CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.9812 Program for quality assurance. (NRS 449.0302) 1. The administrator of an ambulatory surgical center shall establish a program for quality assurance for the center. 2. The program for quality assurance must include, without limitation: (a) Periodic reviews of the clin…

NAC 449.9813 Committee for quality assurance. (NRS 449.0302) 1. The governing body shall establish a committee for quality assurance. 2. The committee must be composed of members of the staff who represent the various clinical and medical services provided by the center. 3. The c…

NAC 449.9815 Maintenance. (NRS 449.0302) The administrator shall ensure that the person in charge of maintenance at the center: 1. Has a written program of maintenance of all of the equipment used at the center. 2. Has written service contracts with vendors that require the inspe…

NAC 449.982 Sanitation and housekeeping. (NRS 449.0302) The administrator shall ensure that the sanitation and housekeeping staff of the center: 1. Maintains a clean and sanitary environment in the center with particular regard for: (a) The sanitary disposal of pathological and i…

NAC 449.983 Protection from fire and other disasters. (NRS 449.0302) 1. The administrator shall ensure that the center, members of the staff and patients are adequately protected from fire or other disasters. He or she shall prepare a written plan describing all actions to be tak…

NAC 449.9832 Establishment of policies for provision of services and care by persons under contract with or who are otherwise not employed by center. (NRS 449.0302) If services and care are provided at an ambulatory surgical center by persons who are under contract with the cente…

NAC 449.9835 Exemption from requirements for governing body and administrator. (NRS 441A.120, 449.0302) 1. If a licensee is a sole physician operator, the ambulatory surgical center operated by the licensee is not required to have a governing body or an administrator. In such a c…

NAC 449.9837 Restrictions on operation of ambulatory surgical center; maintenance of records. (NRS 449.0302) 1. An ambulatory surgical center: (a) May be operated only for the purpose of providing surgical services to patients who do not require care for more than 24 hours. (b) E…

NAC 449.9843 Compliance with certain standards, laws, ordinances and codes; submission and approval of building plans; prerequisites to approval of center for licensure. (NRS 439.200, 449.0302) 1. An ambulatory surgical center shall comply with the provisions of NFPA 99: Health C…

NAC 449.9844 Class designations: Authorized procedures; operating room dimensions. (NRS 439.200, 449.0302) 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 m…

NAC 449.98451 Adoption of guidelines by governing body for establishment of program. (NRS 441A.120, 449.0302) 1. The governing body shall adopt guidelines which must be used by the ambulatory surgical center in establishing the program for the prevention and control of infections…

NAC 449.98452 General requirements of program. (NRS 441A.120, 449.0302) 1. Each ambulatory surgical center shall establish and maintain a program for the prevention and control of infections and communicable diseases. 2. In addition to complying with the provisions of NAC 449.984…

NAC 449.98453 Program required to include policies and procedures for prevention of exposure to blood-borne and other potentially infectious pathogens. (NRS 441A.120, 449.0302) Each program for the prevention and control of infections and communicable diseases must include polici…

NAC 449.98454 Program required to include policies and procedures for single-dose vials and multidose vials. (NRS 441A.120, 449.0302) 1. Each program for the prevention and control of infections and communicable diseases must include policies and procedures for single-dose vials …

NAC 449.98455 Sterilization and disinfection of surgical instruments, items and equipment; training required for employees and contractors responsible for sterilization or disinfection. (NRS 441A.120, 449.0302) 1. All surgical instruments, items or equipment used in the care of p…

NAC 449.98456 Center required to designate employee or enter into contract for overseeing and managing program; qualifications and duties of employee or contractor. (NRS 441A.120, 449.0302) 1. Each ambulatory surgical center shall designate an employee or enter into a contract wi…

NAC 449.98457 Mandatory training and evaluation of employees and other persons. (NRS 441A.120, 449.0302) 1. Each employee of an ambulatory surgical center and each person under contract with an ambulatory surgical center who works at the center and has exposure to patients at the…

NAC 449.9855 Policies and requirements for personnel. (NRS 449.0302) 1. An ambulatory surgical center shall have written policies for the personnel employed at the center. These policies must be provided to each employee in the form of a manual and must include provisions concern…

NAC 449.9865 Medical staff. (NRS 449.0302) 1. The medical staff of an ambulatory surgical center is answerable to the governing body for the quality of medical care provided to patients and for the ethical and professional practices of its members. 2. The governing body, or a per…

NAC 449.988 Nursing staff. (NRS 449.0302) 1. Each ambulatory surgical center must have a department of nursing under the direction of a chief nurse who is a registered nurse. 2. A sufficient number of members of the nursing staff must be on duty at all times to ensure that proper…

NAC 449.9883 Requirements for employment of certain persons to engage in practice of surgical technology; documentation. (NRS 439.200, 449.0302, 449.24185) 1. A person employed to engage in the practice of surgical technology in an ambulatory surgical center pursuant to subsectio…

NAC 449.9885 Medical records: Maintenance. (NRS 449.0302) 1. An employee shall oversee the completion, filing and retention of each medical record. 2. Records must be maintained for each patient admitted for care in the center in accordance with accepted professional principles. …

NAC 449.989 Medical records: Contents. (NRS 449.0302) The medical record of each patient must be complete, authenticated, accurate and current, and must include the following information: 1. A complete identification of the patient, including information on his or her next of kin…

NAC 449.990 Medication and treatment. (NRS 441A.120, 449.0302) 1. Any medication or treatment may be given only upon the written or oral order of a person lawfully authorized to prescribe that medication or treatment. This order must be authenticated by the prescriber and the per…

NAC 449.9902 Emergency equipment and supplies. (NRS 449.0302) 1. An ambulatory surgical center must be equipped with: (a) A cardiac defibrillator; (b) A tracheostomy or cricothyroidotomy set; (c) A mobile cart which contains the equipment and supplies specified by the medical sta…

NAC 449.9905 Pharmacist employed by or contracted with center; records, storage and administration of drugs; center required to obtain license to operate pharmacy. (NRS 441A.120, 449.0302) 1. A pharmacist employed by or contracted with an ambulatory surgical center pursuant to NA…

NAC 449.991 Laboratory services. (NRS 449.0302) 1. Laboratory services must be provided to meet the needs of patients and must be available to each center at all times. 2. If the ambulatory surgical center has its own laboratory, it must be a licensed clinical laboratory under th…

NAC 449.992 Pathological services. (NRS 449.0302) 1. Pathology services must be provided by a staff pathologist or by a pathologist used as a consultant by the ambulatory surgical center. The pathologist must be licensed to practice in this State. 2. All material removed from a p…

NAC 449.9925 Blood and derivatives of blood: Procurement, storage, transfusion and administration; policies and procedures; reporting of adverse reaction. (NRS 441A.120, 449.0302) 1. If the ambulatory surgical center provides its own service for blood transfusions through its med…

NAC 449.993 Diagnostic radiological services. (NRS 449.0302) 1. Each ambulatory surgical center shall maintain diagnostic radiological services or have such services immediately available. Whether these services are provided directly or by contract, personnel capable of supervisi…

NAC 449.9935 Operating and recovery rooms; endoscopy suite; revision of certain standards adopted by reference. (NRS 439.200, 449.0302) 1. The operating and recovery rooms of an ambulatory surgical center must be used exclusively for surgical procedures. 2. Except as otherwise pr…

NAC 449.9937 Extended recovery units. (NRS 449.0302) 1. An ambulatory surgical center may operate an extended recovery unit. 2. An extended recovery unit must: (a) Be located in an area of the center that is separate from the other operations of the center; (b) Provide audio and …

NAC 449.994 Records required before surgery; report of surgery. (NRS 449.0302) 1. A physical examination, which must include a medical history of the patient, within the 30 days immediately preceding the date of the patient’s surgery and a presurgical evaluation conducted by a ph…

NAC 449.9945 Administration and record of anesthesia. (NRS 449.0302) 1. Anesthetics must be administered in the operating room of an ambulatory surgical center by an anesthesiologist, a qualified physician, a dentist or, under the direction of the operating physician and in accor…

NAC 449.9947 Register of surgeries performed in operating rooms. (NRS 449.0302) An ambulatory surgical center shall keep a complete and current register of all surgeries performed in an operating room at the center. The register must include, without limitation, for each patient …

NAC 449.9955 Informing patient of rights, services and cost. (NRS 449.0302) The administrator of an ambulatory surgical center shall ensure that: 1. Each patient admitted to the center is treated with respect, consideration and dignity. 2. Each patient admitted to the center is p…

NAC 449.996 Transfer of patients. (NRS 439.200, 449.0302) 1. An ambulatory surgical center shall establish written guidelines for transferring patients to a licensed hospital that has medical and surgical capabilities using an ambulance or air ambulance for emergencies that requi…

NAC 449.9965 Prohibited locations for construction of center. (NRS 449.0302) A new ambulatory surgical center must not be constructed over any underground liquid butane, propane or transmission line for gas, or over any underground high pressure lines, under high voltage electric…

NAC 449.997 Conversion of hazardous building into center prohibited. (NRS 449.0302) No building may be converted for use as an ambulatory surgical center if, because of its location, physical condition, state of repair or arrangement of facilities, the building would be hazardous…

NAC 449.99702 “Recovery center” defined. (NRS 439.200, 449.0302, 449.0303) As used in NAC 449.99702 to 449.99762, inclusive, “recovery center” or “center” means any public or private facility that provides only short-term care, not to exceed 72 hours, to a person recovering from …

NAC 449.99704 License required to operate. (NRS 439.200, 449.0302, 449.0303) A person or a public or private facility shall not operate or provide the services of a recovery center or represent that the person or the public or private facility operates or provides the services of…

NAC 449.99706 Requirements to operate. (NRS 439.200, 449.0302, 449.0303) If a person or a public or private facility wants to operate a recovery center, the person or the public or private facility must: 1. File with the Division an application for a license pursuant to NAC 449.0…

NAC 449.99708 Prelicensure investigation and inspection. (NRS 439.200, 449.0302, 449.0303) After the Division receives a properly completed application, accompanied by the appropriate fee, the Division shall conduct an investigation of the applicant and inspect the proposed recov…

NAC 449.9971 Issuance and expiration of license. (NRS 439.200, 449.0302, 449.0303) 1. The Division shall issue a license to operate a recovery center to the applicant if, after investigation, the Division finds that the applicant is in substantial compliance with the provisions o…

NAC 449.99712 Suspension, revocation or cancellation of license; provisional license. (NRS 439.200, 449.0302, 449.0303) The Division may suspend or revoke a license issued pursuant to NAC 449.99702 to 449.99762, inclusive, or cancel such a license and issue a provisional license …

NAC 449.99714 Governing body; quality improvement and risk management programs; review of programs. (NRS 439.200, 449.0302, 449.0303) A recovery center must have a governing body that is legally responsible for establishing and carrying out policies regarding the management and o…

NAC 449.99716 Appointment, qualifications and responsibilities of administrator. (NRS 439.200, 449.0302, 449.0303) 1. The governing body of a recovery center shall appoint a qualified administrator for the center who is responsible to the governing body for the performance of his…