reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Authorized Activities and General Requirements for Operation › Section 449.3952 - Additional training to be provided by intermediary service organization

Current through June 11, 2024
An intermediary service organization shall make available to
				  a personal assistant employed by the intermediary service organization all
				  training required pursuant to NAC 449.39519 and, at the request of a client,
				  such additional training for a personal assistant as necessary to support the
				  plan of care for the person with a disability, including, without
				  limitation:
1. General training for
				the personal assistant;
2.
				Protocols for a personal assistant, including, without limitation, the rights
				and responsibilities of a client and of a personal assistant;
3. The manner in which to groom and dress the
				person with a disability;
4.
				Procedures for bathing and maintaining proper hygiene for a person with a
				disability, including, without limitation, bed-bath and tub-bath
				techniques;
5. Caring for the
				bowel, bladder and skin of a person with a disability, including, without
				limitation, information concerning caring for a catheter, the identification
				and control of infection, common bowel problems, the early recognition of skin
				problems, the prevention of pressure sores and the routine inspection of
				skin;
6. Assistive technology,
				including, without limitation, examples of assistive technology, how assistive
				technology can be used by the personal assistant and resources from which
				assistive technology may be obtained;
7. Nutrition and food preparation, including,
				without limitation, information about preparing balanced meals, addressing
				special dietary needs or restrictions, guidelines for hydration and the proper
				handling and storage of food; and
8. The manner in which to maintain health
				records, including, without limitation, illustrations of how information should
				be conveyed in a written or dictated form to assure confidentiality and a means
				to ensure that the person with a disability receives services as outlined in
				the plan of care.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.825
NRS
					 449.4308,
					 449.4327
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Authorized Activities and General Requirements for Operation › Section 449.39521 - Visits and telephone interviews with clients

Current through
				June 11, 2024
1. Except
				as otherwise provided in subsection 3, an intermediary service organization
				shall, not less than once every 6 months, conduct a visit of the residence of
				the person with a disability or perform a telephone interview with the client
				to monitor the quality of care received by the person with a
				disability.
2. The intermediary
				service organization shall document each visit or telephone interview conducted
				pursuant to subsection 1. Such documentation must include, without limitation:
(a) The date of the visit or telephone
				interview;
(b) Whether the plan of
				care is meeting the needs of the person with a disability;
(c) Whether the personal assistant has
				received sufficient training to provide the services for the person with a
				disability; and
(d) Whether there
				have been changes in the health status of the person with a
				disability.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Authorized Activities and General Requirements for Operation › Section 449.39522 - Written statement of services provided to clients

Current
				through June 11, 2024
1.
				An intermediary service organization shall provide to each client for his or
				her signature a written statement which contains a description of the services
				provided by the intermediary service organization. The statement must include,
				without limitation:
(a) An easily
				understandable statement that it is not within the scope of services provided
				by the intermediary service organization to manage the medical and health
				conditions of a person with a disability;
(b) The qualifications and required training
				for personal assistants;
(c) The
				amount that will be charged for the services provided by the intermediary
				service organization;
(d) A
				description of billing methods, acceptable payment methods and due dates for
				payments, and the policy for notifying the client of any increase in the amount
				that will be charged for the services provided by the intermediary service
				organization;
(e) Criteria,
				circumstances or conditions which may result in the termination of services by
				the intermediary service organization, the procedures for notifying the client
				of such termination and the procedures for appealing such
				termination;
(f) The manner in
				which the intermediary service organization may be contacted during all hours
				when services are being provided to a person with a disability; and
(g) Information about the rights of a client
				of the intermediary service organization and the procedures for filing a
				grievance.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Authorized Activities and General Requirements for Operation › Section 449.39523 - Discussion of services provided to clients

Current through June
				11, 2024
1. An
				intermediary service organization shall discuss with each potential client
				before providing services:
(a) The planned
				training to be provided by the intermediary service organization to the
				personal assistant;
(b) The
				responsibilities of the intermediary service organization; and
(c) A contingency plan in the event that a
				personal assistant fails to report for a scheduled visit with the person with a
				disability.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Authorized Activities and General Requirements for Operation › Section 449.39524 - Rights of person with a disability receiving services

Current
				through June 11, 2024
1.
				An intermediary service organization shall ensure that a person with a
				disability who receives services from the intermediary service organization or,
				as applicable, other responsible person acting on his or her behalf:
(a) Has the right to select the personal
				assistant of his or her choice;
(b)
				Has the right to choose community-based care or institutional care;
(c) Receives services from the intermediary
				service organization without regard to race, color, creed, national origin, sex
				or disability;
(d) Is treated with
				respect, receives recognition of his or her individuality and is free from
				physical, verbal or psychological abuse;
(e) Is allowed to make informed decisions
				regarding the care of the person with a disability and to participate in the
				development of a plan of care;
(f)
				Receives a description of advance directives, as defined in
				NRS
				449.905, and information on how to obtain an
				advance directive;
(g) Has the
				right to appeal any termination, reduction or suspension of services by the
				intermediary service organization and to receive a written explanation of
				decisions of the intermediary service organization relating to the provision of
				services;
(h) Receives confidential
				treatment of personal, medical and financial information;
(i) Has access to any records maintained by
				the intermediary service organization relating to the care of the person with a
				disability;
(j) Is informed of the
				primary contact person for the intermediary service organization, the person
				with whom a grievance may be filed with the intermediary service organization
				and the process to follow when filing a grievance with the intermediary service
				organization; and
(k) Receives
				timely responses to a concern expressed to the intermediary service
				organization regarding the provision of services by the intermediary service
				organization.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39525 - Request for administrative review of complaint

Current through
				June 11, 2024
1. An
				applicant for a certificate to operate an intermediary service organization or
				a person who is certified to operate an intermediary service organization may
				submit a written request to the Administrator or the Administrator's designee
				for an administrative review of a complaint if the complainant:
(a) Has a legitimate grievance with any
				action of the Division in the certification process; and
(b) Has not resolved the grievance through
				informal negotiations with an officer of the Division.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39526 - Scheduling of administrative review

Current through June 11,
				2024
The Administrator or the Administrator's designee shall
				  conduct an administrative review at a time and place which is reasonable for
				  the parties. Unless otherwise scheduled to accommodate the complainant, the
				  Administrator or the designee shall conduct an administrative review within 10
				  days after the Administrator or the designee receives a request for an
				  administrative review pursuant to NAC 449.39525.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.831
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39527 - Conduct of administrative review

Current through June 11,
				2024
An administrative review must be:
1. Conducted informally without attorneys or
				witnesses.
2. Based on the record
				available, except that the complainant may, upon the complainant's request,
				appear and present additional facts.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.832
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39528 - Issuance of written decision following administrative review

Current through June 11, 2024
1. Not later than 15 days after an
				administrative review, the Administrator or the Administrator's designee shall
				issue a written decision, including the findings of fact and conclusions of law
				concerning the complaint and any appropriate orders.
2. The Division will mail the written
				decision to the complainant by registered or certified mail, return receipt
				requested, or a representative of the Division may personally deliver the
				decision to the complainant and read it to the complainant. If the decision is
				personally delivered to the complainant, the complainant shall date and sign a
				copy of the decision as an acknowledgment of the receipt.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.833
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39529 - Request for hearing

Current through June 11,
				2024
1. Not later than
				15 days after receipt of a written decision on a complaint, a complainant may
				submit a written request to the Administrator for a hearing on the complaint.
				The request must be mailed to the Administrator by certified or registered
				mail, return receipt requested.
2.
				The written request for a hearing must include a copy of the original complaint
				filed by the complainant.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.834
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.395295 - Hearings: Scheduling; notice

Current through June 11,
				2024
1. Not later than
				30 days after the Administrator receives a written request for a hearing, a
				hearing officer appointed by the senior hearing officer of the Hearings
				Division of the Department of Administration shall conduct a hearing at a time
				and location that is reasonable for the parties. The hearing officer must not
				have any personal involvement in the complaint.
2. Not less than 10 days before the date of
				the hearing, the Division of Public and Behavioral Health will, in accordance
				with
				NRS
				233B.121, provide to all parties notice of
				the time, date and place of the hearing.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.835
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.3953 - Hearings: Representation; evidence; rights of parties

Current
				through June 11, 2024
1.
				The complainant may be represented at the hearing by an attorney or another
				person designated by the complainant.
2. The hearing officer is not bound by the
				technical rules of evidence. Decisions concerning the admissibility of evidence
				must be made in accordance with
				NRS 233B.123.
3. Each party must be granted the opportunity
				to present the party's case, examine and cross-examine witnesses, and rebut
				evidence.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.8355
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39531 - Resolution of complaint

Current through June 11,
				2024
Unless otherwise provided by statute, a complaint may be
				  resolved by arbitration, mutual agreement of the parties, settlement, consent
				  decree or default of a party.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.836
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39532 - Final decision of hearing officer; request for judicial review

Current through June 11, 2024
1. A final decision by a hearing officer on a
				complaint must be in writing or stated in the record. A final decision must
				include findings of fact and conclusions of law. Findings of fact must include
				a statement of the facts which support the findings.
2. Not more than 30 days after a final
				decision is made, a party may appeal the final decision of the hearing officer
				and request judicial review pursuant to
				NRS
				233B.130 to
				233B.150,
				inclusive.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.837
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39533 - Record of hearing

Current through June 11,
				2024
The record of the hearing must include:
1. The transcript of the oral testimony
				provided at the hearing;
2. All
				pleadings and motions filed by the parties;
3. Any rulings made by the hearing officer,
				including rulings on offers of proof;
4. Evidence that was admitted;
5. Facts which were officially noticed by the
				hearing officer; and
6. Any other
				decision, opinion or report of the hearing officer.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.838
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Review and Hearings › Section 449.39534 - Provision of transcript of oral proceedings of hearing

Current
				through June 11, 2024
Upon request of a party, the Division will provide a
				  transcript of the oral proceedings of the hearing. The Division may require
				  payment of the cost incurred for providing the transcript.
Added to NAC by Aging
				  & Disability Services Div. by R197-09, eff. 7-22-2010-Substituted in
				  revision for NAC 427A.839
NRS
					 449.4337
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39535 - Definitions

Current through June 11, 2024
As used in NAC 449.39535 to 449.39561, inclusive, unless the
				  context otherwise requires, the words and terms defined in NAC 449.39536 to
				  449.39544, inclusive, have the meanings ascribed to them in those
				  sections.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.840
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39536 - "Ban on enrollment" defined

Current through June 11,
				2024
"Ban on enrollment" means a prohibition on the provision of
				  services to clients who are newly enrolled.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.841
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39537 - "Cluster" defined

Current through June 11,
				2024
"Cluster" means a violation that involves the same or similar
				  kinds of services as one or more other violations.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.842
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39538 - "Compliance" defined

Current through June 11,
				2024
"Compliance" means that no major violation is present and
				  that effective steps have been taken to resolve all violations.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.843
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39539 - "De minimis violation" defined

Current through June 11,
				2024
"De minimis violation" means a violation 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 R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.844
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.3954 - "Major violation" defined

Current through June 11,
				2024
"Major violation" means a violation with a severity and scope
				  score of five or more.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.845
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39541 - "Plan of correction" defined

Current through June 11,
				2024
"Plan of correction" means a plan developed by the
				  intermediary service organization and approved by the Division that:
1. Describes the actions to be taken by the
				intermediary service organization to correct one or more violations;
				and
2. Specifies the date by which
				those violations will be corrected.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.846
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39542 - "Resurvey" defined

Current through June 11,
				2024
"Resurvey" means a survey conducted after the initial survey
				  to evaluate compliance with a plan of correction.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.847
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39543 - "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 violation.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.848
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39544 - "Subsequent violation" defined

Current through June 11,
				2024
"Subsequent violation" means a violation found on a
				  resurvey.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.849
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39545 - Imposition of sanctions generally

Current through June 11,
				2024
1. The Division
				will impose at least one administrative sanction against an intermediary
				service organization for each violation by the intermediary service
				organization with a severity level of four and for each violation with a
				severity and scope score of six or more as determined pursuant to the
				provisions of NAC 449.39551 to 449.39555, inclusive.
2. The Division may impose sanctions if
				violations of a severity level of three or less or a severity and scope score
				of less than six are identified.
3.
				The Division will minimize the time between identification of a violation and
				the imposition of a sanction for the violation.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.855
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39546 - Minimum sanction to be imposed

Current through June 11,
				2024
The Division will impose at least one sanction upon any
				  intermediary service organization that has a violation with a severity level of
				  four or a severity and scope score of six or more as determined pursuant to the
				  provisions of NAC 449.39551 to 449.39555, inclusive. More than one of these
				  sanctions may be imposed at the discretion of the Division.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.856
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39547 - Available sanctions

Current through June 11,
				2024
1. The Division may
				apply one or more sanctions as provided in
				NRS
				449.4335, including, without limitation:
(a) The imposition of a plan of correction as
				directed by the Division;
(b) The
				imposition of a ban on enrollment;
(c) Monitoring of the intermediary service
				organization by the Division;
(d)
				The assessment of monetary penalties in an amount set forth in NAC
				449.39561;
(e) The requirement that
				the intermediary service organization be managed temporarily by a person
				appointed by the Division; and
(f)
				The denial, suspension or revocation of the certificate.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39548 - Duration of sanctions

Current through June 11,
				2024
Sanctions applied pursuant to NAC 449.39535 to 449.39561,
				  inclusive, may be imposed until substantial compliance is achieved or, if
				  compliance is not achieved, until the day before termination of the certificate
				  becomes effective.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.858
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39549 - Notice of sanction; appointment of temporary manager; ban on enrollment or suspension of certificate authorized in certain circumstances

Current through June 11, 2024
1. The Division will give notice of a
				sanction to the holder of a certificate by certified mail as required pursuant
				to
				NRS
				449.4337.
2. If there is an immediate and serious
				threat to the health and safety of any person with a disability served by an
				intermediary service organization, the Division may appoint a temporary manager
				to remove the threat.
3. The
				Division may, in an emergency, impose a ban on enrollment or may suspend a
				certificate upon transmitting notice of such sanction to the holder of the
				certificate by certified mail.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.859
NRS
					 449.4335,
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.3955 - Imposition of one or more sanctions; reporting of violations; presumption of de minimis violation

Current through June 11,
				2024
1. The Division may
				apply one or more sanctions on the basis of violations found during surveys or
				investigations of complaints conducted by the Division.
2. Violations must be reported to the
				intermediary service organization and any client of the intermediary service
				organization who may be affected by the violation. The report to the
				intermediary service organization must specify the violations found and the
				severity and scope score for each violation determined by the Division pursuant
				to the provisions of NAC 449.39551 to 449.39555, inclusive.
3. Any violation for which a severity and
				scope score is not specified is presumed to be a de minimis
				violation.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.860
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39551 - Severity and scope of violations to be considered in determining sanctions to be imposed

Current through June 11,
				2024
In determining the sanctions to be imposed, the Division will
				  consider the severity and scope of the violations according to the
				  classifications of severity and scope described in NAC 449.39551 to 449.39555,
				  inclusive.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.861
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39552 - Scope of violations: Survey of organization; sampling of clients; use of scope relating to one client authorized

Current through June 11,
				2024
1. In determining
				the scope of a violation by an intermediary service organization, a survey of
				an intermediary service organization must evaluate a representative sample of
				clients of the intermediary service organization. The sample must consist of at
				least:
Number of clients
Minimum number of clients in sample
1 -
							 9................................................................................................
All clients
10 -
							 40............................................................................................
10
41 -
							 75............................................................................................
15
76 -
							 100..........................................................................................
20
101 -
							 175........................................................................................
25
176 -
							 250........................................................................................
30
251 -
							 350........................................................................................
35
351 -
							 450........................................................................................
40
451 or
							 more....................................................................................
50
2.
				In determining the scope of a violation involving particular kinds of services,
				the sampling of clients must evaluate a representative sample of clients of the
				intermediary service organization receiving or requiring the particular kinds
				of services.
3. The Division may
				review more than the minimum number of clients and determine the scope based on
				the number of clients actually reviewed.
4. If the Division investigates a specific
				complaint relating to a client, the Division may use only that client as the
				sample. The scope of any violation determined pursuant to this subsection must
				be a scope level of one.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.862
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39553 - Scope of violations: Use of scope; basis for assessment

Current through June 11, 2024
1. The scope scale must be used to assess the
				scope of a particular violation by the intermediary service
				organization.
2. The basis for the
				assessment is the actual or potential harm to clients as shown by:
(a) The frequency of the violation;
(b) The number or percentage of clients
				affected;
(c) The number or
				percentage of staff involved; and
(d) The pattern or lack of pattern of the
				violations.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39554 - Scope of violations: Criteria for evaluation

Current through
				June 11, 2024
1. The
				scope of the violations must be evaluated using the criteria prescribed in this
				section.
2. A violation with a
				scope level of one consists of one or a few unrelated incidents in the sample
				surveyed. A violation is of this scope if it involves 20 percent or less of the
				clients sampled.
3. A violation has
				a scope level of two if the Division identifies a pattern of incidents
				involving the intermediary service organization, including, without limitation,
				any violations involving clients who require particular kinds of services. The
				number or percentage of clients or staff involved in the violation or the
				repeated occurrences of the violation in short succession may also establish a
				pattern by indicating a reasonable degree of predictability of similar
				incidents. A violation is also of this scope if it involves more than 20
				percent but not more than 50 percent of the clients sampled.
4. A violation has a scope level of three if
				it occurs in a sufficient number or percentage of clients or staff or with
				sufficient regularity over time that it may be considered systemic or pervasive
				in or by the intermediary service organization. A violation is also of this
				scope if it involves more than 50 percent of the clients sampled.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.864
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39555 - Severity of violations: 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 violation pertaining
				to the intermediary service organization. The basis for the assessment must be
				the actual or potential harm to a person with a disability or, as applicable,
				other responsible person acting on his or her behalf.
2. Violations with a severity level of one
				concern requirements promulgated primarily for administrative purposes. No harm
				is likely to occur to a person with a disability. No negative impact has
				occurred or is likely to occur. The ability of a person with a disability to
				achieve the highest practicable physical, mental or psychosocial well-being has
				not been and is not likely to be compromised.
3. Violations with a severity level of two
				indirectly threaten the health, safety, rights, security, welfare or well-being
				of a person with a disability or, as applicable, other responsible person
				acting on his or her behalf. A potential for harm, as yet unrealized, exists.
				If continued over time:
(a) A negative impact
				on or a violation of one or more rights of a person with a disability or, as
				applicable, other responsible person acting on his or her behalf would occur or
				would be likely to occur; or
(b)
				The ability of one or more persons with disabilities to achieve the highest
				practicable physical, mental or psychosocial well-being would be or would
				likely be compromised.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39556 - Subsequent violation on resurvey: Rebuttable presumption; imposition of sanction

Current through June 11,
				2024
If the same violation is found on a resurvey, there is a
				  rebuttable presumption that the violation continued through the period between
				  the survey and resurvey. A sanction may be imposed for a subsequent violation
				  only if the resurvey is made and the violation is again actually found to be
				  present.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.866
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39557 - Determination of sanctions: Initial assessment

Current through June
				11, 2024
The Division will initially assess individual violations or
				  clusters of violations according to the following initial factors:
1. The presence or absence of an immediate
				and serious threat to the health and safety of persons with disabilities who
				receive services from the intermediary service organization or, as applicable,
				other responsible person acting on his or her behalf; and
2. The severity of the violation.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.867
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39558 - Determination of sanctions: Secondary factors to be considered

Current through June 11, 2024
After the initial assessment, the Division will consider the
				  following secondary factors in determining the sanction to impose:
1. The relationship of one violation or
				cluster of violations to other violations;
2. The history of previous compliance by the
				intermediary service organization generally and specifically with reference to
				the violations in issue;
3. Whether
				the violations are directly related to the services received by a person with a
				disability from the intermediary service organization; and
4. The corrective and long-term compliance
				outcomes desired.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.868
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39559 - Determination of sanctions: Basis for selection; restrictions upon service and monetary penalties presumed to be most effective

Current
				through June 11, 2024
The selection of a sanction must be based upon the nature of
				  the violations or cluster of violations and the sanction most likely to correct
				  those violations. Absent evidence to the contrary, restrictions upon service
				  and monetary penalties are presumed to be the most effective sanctions for
				  violations that do not cause an immediate and serious threat to clients.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.869
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.3956 - Plan of correction: Development by intermediary service organization; authority of Division when plan is not acceptable; effect of failure to submit plan

Current through June 11,
				2024
1. The intermediary
				service organization shall develop a plan of correction for each violation and
				submit the plan to the Division for approval within 10 days after receipt of
				the notice of violations from the Division pursuant to NAC 449.39549. The plan
				of correction must include specific requirements for corrective action, which
				must include the time within which the violations are to be
				corrected.
2. If the plan of
				correction is not acceptable to the Division, the Division may direct the
				intermediary service organization to resubmit a plan of correction or the
				Division may develop a directed plan of correction with which the intermediary
				service organization must comply.
3. Failure to submit the plan of correction
				to the Division within 10 days after receipt of the notice of violations
				constitutes a separate violation subject to monetary penalties pursuant to NAC
				449.39561 with severity and scope rated at the same levels as the highest
				violation identified on the notice of violations.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.870
NRS
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › INTERMEDIARY SERVICE ORGANIZATIONS › Administrative Sanctions › Section 449.39561 - Monetary penalties: Determination of initial penalty; daily penalties; maximum total penalties

Current through June 11,
				2024
1. In determining
				the amount of an initial monetary penalty, the Division will 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, the severity and
				scope score must be considered.
2.
				For initial violations with a severity level of four, an initial monetary
				penalty of up to $1,000 per violation may be imposed.
3. For initial violations with a severity
				level of three and a scope level of three, a monetary penalty of up to $800 per
				violation may be imposed.
4. For
				initial violations with a severity level of three and a scope level of two or
				less, an initial monetary penalty of up to $400 per violation may be
				imposed.
5. For initial violations
				with a severity level of two and a scope level of three, an initial monetary
				penalty of up to $200 per violation may be imposed. The payment of this
				monetary penalty must be suspended if the facility has corrected the violations
				within the time specified in the plan of correction approved by the
				Division.
6. Except as otherwise
				provided in subsection 7, in addition to any monetary penalty imposed pursuant
				to this section, the Division may impose a monetary penalty of not more than
				$10 per client per day for each day the violation continues.
7. The total monetary penalties imposed by
				the Division pursuant to this section must not be more than $1,000 per day for
				each violation, together with interest thereon at a rate of 10 percent per
				annum.
Added to NAC by Bd. of
				  Health by R167-07, eff. 1-30-2008-Substituted in revision for NAC
				  427A.871
NRS
					 449.4335,
					 449.4336
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39565 - Definitions

Current through June 11, 2024
As used in NAC 449.39565 to 449.39591, inclusive, unless the
				context otherwise requires, the words and terms defined in NAC 449.39567 to
				449.39575, inclusive, have the meanings ascribed to them in those
				sections.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39567 - "Client" defined

Current through June 11,
			 2024
"Client" means a person who receives the services of a
				community health worker.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39569 - "Continuing education" defined

Current through June 11,
			 2024
"Continuing education" means a course of study or training that
				is designed to develop and enhance the knowledge, skills and competency of a
				community health worker with regard to providing the services of a community
				health worker to a client.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39571 - "Representative of the client" defined

Current through June 11,
			 2024
"Representative of the client" means the spouse of a client, a
				parent or stepparent of a client who is a minor, the legal guardian of a client
				and any other person required by law to provide medical support to a
				client.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39573 - "Service plan" defined

Current through June 11,
			 2024
"Service plan" means a plan which includes a written
				description of the needs of a client for the services of a community health
				worker and which specifies the tasks that a community health worker is
				authorized to provide for the client.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39575 - "Services of a community health worker" defined

Current through
			 June 11, 2024
"Services of a community health worker" means the services
				provided by a community health worker at the direction of a community health
				worker pool which may include, without limitation, outreach, community
				education, informal counseling, social support, advocacy and improvement of the
				social determinants of health.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39577 - Location to which license applies; name of administrator to appear on license; liability coverage

Current through June 11,
			 2024
1. Except as
			 otherwise provided in this subsection, each license issued to operate a
			 community health worker pool is separate and distinct and is issued to a
			 specific person, who is designated on the license, to operate the community
			 health worker pool at a specific location. The person may operate a community
			 health worker pool at multiple work stations if the community health worker
			 pool maintains the records for the clients, community health workers, other
			 members of the staff of the community health worker pool and operations of the
			 community health worker pool at the specific location designated on the
			 license.
2. The name of the
			 administrator of the community health worker pool must appear on the face of
			 the license.
3. Each community
			 health worker pool must retain proof that it is adequately covered against
			 liabilities resulting from claims incurred in the course of
			 operation.
4. The proof of liability
			 coverage required by subsection 3 must be verified at the time the community
			 health worker pool submits its initial application to the Division for a
			 license and upon request by the Division.
5. As used in this section, "work station"
			 means a satellite office of a community health worker pool that is established
			 for the sole purposes of providing a location where copies of records may be
			 sent to a community health worker pool and providing a location from which a
			 community health worker may work to serve a geographic area outside the
			 geographic area in which the community health worker normally
			 works.
Added to NAC by Bd. of
				Health by R133-15, eff. 12-19-2017
NRS
				  449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39579 - Qualifications and duties of administrator; access to records in absence of administrator

Current through June 11,
			 2024
1. The
			 administrator of a community health worker pool must:
(a) Be at least 18 years of age;
(b) Have a high school diploma or its
			 equivalent;
(c) Be responsible and
			 mature and have the personal qualities which will enable the administrator to
			 understand the problems relating to the prevention and management of chronic
			 disease, the social determinants of health, the field of behavioral health and
			 community services;
(d) Understand
			 the provisions of this chapter and chapter 449 of NRS; and
(e) Demonstrate the ability to read, write,
			 speak and understand the English language.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › COMMUNITY HEALTH WORKER POOLS › Section 449.39581 - Written policies and procedures

Current through June 11,
			 2024
A community health worker pool shall maintain written policies
				and procedures concerning the qualifications, responsibilities and conditions
				of employment for each community health worker and other members of the staff
				of the community health worker pool. The written policies and procedures must
				be reviewed and revised as needed. The written policies and procedures must be
				made available to the community health workers and other members of the staff
				of the community health worker pool upon hire and whenever revisions are made
				to those policies and procedures. At a minimum, the policies and procedures
				must:
1. Provide descriptions of the
			 duties and responsibilities of community health workers;
2. Provide descriptions of any activities
			 that community health workers are prohibited from engaging in, including,
			 without limitation:
(a) Making a long distance
			 telephone call that is personal in nature:
(1)
			 On a telephone owned by or provided by a client; or
(2) While on duty providing the services of a
			 community health worker to a client;