reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 6.1 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in subsection 2, a freestanding birthing center
		  shall, not later than 6 months after initial licensure pursuant to
		  NRS
		  449.080, submit to the Division proof that
		  the freestanding birthing center holds accreditation as a birth center from the
		  Commission for the Accreditation of Birth Centers, or its successor
		  organization.
2. If the Commission
		  for the Accreditation of Birth Centers, or its successor organization, notifies
		  a freestanding birthing center that the Commission is not able to accredit the
		  freestanding birthing center within the period described in subsection 1, the
		  freestanding birthing center shall:
(a)
		  Immediately notify the Division; and
(b) Submit to the Division proof of such
		  accreditation not later than 12 months after initial licensure pursuant to NRS
		  449.040.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 6.2 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in subsection 2, before any construction of a new
		  facility for hospice care or remodeling of an existing facility for hospice
		  care commences, the facility must submit two complete sets of the building
		  plans for the construction or remodeling, as applicable, to:
(a) The entity designated by the Division to
		  review such plans in the manner prescribed by NAC
		  449.0115, regardless of whether
		  the facility is applying for a license or the renewal of a license. The review
		  by that entity is only advisory, and approval by that entity does not
		  constitute the approval of the construction or remodeling by the
		  Bureau.
(b) The Division. The
		  facility shall not commence the construction or remodeling, as applicable,
		  until the plans have been approved by the Division.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 6.3 - NEW

Current
		  through June 11, 2024
"Tier 2 training" means training for employees of a residential
			 facility that includes, without limitation, training in:
1. The psychosocial aspects of
		  dementia;
2. Current science
		  concerning dementia;
3. Signs and
		  symptoms of dementia; and
4.
		  Working with persons who have dementia, including, without limitation:
(a) Communication;
(b) Providing person-centered care;
(c) Assessment of persons with
		  dementia;
(d) Planning the
		  provision of care; and
(e)
		  Assisting with activities of daily living.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 7 - NEW

Current
		  through June 11, 2024
Pursuant to paragraph (e) of subsection 1 of
			 NRS
			 449.0302 and paragraph (a) of subsection 2 of
			 NRS
			 449.101, the specific types of prohibited
			 discrimination include, without limitation:
1. Discrimination that results in a person
		  not being treated with dignity and which is based wholly or partially on the
		  actual or perceived race, color, religion, national origin, ancestry, age,
		  gender, physical or mental disability, sexual orientation, gender identity or
		  expression or human immunodeficiency virus status of the patient or resident or
		  any person with whom the patient or resident associates.
2. Indirect discrimination that may or may
		  not be intentional and which results in the application of policies that are
		  applied uniformly and in a nondiscriminatory manner by the facility.
3. Discrimination which is based wholly or
		  partially on the person associating with other persons who:
(a) Are actually or perceived to be of a
		  different race, color, religion, national origin, ancestry, age, gender, sexual
		  orientation, gender identity or expression or human immunodeficiency virus
		  status of the person; or
(b)
		  Actually or are perceived to have a physical or mental disability.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 7.1 - NEW

Current
		  through June 11, 2024
1.
		  A freestanding birthing center must be designed, constructed, equipped and
		  maintained in a manner that protects the health and safety of the pregnant
		  persons, persons who have given birth and newborns who receive care at the
		  freestanding birthing center, the staff of the freestanding birthing center and
		  members of the general public.
2. A
		  freestanding birthing center must have:
(a)
		  Designated parking for pregnant persons and visitors; and
(b) At least one parking space reserved for
		  emergency vehicles.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 7.2 - NEW

Current
		  through June 11, 2024
"Group housing arrangement" means a residential facility for
			 groups or any other group housing arrangement that provides assistance, food,
			 shelter or limited supervision to a person with a mental illness, intellectual
			 disability, developmental disability or physical disability or who is aged or
			 infirm.
Added
			 to NAC by Bd. of Health by
			 R048-22A,
			 eff. 12/29/2022
NRS
				439.200,
				449.0302,
				449.0305
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 7.3 - NEW

Current
		  through June 11, 2024
1.
		  Tier 2 training must be:
(a) A training
		  included on the list compiled pursuant to subsection 2; or
(b) A training provided by:
(1) A nationally recognized organization
		  focused on dementia, which may include, without limitation, the National
		  Alzheimer's and Dementia Resource Center and the Alzheimer's Association, or
		  their successor organizations;
(2)
		  An accredited college or university located in the District of Columbia or any
		  state or territory of the United States; or
(3) The Federal or State
		  Government.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 8 - NEW

Current
		  through June 11, 2024
A facility shall adopt and maintain policies and procedures for
			 the transfer and discharge of, and the provision of services to, patients or
			 residents in the facility which do not discriminate against a patient or
			 resident based on the source of payment for the services
			 provided.
Added to NAC
			 by Bd. of Health by
			 R016-20A,
			 eff. 11/2/2020
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 8.1 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in subsection 2, before any new construction of a
		  freestanding birthing center or any remodeling of an existing freestanding
		  birthing center is begun, the freestanding birthing center must submit building
		  plans for the new construction or remodeling to the entity designated by the
		  Division to review such plans pursuant to the provisions of NAC
		  449.0115.
		  The review of those plans conducted by the entity is advisory only and does not
		  constitute approval for the licensing of the freestanding birthing center. The
		  Division shall not issue a license to the freestanding birthing center or renew
		  the license of the freestanding birthing center, as applicable, until all
		  construction is completed and a survey is conducted at the site of the
		  freestanding birthing center.
2. A
		  freestanding birthing center is not required to submit plans for remodeling to
		  the entity designated by the Division to review such plans pursuant to the
		  provisions of NAC
		  449.0115
		  if the remodeling is limited to refurbishing an area within the freestanding
		  birthing center, including, without limitation, painting the area, replacing
		  the flooring in the area, repairing windows in the area and replacing window or
		  wall coverings in the area.
3.
		  Before issuing an initial license to a freestanding birthing center, the
		  Division shall conduct an on-site inspection of the freestanding birthing
		  center.
Added
			 to NAC by Bd. of Health by
			 R062-21A,
			 eff. 9/8/2022
NRS
				439.200,
				449.0302,
				as amended by section 16.5 of Assembly Bill No. 287, chapter 517, Statutes of
				Nevada 2021, at page 3437
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 8.2 - NEW

Current
		  through June 11, 2024
1.
		  To comply with the requirements of paragraph (a) of subsection 2 of NAC
		  449.3973 concerning the training
		  of employees, an agency shall:
(a) Provide or
		  arrange for the provision of the training required by that paragraph;
(b) Except as otherwise provided in
		  subsection 4, pay any costs associated with attending such training, including,
		  without limitation:
(1) The cost of the
		  training; and
(2) If the training
		  is not provided at the agency, the costs of travelling to and from the location
		  where the training is provided; and
(c) Pay an employee attending such training
		  his or her salary or hourly wage as if the employee were working for:
(1) Time spent attending the training;
		  and
(2) The time that would
		  ordinarily be required to travel from the agency to the location of the
		  training and back to the agency.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 8.3 - NEW

Current
		  through June 11, 2024
As used in
			 NRS
			 449.1845, the Division shall interpret the
			 term "qualified provider of health care" to mean a provider of health care for
			 whom the activities described in
			 NRS
			 449.1845 are within the scope of his or her
			 license or certification. The term includes a provider of health care who is
			 licensed or certified in another state or territory or the District of Columbia
			 if a resident of that jurisdiction or his or her legal representative is
			 seeking placement in a residential facility for groups in this
			 State.
Added
			 to NAC by Bd. of Health by
			 R043-22A,
			 eff. 7/26/2023
NRS
				439.200,
				449.0302,
				449.1845
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 9 - NEW

Current
		  through June 11, 2024
In addition to the statement prescribed by paragraph (b) of
			 subsection 2 of
			 NRS
			 449.101, a facility shall post prominently in
			 the facility and include on any Internet website to market the facility:
1. Notice that a patient or resident who has
		  experienced prohibited discrimination may file a complaint with the Division;
		  and
2. The contact information for
		  the Division.
Added to NAC
			 by Bd. of Health by
			 R016-20A,
			 eff. 11/2/2020
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 9.1 - NEW

Current
		  through June 11, 2024
1.
		  A freestanding birthing center must have a supply of oxygen, which may include,
		  without limitation, portable oxygen, that is adequate to provide oxygen
		  supplementation to all pregnant persons, persons who have given birth and
		  newborns receiving care at the freestanding birthing center.
2. The director of a freestanding birthing
		  center shall establish policies and procedures for the safe administration and
		  storage of oxygen at the freestanding birthing center. Those policies and
		  procedures must include, without limitation, policies and procedures for the
		  safe storage of portable oxygen in accordance with standards for the safe
		  storage of a medical gas prescribed by a nationally recognized fire protection
		  association or another appropriate nationally recognized
		  organization.
Added
			 to NAC by Bd. of Health by
			 R062-21A,
			 eff. 9/8/2022
NRS
				439.200,
				449.0302,
				as amended by section 16.5 of Assembly Bill No. 287, chapter 517, Statutes of
				Nevada 2021, at page 3437
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 9.2 - NEW

Current
		  through June 11, 2024
1.
		  "Appendix B - Guidance to Surveyors: Home Health Agencies" of the
State
		  Operations Manual
, issued February 21, 2020, published by the Centers
		  for Medicare and Medicaid Services of the United States Department of Health
		  and Human Services, is hereby adopted by reference. The publication is
		  available at no cost on the Internet at
https://www.hhs.gov/guidance/document/state-operations-manual-appendix-b-guidance-surveyors-home-health-agencies
,
		  or, if that Internet website ceases to exist, from the Division.
2. If the publication adopted by reference in
		  subsection 1 is revised, the Division shall review the revision to determine
		  its suitability for this State. If the Division determines that the revision is
		  not suitable for this State, the Division shall hold a public hearing to review
		  its determination and give notice of that hearing within 90 days after the date
		  of the publication of the revision. If, after the hearing, the Division does
		  not revise its determination, the Division shall give notice that the revision
		  is not suitable for this State within 90 days after the hearing. If the
		  Division does not give such notice, the revision becomes part of the
		  publication adopted by reference in subsection 1.
Added
			 to NAC by Bd. of Health by
			 R048-22A,
			 eff. 12/29/2022
NRS
				439.200,
				449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 9.3 - NEW

Current
		  through June 11, 2024
As used in sections 9 to 16, inclusive, unless the context
			 otherwise requires, the words and terms defined in sections 10 and 11 have the
			 meanings ascribed to them in those sections.
Added
			 to NAC by Bd. of Health by
			 R043-22A,
			 eff. 7/26/2023
NRS
				439.200,
				449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 10 - NEW

Current
		  through June 11, 2024
1.
		  The statement required to be posted pursuant to paragraph (b) of subsection 2
		  of
		  NRS
		  449.101 and the notice and information
		  required to be posted pursuant to subsection 3 of
		  NRS
		  449.101 or section 9 of this regulation, as
		  applicable, must:
(a) State the name of the
		  facility; and
(b) When posted in
		  the facility:
(1) Be not less than 8.5 inches
		  in height and 11 inches in width, with margins not greater than 0.5 inches on
		  any side; and
(2) Be written using
		  a single typeface in not less than 22-point type.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 10.1 - NEW

Current
		  through June 11, 2024
1.
		  A freestanding birthing center shall develop and implement written policies and
		  procedures to be followed by the members of the staff of the freestanding
		  birthing center for the control of infection that are in accordance with
		  nationally recognized guidelines. Acceptable guidelines include, without
		  limitation, the most recent version of the
Guidelines for Environmental
		  Infection Control in Health-Care Facilities
published by the Centers
		  for Disease Control and Prevention of the United States Department of Health
		  and Human Services.
2. The policies
		  and procedures developed pursuant to subsection 1 must prescribe the procedures
		  for:
(a) Hand hygiene;
(b) Cleaning and disinfecting surfaces and
		  substances that pose a risk of infection to pregnant persons, persons who have
		  given birth and newborns;
(c) The
		  proper use of syringes, needles, vials and lancets; and
(d) The proper sterilization and disinfection
		  of all reusable equipment.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 10.2 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in this subsection, a home health agency shall
		  comply with the provisions of
		  42 C.F.R. §§
								484.1 to
		  484.115, inclusive, and the
		  publication adopted by reference in section 9. A home health agency that is not
		  certified by the Centers for Medicare and Medicaid Services of the United
		  States Department of Health and Human Services is not required to comply with:
(a)
								42 C.F.R. §
									484.45 and any associated guidance prescribed
		  by the publication adopted by reference in section 9, except that the home
		  health agency shall:
(1) Collect the data
		  prescribed by 42 C.F.R.
		  §
										484.55(c)(8);
		  and
(2) Update and revise that data
		  at the frequency required by 42 C.F.R. §
										484.55(d);
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 10.3 - NEW

Current
		  through June 11, 2024
"Course" means a course of training in the administration of
			 medication offered to satisfy the requirements of NAC
			 449.196,
			 449.2726 and
			 449.2742 and section
			 15.
Added
			 to NAC by Bd. of Health by
			 R043-22A,
			 eff. 7/26/2023
NRS
				439.200,
				449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 11 - NEW

Current
		  through June 11, 2024
1.
		  Upon admission of a patient or resident, the facility shall:
(a) Provide the patient or resident with a
		  written copy of the statement required pursuant to paragraph (b) of subsection
		  2 of
		  NRS
		  449.101 and the notice and information
		  required pursuant to subsection 3 of
		  NRS
		  449.101 or section 9 of this regulation, as
		  applicable.
(b) Provide the patient
		  or resident with a written notice that a patient or resident who has
		  experienced prohibited discrimination may file a complaint with the facility.
		  The written notice provided by the facility must include, without limitation:
(1) The contact information for the
		  Division;
(2) A clear statement
		  that such a complaint with the facility:
(I)
		  May be filed in addition to the complaint that may be filed with the Division
		  pursuant to subsection 3 of
		  NRS
		  449.101 or section 9 of this regulation, as
		  applicable; and
(II) Is not
		  required to be filed for the patient or resident to file a complaint with the
		  Division pursuant to subsection 3 of
		  NRS
		  449.101 or section 9 of this regulation, as
		  applicable; and
(3) The
		  procedure that the facility uses to address such complaints with the facility
		  and the timeframe for how long it will take the facility to address such
		  complaints with the facility.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 11.1 - NEW

Current
		  through June 11, 2024
1.
		  A freestanding birthing center shall comply with all applicable:
(a) Federal and state laws;
(b) Local ordinances, including, without
		  limitation, zoning ordinances;
(c)
		  Environmental, health and local building codes; and
(d) Fire and safety codes, including, without
		  limitation, those codes relating to ingress and egress of occupants, placement
		  of smoke alarms, fire extinguishers or sprinkler systems and fire escape
		  routes, related to the design, construction and maintenance of the freestanding
		  birthing center. If there is a difference between state and local requirements,
		  the more stringent requirements apply.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 11.2 - NEW

Current
		  through June 11, 2024
1.
		  An ambulatory surgical center must be designated as Class A, Class B, Class C,
		  Class E or Endoscopy Only.
2. An
		  ambulatory surgical center that is designated as Class A may provide minor
		  surgical procedures performed under local or topical anesthesia. An operating
		  room in an ambulatory surgical center that is designated as Class A must have a
		  minimum clear area of 130 square feet (12.077 square meters) and a
		  minimum clear dimension of 10 feet (3.05 meters).
3. An ambulatory surgical center that is
		  designated as Class B may provide any surgical procedure authorized for an
		  ambulatory surgical center that is designated as Class A and any surgical
		  procedure performed under conscious or deep sedation. An operating room in an
		  ambulatory surgical center that is designated as Class B must have a minimum
		  clear area of 250 square feet (23.23 square meters)
		  and a minimum clear dimension of 15 feet (4.57 meters).
4. An ambulatory surgical center that is
		  designated as Class C may provide any surgical procedure authorized for an
		  ambulatory surgical center that is designated as Class A or B and any surgical
		  procedure that requires general anesthesia. An operating room in an ambulatory
		  surgical center that is designated as Class C must have a minimum clear area of
		  400 square feet (37.16 square meters) and a minimum
		  clear dimension of 18 feet (5.49
		  meters).
5. An ambulatory surgical
		  center that is designated as Class E must have been licensed before August 5,
		  2004.
6. An ambulatory surgical
		  center that is designated as Endoscopy Only may only provide endoscopy
		  procedures. An operating room in an ambulatory surgical center that is
		  designated as Endoscopy Only must have a minimum clear area of 180 square feet
		  (16.7225 square meters).
7. As used in this section:
(a) "Clear area" means the open area of an
		  operating room, excluding fixed cabinets and built-in shelves.
(b) "Clear dimension" means the open space
		  between the operating room and another area of the building.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 11.3 - NEW

Current
		  through June 11, 2024
"Instructor" means the instructor of a course.
Added
			 to NAC by Bd. of Health by
			 R043-22A,
			 eff. 7/26/2023
NRS
				439.200,
				449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 12 - NEW

Current
		  through June 11, 2024
A facility shall:
1.
		  Develop and adopt a written policy on how a complaint with the facility that is
		  filed pursuant to paragraph (b) of subsection 1 of section 11 of this
		  regulation is documented, investigated and resolved; and
2. Maintain a log that lists:
(a) All complaints with the facility that are
		  filed pursuant to paragraph (b) of subsection 1 of section 11 of this
		  regulation;
(b) The actions taken
		  by the facility to investigate and resolve the complaint; and
(c) If no action was taken, an explanation as
		  to why no action was taken.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 12.1 - NEW

Current
		  through June 11, 2024
1.
Indicators of Compliance with Standards for Birth Centers
is
		  hereby adopted by reference in the form most recently published by the
		  Commission for the Accreditation of Birth Centers, unless the Board gives
		  notice that the most recent revision is not suitable for this State pursuant to
		  subsection 2. A copy of the publication may be obtained at no cost at the
		  Internet address
https://birthcenteraccreditation.org/go-get-cabc-indicators/
or, if that Internet website ceases to exist, from the Board.
2. The Board will review each revision of the
		  publication adopted by reference in subsection 1 to ensure its suitability for
		  this State. If the Board determines that a revision is not suitable for this
		  State, the Board will hold a public hearing to review its determination within
		  12 months after the date of the publication of the revision and give notice of
		  that hearing. If, after the hearing, the Board does not revise its
		  determination, the Board will give notice within 30 days after the hearing that
		  the revision is not suitable for this State. If the Board does not give such
		  notice, the revision becomes part of the publication adopted by reference
		  pursuant to subsection 1.
3. A
		  freestanding birthing center shall:
(a)
		  Provide care during labor and delivery, care for newborns and care during
		  recovery;
(b) Comply with the
		  standards prescribed in the publication adopted by reference in subsection 1 to
		  the extent those standards do not conflict with the provisions of this chapter
		  and chapter 449 of NRS; and
(c)
		  Maintain a copy of the most recent version of the publication adopted by
		  reference in subsection 1 on the premises of the freestanding birthing center
		  and make the copy available to all members of the staff of the freestanding
		  birthing center.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 12.2 - NEW

Current
		  through June 11, 2024
1.
		  A person employed to engage in the practice of surgical technology in an
		  ambulatory surgical center pursuant to subsection 3 of
		  NRS
		  449.24185 must have passed a written
		  competency evaluation demonstrating that he or she is competent to practice
		  surgical technology and have:
(a) Not less
		  than 1 year of experience within the immediately preceding 3 years practicing
		  surgical technology in a hospital or surgical center for ambulatory patients
		  that is licensed in a state of the United States, the District of Columbia, the
		  Commonwealth of Puerto Rico or a territory or insular possession subject to the
		  jurisdiction of the United States; or
(b) Completed evidence-based training
		  concerning:
(1) Proper surgical
		  attire;
(2) Identification of
		  patients;
(3) Proper positioning of
		  a patient on an operating table;
(4) Consent of a patient to
		  surgery;
(5) Time-out before
		  surgery;
(6) The proper use of
		  instruments and equipment, including, without limitation, identifying dangers
		  associated with equipment;
(7)
		  Asepsis and sterile technique, including, without limitation, identifying a
		  break in the sterile field;
(8)
		  Washing hands before surgery;
(9)
		  Counting surgical instruments, surgical sponges and any other items used during
		  surgery that may be left in the body of a patient;
(10) Preparing medications in the sterile
		  field;
(11) The use of gowns and
		  gloves;
(12) Draping of the
		  patient;
(13) Proper care for
		  specimens;
(14) Procedures for
		  disinfecting and sterilizing equipment and supplies;
(15) Procedures for determining whether
		  equipment and supplies have been properly sterilized and measures to be taken
		  if a break in the sterile field is identified;
(16) Storage of sterile equipment and
		  supplies; and
(17) Environmental
		  cleaning and disinfecting the operating room.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 12.3 - NEW

Current
		  through June 11, 2024
1.
		  To obtain the approval of the Division for a course, the person or entity that
		  proposes to offer the course must apply to the Division in the form prescribed
		  by the Division. The application must include, without limitation:
(a) Certification that the course will be
		  taught by an instructor who has been approved by the Division pursuant to
		  section 14;
(b) The proposed
		  syllabus of the course;
(c) The
		  information that will be provided to participants in the course;
(d) A written evaluation of the content and
		  presentation of the course that will be completed by each participant in the
		  course;
(e) A statement of the
		  purpose of the course and the requirements for attendance; and
(f) Any additional proof necessary to
		  demonstrate that the course meets the requirements of section 13.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 13 - NEW

Current
		  through June 11, 2024
To provide express permission pursuant to subsection 2 of
			 NRS
			 449.102, a patient or resident or the
			 authorized representative of the patient or resident must provide permission in
			 writing.
Added to NAC
			 by Bd. of Health by
			 R016-20A,
			 eff. 11/2/2020
NRS
			 449.0302
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 13.1 - NEW

Current
		  through June 11, 2024
1.
		  A clinical provider at a freestanding birthing center must be:
(a) A physician licensed pursuant to chapter
		  630 or 633 of NRS;
(b) A certified
		  nurse-midwife; or
(c) A midwife who
		  meets the requirements prescribed in the publication adopted by reference in
		  section 12 for serving on the professional midwifery staff of a freestanding
		  birthing center.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 13.2 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in subsection 2, a natural person responsible for
		  the operation of a provider of community-based living arrangement services and
		  each employee of a provider of community-based living arrangement services who
		  supervises or provides support to recipients of community-based living
		  arrangement services shall:
(a) Complete not
		  less than 16 hours of training concerning the provision of community based
		  living arrangement services to persons with mental illness within 30 days after
		  the date of hire or before providing services to a patient, whichever is later;
		  and
(b) Annually complete not less
		  than 8 hours of continuing education approved by the Division concerning the
		  particular population served by the provider.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 13.3 - NEW

Current
		  through June 11, 2024
1.
		  A course must:
(a) Be conducted entirely in
		  English and consist of:
(1) At least 16 hours
		  of training in the management of medication, consisting of not less than 12
		  hours of classroom training and not less than 4 hours of practical training;
		  or
(2) At least 8 hours of
		  refresher or remedial training in the management of medication.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 14 - NEW

Current
		  through June 11, 2024
1.
		  Pursuant to subsection 1 of
		  NRS
		  449.103, within 30 business days after the
		  course or program is assigned a course number by the Division pursuant to
		  section 18 of this regulation or within 30 business days of any agent or
		  employee being contracted or hired, whichever is later, and at least once each
		  year thereafter, a facility shall conduct training relating specifically to
		  cultural competency for any agent or employee of the facility who provides care
		  to a patient or resident of the facility so that the agent or employee may:
(a) More effectively treat patients or care
		  for residents, as applicable; and
(b) Better understand patients or residents
		  who have different cultural backgrounds, including, without limitation,
		  patients or residents who fall within one or more of the categories in
		  paragraphs (a) to (f), inclusive, of subsection 1 of
		  NRS
		  449.103.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 14.1 - NEW

Current
		  through June 11, 2024
A birth assistant in a freestanding birthing center must:
1. Hold a certification in basic life support
		  issued by the American Heart Association, or its successor organization, or
		  hold an equivalent certification, and have successfully completed training in
		  the techniques of administering neonatal resuscitation provided through the
		  Neonatal Resuscitation Program of the American Academy of Pediatrics, or any
		  successor to that program; and
2.
		  Have successfully completed:
(a) A program of
		  training for birth assistants offered by:
(1)
		  A nationally recognized organization for training birth assistants, including,
		  without limitation, the American Association of Birth Centers, or its successor
		  organization; or
(2) An accredited
		  college or university;
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 14.2 - NEW

Current
		  through June 11, 2024
1.
		  A provider who operates a facility that provides assistance to residents in the
		  administration of medications shall maintain:
(a) A log for each medication received by the
		  facility for use by a resident of the facility.
The log must include:
(1) The type and quantity of medication
		  received by the facility;
(2) The
		  date of its delivery;
(3) The name
		  of the person who accepted the delivery;
(4) The name of the resident for whom the
		  medication is prescribed; and
(5)
		  The date on which any unused medication is removed from the facility or
		  destroyed.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 14.3 - NEW

Current
		  through June 11, 2024
1.
		  To obtain the approval of the Division as an instructor, a person must apply to
		  the Division in the form prescribed by the Division. The application must
		  include, without limitation:
(a) The name and
		  address of the applicant;
(b) The
		  resume of the applicant;
(c) Proof
		  that the applicant meets the requirements of subsection 1 of section 15;
		  and
(d) A statement signed by the
		  applicant agreeing to comply with the requirements of subsection 2 of section
		  15 if the application is approved.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 15 - NEW

Current
		  through June 11, 2024
1.
		  Within 90 days after a facility is licensed to operate, the facility must
		  submit to the Department on a form prescribed by the Department the course or
		  program which the facility will use to provide cultural competency training.
		  The facility may:
(a) Develop or operate the
		  course or program; or
(b) Contract
		  with a third party to develop and operate the course or program.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 15.1 - NEW

Current
		  through June 11, 2024
1.
		  A birth assistant at a freestanding birthing center must be supervised at all
		  times by the director of the freestanding birthing center or a clinical
		  provider at the freestanding birthing center.
2. The supervisor of a birth assistant may
		  only delegate to the birth assistant tasks that the birth assistant has been
		  trained and is competent to perform, as documented in the personnel file of the
		  birth assistant pursuant to subsection 3. Such tasks may include, without
		  limitation:
(a) Checking vital signs and fetal
		  heart tones;
(b) Educating and
		  providing support to pregnant persons and their supporters;
(c) Nonclinical tasks, including, without
		  limitation, cleaning, laundry, organization, and ordering and stocking
		  supplies;
(d) Assisting clinical
		  providers with required documentation, including, without limitation, the
		  documentation of data relating to vital signs;
(e) Assisting pregnant persons or persons who
		  have given birth with activities of daily living, including, without
		  limitation, getting dressed, bathing and mobility;
(f) Assisting a clinical provider or other
		  member of the staff of the freestanding birthing center in an emergency;
		  and
(g) Ensuring that equipment and
		  supplies are cleaned, disinfected or sterilized, as applicable, in the manner
		  prescribed by the policies and procedures developed pursuant to section
		  10.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 15.2 - NEW

Current
		  through June 11, 2024
1.
		  If the Bureau determines that there is an immediate and serious threat to the
		  health and safety of recipients served by a facility, the Bureau:
(a) Shall notify the facility as soon as
		  possible; and
(b) May require the
		  facility to submit a plan of abatement.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 15.3 - NEW

Current
		  through June 11, 2024
1.
		  An instructor must:
(a) Be authorized to use
		  a curriculum concerning the management of medication that is approved by the
		  Division pursuant to section 12;
(b) Have completed:
(1) At least 16 hours of training in the
		  management of medication, consisting of not less than 12 hours of classroom
		  training and not less than 4 hours of practical training, approved by the
		  Division pursuant to section 12 within the year immediately preceding the
		  submission of an application pursuant to section 14; or
(2) At least 16 hours of training in the
		  management of medication, consisting of not less than 12 hours of classroom
		  training and not less than 4 hours of practical training approved by the
		  Division pursuant to section 12, at any time and at least 8 hours of refresher
		  or remedial training in the management of medication approved by the Division
		  pursuant to section 12 within the year immediately preceding the submission of
		  an application pursuant to section 14;
(c) Have the ability to speak, read, write
		  and teach the entire course in the English language;
(d) Have at least 3 years of experience
		  administering medication or supervising the administration of medication in a
		  medical facility or a facility for the dependent or be licensed in good
		  standing as a physician, physician assistant, advanced practice registered
		  nurse, registered nurse or licensed practical nurse; and
(e) In addition to passing the examination
		  administered pursuant to paragraph (d) of subsection 1 of section 13 at the
		  conclusion of the course completed pursuant to paragraph (b), have achieved a
		  score of at least 80 percent on a comprehensive examination concerning:
(1) The curriculum that the applicant
		  proposes to teach;
(2) Regulations
		  concerning the management of medication; and
(3) Skills for presenting information in
		  person or by videoconference.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 16 - NEW

Current
		  through June 11, 2024
1.
		  A course or program subject to the requirements of subsection 4 of section 15
		  of this regulation must include, without limitation, the following course
		  materials:
(a) An overview of cultural
		  competency;
(b) An overview of
		  implicit bias and indirect discrimination;
(c) The common assumptions and myths
		  concerning stereotypes and examples of such assumptions and myths;
(d) An overview of social determinants of
		  health;
(e) An overview of best
		  practices when interacting with persons who fall within one or more of the
		  categories in paragraphs (a) to (f), inclusive, of subsection 1 of
		  NRS
		  449.103;
(f) An overview of gender, race and
		  ethnicity;
(g) An overview of
		  religion;
(h) An overview of sexual
		  orientation and gender identities or expressions;
(i) An overview of mental and physical
		  disabilities;
(j) Examples of
		  barriers to providing care;
(k)
		  Examples of language and behaviors that are discriminatory; and
(l) Examples of a welcoming and safe
		  environment.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 16.1 - NEW

Current
		  through June 11, 2024
1.
		  A program of supervised training for providers of health care offered at a
		  freestanding birthing center:
(a) Must be
		  supervised by:
(1) A preceptor registered
		  with the North American Registry of Midwives, or its successor
		  organization;
(2) A certified
		  nurse-midwife who has been practicing as a midwife for the immediately
		  preceding 3 years; or
(3) A
		  physician licensed pursuant to chapter 630 or 633 of NRS who has been
		  practicing in the area of obstetrics for the immediately preceding 3
		  years.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 16.3 - NEW

Current
		  through June 11, 2024
1.
		  The Division may revoke the approval of a course or an instructor upon a
		  determination that the course or instructor, as applicable, has:
(a) Failed to comply with the requirements of
		  sections 9 to 16, inclusive;
(b)
		  Presented false, misleading or materially incomplete information to the
		  Division; or
(c) Engaged in other
		  unlawful conduct relating to a course or the ability to offer or teach, as
		  applicable, such a course.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 17 - NEW

Current
		  through June 11, 2024
1.
		  The Department shall review the course or program information submitted
		  pursuant to section 15 of this regulation and, if applicable, section 16 of
		  this regulation within 60 days after receipt. During this review process, the
		  Department may have the course or program reviewed by a person who is an expert
		  on cultural competency or a committee of persons who are experts on cultural
		  competency.
2. If the information
		  that is provided to the Department meets the requirements set forth in sections
		  15 and 16, if applicable, of this regulation, the Director or his or her
		  designee may approve the course or program. If the information that is provided
		  to the Department does not meet the requirements set forth in sections 15 and
		  16, if applicable, of this regulation, the Director or his or her designee
		  shall not approve the course or program.
3. Within 5 business days after completing
		  the review of the information pursuant to subsection 1, the Director or his or
		  her designee shall:
(a) Notify the facility
		  that submitted the information whether the course or program is approved or not
		  approved pursuant to subsection 2; and
(b) If the Director or his or her designee
		  does not approve the course or program, inform the facility of any additional
		  information that the facility needs to submit for the course or program to be
		  approved.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 17.1 - NEW

Current
		  through June 11, 2024
1.
		  The director of a freestanding birthing center shall establish:
(a) Criteria for determining whether the risk
		  of a pregnancy is too high for a person to give birth in the freestanding
		  birthing center. Those criteria must align with the risk factors prescribed in
		  the publication adopted by reference in section 12.
(b) Protocols for determining whether a
		  pregnant person is progressing normally through active labor.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 18 - NEW

Current
		  through June 11, 2024
1.
		  Not later than 7 business days after receiving the notice of approval of the
		  course or program pursuant to subsection 6 of section 17 of this regulation,
		  the Division shall assign a course number to the approved course or
		  program.
2. Not later than 7
		  business days after assigning the course number pursuant to subsection 1, the
		  Division shall notify the facility whose course or program is approved pursuant
		  to section 17 of this regulation of the course number assigned pursuant to
		  subsection 1.
Added to NAC
			 by Bd. of Health by
			 R016-20A,
			 eff. 11/2/2020
NRS
			 449.0302,
			 449.103
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 18.1 - NEW

Current
		  through June 11, 2024
1.
		  A freestanding birthing center shall inform each pregnant person or person who
		  has given birth who seeks care from the freestanding birthing center orally and
		  in writing in a language understood by the person of:
(a) The rights prescribed in NRS 449A.100,
		  449A.106 and 449A.112.
(b) The provisions of
		  NRS
		  449.101 to 449.104, inclusive, and the
		  regulations adopted pursuant thereto.
(c) The right to file a complaint with the
		  Division concerning care provided by the freestanding birthing center,
		  including, without limitation, the address and telephone number for filing such
		  a complaint.
(d) The risks and
		  benefits of care provided by a freestanding birthing center and the
		  alternatives to such care. The information provided pursuant to this paragraph
		  must be evidence based and obtained from a source that is nationally recognized
		  for research relating to freestanding birthing centers. Acceptable sources
		  include, without limitation, the American Association of Birth Centers, or its
		  successor organization, and the Journal of Midwifery and Women's
		  Health.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 19 - NEW

Current
		  through June 11, 2024
1.
		  A facility shall:
(a) Develop policies to
		  ensure that a patient or resident is addressed by his or her preferred name and
		  pronoun and in accordance with his or her gender identity or expression;
		  and
(b) Adapt electronic records
		  and any paper records the facility has to reflect the gender identities or
		  expressions of patients or residents with diverse gender identities or
		  expressions, including, without limitation:
(1) If the facility is a medical facility,
		  adapting health records to meet the medical needs of patients or residents with
		  diverse sexual orientations and gender identities or expressions, including,
		  without limitation, integrating information concerning sexual orientation and
		  gender identity or expression into electronic systems for maintaining health
		  records; and
(2) If the facility is
		  a facility for the dependent or other residential facility, adapting electronic
		  records and any paper records the facility has to include the preferred name
		  and pronoun and gender identity or expression of a resident.
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 19.1 - NEW

Current
		  through June 11, 2024
For the purposes of
			 NRS
			 449.198, as amended by section 29.5 of
			 Assembly Bill No. 287, chapter 517, Statutes of Nevada 2021, at page 3442,
			 surgery does not include:
1.
		  Episiotomy; or
2. Repair of
		  lacerations sustained during the delivery of a newborn.
Added
			 to NAC by Bd. of Health by
			 R062-21A,
			 eff. 9/8/2022
NRS
				439.200,
				449.0302,
				as amended by section 16.5 of Assembly Bill No. 287, chapter 517, Statutes of
				Nevada 2021, at page 3437
Nevada Administrative Code › Chapter 449 - Medical and Other Related Facilities › Section 449.Sec. 20 - NEW

Current
		  through June 11, 2024
1.
		  Except as otherwise provided in subsection 2, the statements, notices and
		  information required by sections 2 to 22, inclusive, of this regulation and
		  NRS
		  449.101 to
		  449.104,
		  inclusive, must be in English and, as appropriate for a facility, in any other
		  language the Department determines is appropriate based on the demographic
		  characteristics of this State. In addition to the notices and information
		  provided in English and any other language the Department determines is
		  appropriate based on the demographic characteristics of this State, a facility
		  may provide the statements, notices and information in any other language the
		  facility may desire.
2. A facility
		  must make reasonable accommodations in providing the statements, notices and
		  information described in subsection 1 for patients or residents who:
(a) Are unable to read;
(b) Are blind or visually impaired;
(c) Have communication impairments;
		  or
(d) Do not read or speak English
		  or any other language in which the statements, notices and information are
		  written pursuant to subsection 1.