All Roll Calls
Yes: 63 • No: 0
NevadaAB51983rd Regular Session (2025)HouseWALLET
AN ACT relating to health care; establishing separate provisions for the licensing or certification, regulation and discipline of agencies to provide personal care services in the home, employment agencies that contract to provide certain nonmedical services and intermediary service organizations; enacting provisions to facilitate the collecting of certain debts from applicants for certain licenses; imposing certain requirements as an applicant for a certificate to operate an intermediary service organization; revising the training requirements for certain caregivers who receive reimbursement through Medicaid; authorizing a family member to serve as the personal care assistant for a recipient of Medicaid under certain circumstances; providing penalties; and providing other matters properly relating thereto.
Sponsored By: Assembly Committee on Health and Human Services
Signed by Governor
BDR 40-805
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Bill Overview
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34 provisions identified: 13 benefits, 6 costs, 15 mixed.
Bonds or deposits for care providers
Home care agencies must keep a surety bond to protect clients: $5,000 for fewer than 7 employees, $25,000 for 7–25, and $50,000 for more than 25. A license is suspended if coverage lapses. With approval, an intermediary organization may deposit approved bank or government securities instead of a bond. The deposit must at least match the bond amount, earns interest, is assigned to the state, and can be released only by the Administrator. State‑run agencies are exempt.
Family can be paid caregivers
A family member may serve as a paid personal care assistant for a Medicaid recipient. The family member must finish the training in section 30 and get authorization from a health care provider under NRS 629.091. This option applies only when federal Medicaid rules allow it.
Medicaid pay for self-directed care
The law lets a Medicaid recipient be treated as a provider. The recipient can receive the Medicaid payment and use it to pay a personal care assistant or a home care agency under a self-directed model. The state applies for a waiver to pay family caregivers for people with dementia. The caregiver must be an employee of an agency or an intermediary group, and get at least 65% of the agency’s per‑day rate as a daily stipend. Caregivers must complete required training. These changes take effect only if the federal government approves them.
More simple health tasks at home
Trained agency staff may, with the person’s consent, take vital signs, help with insulin auto-injectors, and perform FDA‑approved blood sugar tests. These tasks must follow CLIA and other federal rules, and a blood glucose device may not be used on more than one person. Tasks done under these Board rules are not treated as “respiratory care” and are exempt from chapter 652.
Privacy and respect rules for clients
Agencies must keep private a client’s sexual orientation, transgender status or surgery, and HIV status. Staff not giving care cannot be present when a client is unclothed without permission; visual barriers must protect privacy. Clients can refuse exams or observations done mainly for teaching. Agencies must use clients’ preferred names and pronouns and update electronic records. Staff who regularly see clients and their supervisors must complete cultural‑competency training; the Board sets how often and DHHS approves courses within 10 business days on request.
Tougher penalties for assaulting health workers
Assaulting a health‑care provider at work is a gross misdemeanor. Using a deadly weapon makes it a category B felony with 1 to 6 years in prison and up to a $5,000 fine. If the attacker is on probation, in custody, or on parole, the assault is a category D felony, or category B with a deadly weapon.
Licenses and renewals for home-care businesses
You must hold a state license to run a home personal care agency or an employment agency that places nonmedical caregivers in Nevada. The State Board of Health sets licensing rules, fees, and training. At renewal, you must say if you have a state business license and give your business ID. The Division will not renew if you do not provide this info or if the State Controller reports a debt assigned for collection and you have not paid, set up an approved plan under NRS 353C.130, or proved the debt is invalid. All applicants must file a child support compliance statement, and the Division denies issuance or renewal if you are not in compliance or in a repayment plan.
New certificate and bonds for intermediaries
You must have a state certificate to run an intermediary service organization. Operating without one is a misdemeanor. You must file a surety bond sized by staff: $5,000 (<7 employees), $25,000 (7–25), or $50,000 (>25). Your application must include required details and your Social Security number, and you must pay a Board‑set fee (installments may be allowed). The Division can investigate applicants and complaints, and ISO operators, workers, and contractors must report legal violations.
Stronger background checks for home care
Certificate applicants must submit fingerprints for an FBI check. Within 10 days of hire or contract, organizations must collect written conviction statements, take fingerprints, and submit them; they must re‑check at least every 5 years. If a listed crime is found, the worker must be removed after at least 30 days to fix any errors. Certain crimes, some within the last 7 years, can block or revoke certification or employment. Organizations must keep background records and worker lists; lying during checks is a misdemeanor. People with a record can ask for a determination within 90 days and get instructions to fix issues.
Worker rules and sleep pay in home care
The law clarifies who counts as a home‑care employee: agency staff, ISO‑employed personal assistants, and contracted respite staff. If your fingerprints were sent to the state within the last 6 months, a sheriff may not require a new check. For 24‑hour or longer shifts, you and your employer can agree in writing to exclude up to 8 hours of sleep from pay if a bed is provided. Calls count as work, and if sleep drops below 5 hours, you are paid for the whole sleep period.
ID and child‑support checks for certificates
Applicants must submit a child‑support compliance statement. If the Division gets a court order to suspend licenses, a certificate is suspended on day 30 unless a compliance letter arrives. Applications cannot be denied just because of immigration status. If you do not have an SSN, you may provide an ITIN or other ID. SSNs and alternate IDs are confidential and used only for taxes, licensing, or child support enforcement.
Licensing rules for home care agencies
To get a license, an agency must give its address, services, the person in charge, proof of good character, and show it can follow the rules. The Board sets application fees and may allow installments. Licenses are nontransferable, list who may operate and services, expire on December 31, and renew yearly with fees and compliance statements. The Division may give a provisional license while fixes are made and can bill actual enforcement costs unless already covered by other fees or agreements. License fees go to the State General Fund for the Division. In‑home personal care agencies are treated as a “facility for the dependent,” so related oversight applies.
New rules for intermediary organizations
The Division issues a certificate only when the applicant meets all laws and standards. Each certificate names the operator and services, expires on December 31, and renews yearly with required fees and a compliance statement. The Division can give a provisional certificate while fixes are made, and can deny, suspend, or revoke for breaking laws or risking health or safety. It can fine up to $1,000 per day, add interest up to 10% a year, appoint temporary managers, and stop services until problems are fixed. The Board sets sanction rules, and the Division must give notice and an appeal, unless an immediate suspension is needed to protect health.
Required training for caregivers and agencies
Unlicensed caregivers and people paid by Medicaid for personal care must take training set by the State Board of Health. Training must include infection control and is reviewed each year. Applicants, managers, and staff must get elder‑abuse recognition and prevention training before providing care and every year after. Agency administrators must ensure all training is done, keep proof in files, and keep a written infection‑control plan updated yearly and shared with staff and clients. The Division posts free or low‑cost training options you can use.
Stronger background checks for home care staff
Agencies and placement firms must run background checks within 10 days of hire or contract and recheck at least every 5 years. License applicants must submit fingerprints; the state and FBI report results to the agency and the state right away. Recent clean checks can be reused: within 6 months (no new prints) or within 5 years with consent for future conviction notices. The Central Repository may charge a fee; agencies can collect up to half from workers, with payments allowed over time. False statements in checks are a misdemeanor. Agencies using temp staff must verify continuous employment and that checks are current. Agencies must keep background records, and if a state website exists, they must list current workers there; the Division may run a secure background-check website. The Repository may store prints and alert on later convictions. If a listed conviction appears, the person must be removed, but at least 30 days are allowed to fix an error; no unsupervised contact with a child is allowed while waiting. Agencies that follow these steps are not liable just for letting someone work while results are pending or being corrected.
Tough inspections and fines for home care
The Division can inspect agencies anytime, with or without notice, and must issue written reports with fix steps. It can stop services, appoint temporary managers, and fine up to $5,000 per day per violation, with interest up to 10% yearly, and collect court and attorney fees if unpaid. Local prosecutors must bring cases when the Division asks, and the state can seek court orders to stop unlicensed operations. A placement agency that sends unqualified caregivers faces civil penalties: up to $10,000 for a first offense and $10,000–$20,000 after; these funds support enforcement and client protection. Licenses can be denied or revoked for unsafe or illegal conduct, failing to abate nuisances, or not fixing ordered code violations.
No discrimination by home-care agencies
Home-care agencies and their workers must not discriminate against clients based on race, color, religion, origin, age, gender, disability, sexual orientation, gender identity, HIV status, or association. Agencies must adopt policies to prevent discrimination and post a nondiscrimination statement on any website used to market the agency.
Report elder abuse within 24 hours
Staff of home personal care and nursing agencies and intermediary organizations must report suspected abuse, neglect, exploitation, isolation, or abandonment of older or vulnerable persons. Make the report as soon as possible, and no later than 24 hours. If the accused person holds a state health or care license, the report information must be sent to the licensing board for review and possible discipline.
Stronger help for seniors using home care
Nevada 2‑1‑1 must show the current licensing status of listed care providers and update it at least every three months. An older patient can file a verified complaint within one year if a home‑care agency or intermediary damages property. If liable, money from the provider’s surety bond can be used to pay damages. The Division keeps collected money in a separate account and distributes it.
Better care handoffs and diet help
When a hospital sends a patient home to receive in‑residence care from a chapter 449‑licensed entity, that entity must consult a dietitian when appropriate so the patient or caregiver understands dietary needs. When a patient is moved from a division facility to another facility or provider, the sending facility must forward medical records on or before the transfer date, subject to federal and Nevada privacy exceptions.
No license renewal fee on active duty
If you serve on active duty in the U.S. Armed Forces or U.S. Public Health Service, you do not pay the annual license renewal fee while on active duty.
Fewer duplicate licenses for providers
If you already hold a related state license, you do not need a second license to contract for nonmedical personal care. Licensed facilities and agencies do not need a separate community health worker pool license. The law also removes an older required elder‑abuse training for these agencies and trims one license‑suspension reference for in‑home nursing in another statute.
Complaint reports and use of fines
The Division keeps a log of complaints that could lead to license revocation and sends a report every two years by February 1. Money from administrative penalties is kept in a separate account and used to run and enforce these programs to protect clients’ health, safety, and property.
Smooth shift to new home‑care rules
This law takes effect upon passage. Licenses and ISO certificates that are valid on that date stay valid until their normal expiration if you remain qualified. Any valid training finished by operators, workers, and chosen Medicaid caregivers before that date still counts. Disciplinary actions already in effect continue. The Board must move and replace prior rules; old rules stay in place until the new ones start. The act repeals certain old sections, defines key home‑care terms, and exempts federal government‑run home‑care agencies. Certain sections end if federal child‑support law (42 U.S.C. 666) is repealed.
Foreclosure filing adds $250 in fees
When a notice of default and election to sell is recorded, extra fees total $250. You pay $150 to the State, $95 to a foreclosure‑mediation account, and $5 to the county.
More training required for health providers
Many license holders must add suicide prevention and cultural competency hours. Therapists and counselors need at least 2 hours in suicide prevention and 6 hours in cultural competency. Social workers need 2 hours in suicide prevention and 6 hours in cultural competency every two years; alcohol and drug counselors need 1 hour in suicide prevention and 3 hours in cultural competency each year. Behavior analysts must meet national CE standards that include 2 hours in suicide prevention and 6 hours in cultural competency. Psychologists need 2 hours in suicide prevention within two years and at least every four years, plus 6 hours in cultural competency every two years. Osteopathic physicians must complete 2 hours in suicide prevention within two years and every four years, at least 2 hours biennially in ethics, pain, addiction, or SBIRT, and 2 hours of SBIRT within two years; those who provide or supervise emergency or primary care must also complete 2 hours on HIV stigma within two years of starting that work. The Board is encouraged to include training on medication management and diagnosing rare diseases.
New limits on medical board seats
People who run home-care agencies cannot serve in certain medical board seats. The nonlicensed resident member of the osteopathic board must be a Nevada resident, not licensed in any healing art, not a close relative of a licensee, and not run a medical facility, dependent‑care facility, or home‑care agency.
Provider status expands; emergency immunity narrows
Paid in‑home caregivers and certain identified staff or volunteers are now counted as “providers of health care,” which brings them under provider rules and protections. At the same time, employees of in‑home personal care agencies are no longer explicitly listed as protected from civil damages when giving emergency care in good faith under NRS 449.194.
New continuing education rules for clinicians
Registered behavior technicians do not have to complete Board‑mandated continuing education. Osteopathic licensees cannot use suicide‑prevention credits to meet ethics CE; they must complete both. Courses on genetic counseling and testing now count toward CE totals for certain licenses.
Criminal record precheck before you apply
You can ask the Division to decide in advance if your criminal record blocks a license. The Division must answer within 90 days. It may charge up to $50, but can waive it or let a scholarship or grant pay. You may need to submit state and FBI reports. You can reapply after completing fix steps, or after 6 months, or after 2 years for a final decision.
Stronger screening for home-care workers
Temp agencies may not send a worker to a home-care agency or an intermediary organization after being told the worker is ineligible. Temp agencies must show each worker has been continuously employed since the last background check and tell the organization if that check is older than five years. If an intermediary service organization follows background rules, it is protected from civil or criminal liability for letting a worker start before results arrive, but never for unsupervised contact with a child before results or during a correction period. The Central Repository can request FBI records and must investigate criminal history when fingerprints or biometrics are submitted under this law.
Small fee and less paperwork for agencies
The Board may add a license renewal fee for in‑home personal care agencies, up to 8% of the standard issuance or renewal fee. Money supports the cancer reporting system. These agencies no longer must include a specific compliance statement when they reapply, reducing paperwork.
Home-care oversight moves to new chapter
Personal care agencies are taken out of older “facility for the dependent” rules and regulated under a new chapter run by DHHS. The Legislative Committee now reviews regulations under the new chapter for effects on health care costs and provider availability. The law updates definitions to remove prior references and adds providers licensed or certified under the new chapter to the term “facility or service provider.”
Who the home care rules cover
The law defines who counts as a home personal care agency and who is excluded, like solo independent contractors and certain family‑and‑friends groups. It lists covered nonmedical tasks, such as bathing, dressing, meals, laundry, shopping, cleaning, and rides. In‑home personal care agencies are now treated as health care facilities for some laws, and the broader definition of “health care facility” also covers more non‑residential care locations.
Sponsors & Cosponsors
Sponsor
Assembly Committee on Health and Human Services
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/21/2025
Final Passage - Senate (1st Reprint)
Yes: 21 • No: 0
House vote • 4/22/2025
Final Passage - Assembly (1st Reprint)
Yes: 42 • No: 0
Actions Timeline
Chapter 158.
5/30/2025legislatureApproved by the Governor.
5/30/2025legislatureEnrolled and delivered to Governor.
5/27/2025legislatureIn Assembly. To enrollment.
5/22/2025HouseRead third time. Passed. Title approved. (Yeas: 21, Nays: None.) To Assembly.
5/21/2025SenateTaken from General File. Placed on General File for next legislative day.
5/20/2025SenateRead second time.
5/19/2025SenateFrom committee: Do pass.
5/16/2025SenateRead first time. Referred to Committee on Health and Human Services. To committee.
4/29/2025SenateIn Senate.
4/28/2025SenateTo Senate.
4/25/2025HouseFrom printer. To engrossment. Engrossed. First reprint.
4/25/2025HouseTo printer.
4/22/2025HouseRead third time. Passed, as amended. Title approved, as amended. (Yeas: 42, Nays: None.)
4/22/2025HouseDispensed with reprinting.
4/21/2025HouseRead second time. Amended. (Amend. No. 451.)
4/21/2025HousePlaced on Second Reading File.
4/21/2025HouseFrom committee: Amend, and do pass as amended.
4/21/2025HouseFrom printer. To committee.
3/26/2025HouseRead first time. Referred to Committee on Health and Human Services. To printer.
3/24/2025House
Bill Text
As Enrolled
As Introduced
Reprint 1
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