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › FACILITIES FOR TREATMENT OF IRREVERSIBLE RENAL DISEASE › Provision of Services › Section 449.5435 - Nursing services; physicians and other staff

Current through
				June 11, 2024
1. Each
				facility shall provide nursing services to each patient of the facility to
				prevent or reduce complications and to maximize the functional status of the
				patient.
2. Each facility shall
				employ a full-time registered nurse to supervise and manage the care provided
				to patients of the facility.
3. The
				registered nurse employed pursuant to the provisions of subsection 2 shall:
(a) Conduct an assessment of a patient during
				the admission of the patient to the facility;
(b) Conduct an assessment of a patient if
				requested by the patient or if required because of a change in the medical
				status of the patient;
(c)
				Participate in a team review of the progress of the patient pursuant to the
				provisions of NAC 449.541;
(d)
				Recommend changes in treatment, if appropriate, based on the immediate
				requirements of the patient;
(e)
				Facilitate communication between the patient, the patient's family and each
				member of the interdisciplinary team established for the patient to ensure the
				delivery of care required for the patient;
(f) Provide oversight and direction to
				dialysis technicians and licensed practical nurses; and
(g) Participate in activities conducted by
				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 449.544 - Nutrition services

Current through June 11,
				2024
1. Each facility
				shall provide nutrition services to each patient of the facility and the
				provider of care for that patient to maximize the nutritional status of the
				patient.
2. The licensed dietitian
				for a patient of a facility shall:
(a) Conduct
				an assessment of the nutrition of the patient;
(b) Participate in a team review of the
				progress of the patient in accordance with the provisions of NAC
				449.541;
(c) After consulting with the physician of
				the patient, recommend or order a therapeutic diet for the patient based on:
(1) The cultural preferences of the
				patient;
(2) Changes in the
				treatment of the patient; and
(3)
				The nutritional requirements of the patient;
(d) Except as otherwise provided in
				subsection 7:
(1) Counsel the patient and the
				provider of care for that patient, if required, concerning any diet prescribed
				for the patient at the facility; and
(2) Monitor the patient's adherence and
				response to that diet;
(e) Refer the patient for assistance with any
				resources that are available to the patient, including, without limitation,
				financial assistance, community resources or assistance at the residence of the
				patient;
(f) Participate in
				activities conducted at the facility to ensure the quality of the facility;
				and
(g) Monitor the nutritional
				status of the patient to determine the need for intervention and follow-up by
				the facility. In making that determination, the licensed dietitian shall
				consider:
(1) Changes in the weight of the
				patient;
(2) The chemistry of the
				blood of the patient;
(3) The
				adequacy of the dialysis treatment provided to the patient; and
(4) Changes in the medication prescribed for
				the patient.