Nevada § 449.0302 - Board to adopt standards, qualifications and other regulations

§ 449.0302. Board to adopt standards, qualifications and other regulations

1. The Board shall adopt: (a) Licensing standards for each class of medical facility or facility for the dependent

covered by NRS 449.029 to 449.2428 , inclusive, and for programs of hospice care. (b) Regulations governing the licensing of such facilities and programs. (c) Regulations governing the procedure and standards for granting an extension of

the time for which a natural person may provide certain care in his or her home without

being considered a residential facility for groups pursuant to NRS 449.017 . The regulations must require that such grants are effective only if made in writing. (d) Regulations establishing a procedure for the indemnification by the Division,

from the amount of any surety bond or other obligation filed or deposited by a facility

for refractive surgery pursuant to NRS 449.068 or 449.069 , of a patient of the facility who has sustained any damages as a result of the bankruptcy

of or any breach of contract by the facility. (e) Regulations that prescribe the specific types of discrimination prohibited by NRS 449.101 . (f) Regulations requiring a hospital or independent center for emergency medical care

to provide training to each employee who provides care to victims of sexual assault

or attempted sexual assault concerning appropriate care for such persons, including,

without limitation, training concerning the requirements of NRS 449.1885 . (g) Any other regulations as it deems necessary or convenient to carry out the provisions

of NRS 449.029 to 449.2428 , inclusive. 2. The Board shall adopt separate regulations governing the licensing and operation

of: (a) Facilities for the care of adults during the day; and (b) Residential facilities for groups, which provide care to persons with Alzheimer's disease or other severe dementia, as

described in paragraph (a) of subsection 2 of NRS 449.1845 . 3. The Board shall adopt separate regulations for: (a) The licensure of rural hospitals and rural emergency hospitals which take into

consideration the unique problems of operating such a facility in a rural area. (b) The licensure of facilities for refractive surgery which take into consideration

the unique factors of operating such a facility. (c) The licensure of mobile units which take into consideration the unique factors

of operating a facility that is not in a fixed location. 4. The Board shall require that the practices and policies of each medical facility

or facility for the dependent provide adequately for the protection of the health,

safety and physical, moral and mental well-being of each person accommodated in the

facility. 5. In addition to the training requirements prescribed pursuant to NRS 449.093 , the Board shall establish minimum qualifications for administrators and employees

of residential facilities for groups. In establishing the qualifications, the Board shall consider the related standards

set by nationally recognized organizations which accredit such facilities. 6. The Board shall adopt separate regulations regarding the assistance which may be

given pursuant to NRS 453.375 and 454.213 to an ultimate user of controlled substances or dangerous drugs by employees of residential

facilities for groups. The regulations must require at least the following conditions before such assistance

may be given: (a) The ultimate user's physical and mental condition is stable and is following a

predictable course. (b) The amount of the medication prescribed is at a maintenance level and does not

require a daily assessment. (c) A written plan of care by a physician or registered nurse has been established

that: (1) Addresses possession and assistance in the administration of the medication;

and (2) Includes a plan, which has been prepared under the supervision of a registered

nurse or licensed pharmacist, for emergency intervention if an adverse condition results. (d) Except as otherwise authorized by the regulations adopted pursuant to NRS 449.0304 , the prescribed medication is not administered by injection or intravenously. (e) The employee has successfully completed training and examination approved by the

Division regarding the authorized manner of assistance. 7. The Board shall adopt separate regulations governing the licensing and operation

of residential facilities for groups which provide assisted living services. The Board shall not allow the licensing of a facility as a residential facility

for groups which provides assisted living services and a residential facility for

groups shall not claim that it provides “assisted living services” unless: (a) Before authorizing a person to move into the facility, the facility makes a full

written disclosure to the person regarding what services of personalized care will

be available to the person and the amount that will be charged for those services

throughout the resident's stay at the facility. (b) The residents of the facility reside in their own living units which: (1) Except as otherwise provided in subsection 8, contain toilet facilities; (2) Contain a sleeping area or bedroom; and (3) Are shared with another occupant only upon consent of both occupants. (c) The facility provides personalized care to the residents of the facility and the

general approach to operating the facility incorporates these core principles: (1) The facility is designed to create a residential environment that actively supports

and promotes each resident's quality of life and right to privacy; (2) The facility is committed to offering high-quality supportive services that are

developed by the facility in collaboration with the resident to meet the resident's

individual needs; (3) The facility provides a variety of creative and innovative services that emphasize

the particular needs of each individual resident and the resident's personal choice

of lifestyle; (4) The operation of the facility and its interaction with its residents supports,

to the maximum extent possible, each resident's need for autonomy and the right to

make decisions regarding his or her own life; (5) The operation of the facility is designed to foster a social climate that allows

the resident to develop and maintain personal relationships with fellow residents

and with persons in the general community; (6) The facility is designed to minimize and is operated in a manner which minimizes

the need for its residents to move out of the facility as their respective physical

and mental conditions change over time; and (7) The facility is operated in such a manner as to foster a culture that provides

a high-quality environment for the residents, their families, the staff, any volunteers

and the community at large. 8. The Division may grant an exception from the requirement of subparagraph (1) of

paragraph (b) of subsection 7 to a facility which is licensed as a residential facility

for groups on or before July 1, 2005, and which is authorized to have 10 or fewer

beds and was originally constructed as a single-family dwelling if the Division finds

that: (a) Strict application of that requirement would result in economic hardship to the

facility requesting the exception; and (b) The exception, if granted, would not: (1) Cause substantial detriment to the health or welfare of any resident of the facility; (2) Result in more than two residents sharing a toilet facility; or (3) Otherwise impair substantially the purpose of that requirement. 9. The Board shall, if it determines necessary, adopt regulations and requirements

to ensure that each residential facility for groups and its staff are prepared to

respond to an emergency, including, without limitation: (a) The adoption of plans to respond to a natural disaster and other types of emergency

situations, including, without limitation, an emergency involving fire; (b) The adoption of plans to provide for the evacuation of a residential facility

for groups in an emergency, including, without limitation, plans to ensure that nonambulatory

patients may be evacuated; (c) Educating the residents of residential facilities for groups concerning the plans

adopted pursuant to paragraphs (a) and (b); and (d) Posting the plans or a summary of the plans adopted pursuant to paragraphs (a)

and (b) in a conspicuous place in each residential facility for groups. 10. The regulations governing the licensing and operation of facilities for transitional

living for released offenders must provide for the licensure of at least three different

types of facilities, including, without limitation: (a) Facilities that only provide a housing and living environment; (b) Facilities that provide or arrange for the provision of supportive services for

residents of the facility to assist the residents with reintegration into the community,

in addition to providing a housing and living environment; and (c) Facilities that provide or arrange for the provision of programs for alcohol and

other substance use disorders, in addition to providing a housing and living environment

and providing or arranging for the provision of other supportive services. The regulations must provide that if a facility was originally constructed as a single-family

dwelling, the facility must not be authorized for more than eight beds. 11. The Board shall adopt regulations applicable to providers of community-based living

arrangement services which: (a) Except as otherwise provided in paragraph (b), require 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 to

complete training concerning the provision of community-based living arrangement services

to persons with mental illness and continuing education concerning the particular

population served by the provider; (b) Exempt a person licensed or certified pursuant to title 54 of NRS from the requirements

prescribed pursuant to paragraph (a) if the Board determines that the person is required

to receive training and continuing education substantially equivalent to that prescribed

pursuant to that paragraph; (c) Require a natural person responsible for the operation of a provider of community-based

living arrangement services to receive training concerning the provisions of title

53 of NRS applicable to the provision of community-based living arrangement services;

and (d) Require an applicant for a license to provide community-based living arrangement

services to post a surety bond in an amount equal to the operating expenses of the

applicant for 2 months, place that amount in escrow or take another action prescribed

by the Division to ensure that, if the applicant becomes insolvent, recipients of

community-based living arrangement services from the applicant may continue to receive

community-based living arrangement services for 2 months at the expense of the applicant. 12. The Board shall adopt separate regulations governing the licensing and operation

of freestanding birthing centers. Such regulations must: (a) Align with the standards established by the American Association of Birth Centers,

or its successor organization, the accrediting body of the Commission for the Accreditation

of Birth Centers, or its successor organization, or another nationally recognized

organization for accrediting freestanding birthing centers; and (b) Allow the provision of supervised training to providers of health care, as appropriate,

at a freestanding birthing center. 13. If the regulations adopted pursuant to this section require a physical examination

to be performed on a patient or the medical history of a patient to be obtained before

or after the patient is admitted to a hospital, those regulations must authorize a

certified nurse-midwife to perform such a physical examination or obtain such a medical

history before or after a patient is admitted to a hospital for the purpose of giving

birth. 14. As used in this section: (a) “ Certified nurse-midwife ” means a person who is: (1) Certified as a Certified Nurse-Midwife by the American Midwifery Certification

Board, or its successor organization; and (2) Licensed as an advanced practice registered nurse pursuant to NRS 632.237 . (b) “ Living unit ” means an individual private accommodation designated for a resident within the facility.