CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.99917 Temporary manager: Qualifications. (NRS 449.0302) 1. The temporary manager must: (a) Be a person qualified to operate the facility pursuant to the provisions of chapter 449 of NRS relating to the licensing of the facility; (b) Demonstrate prior competency as an admi…

NAC 449.99918 Temporary manager: Authority. (NRS 449.0302, 449.165) The temporary manager may take such action as is required to mitigate the immediate danger at the facility, including, without limitation, providing for the safe transfer of residents or prohibiting the transfer …

NAC 449.99919 Effect of failure to agree to appointment of or to relinquish authority to temporary manager. (NRS 449.0302, 449.165) If a facility fails to agree to the appointment of a temporary manager or fails to relinquish authority to the temporary manager, the Division of Pu…

NAC 449.9992 Events requiring termination of management; initiation of judicial proceedings. (NRS 449.0302, 449.165) 1. Temporary management of a facility must be terminated if the Bureau determines that: (a) The facility has substantially corrected the deficiency and has secured…

NAC 449.99921 Payment of costs and expenses. (NRS 449.0302, 449.165) The costs and expenses of temporary management, including the compensation of the manager, must be paid by the facility through the Bureau while the temporary manager is assigned to the facility. (Added to NAC b…

NAC 449.99925 Authority of Bureau. (NRS 449.0302) The Bureau shall in an emergency deny, suspend or revoke the license of a facility and, in the case of a residential facility that is no longer licensed to operate, arrange for the appointment of a temporary manager to oversee the…

NAC 449.99926 Requirements for notification. (NRS 449.0302) 1. Except as otherwise provided in subsection 2, if the Bureau proposes to close a facility, the Division shall, at least 5 days before the transfer, notify or cause to be notified personally or by written or telephonic …

NAC 449.99927 Appointment of temporary manager. (NRS 449.0302) If the Bureau denies, revokes or suspends the license of a facility, the Bureau shall appoint a temporary manager to assist in the orderly closure of the facility and, in the case of a residential facility, the transf…

NAC 449.99928 Bureau to supervise or appoint temporary manager to supervise transfer; imposition of other appropriate sanctions. (NRS 449.0302) If a residential facility is to be closed, the Bureau shall supervise, or appoint a temporary manager to supervise, the orderly transfer…

NAC 449.99929 Determination of appropriate placement of residents. (NRS 449.0302) If the residents of a residential facility are to be transferred, the following criteria must be applied by the Bureau or temporary manager responsible for supervising the orderly transfer of reside…

NAC 449.9993 Rights of appeal for transferred residents. (NRS 449.0302) Except in cases of emergency or termination of the license of a facility, the rights of appeal provided by federal and state statutes or regulations governing the transfer of residents apply to residents who …

NAC 449.99935 Authorized recommendations in addition to available sanctions. (NRS 449.0302) For a facility that participates in Medicaid, in addition to imposing any sanction authorized by NAC 449.99863, the Bureau may recommend to the Division of Health Care Financing and Policy…

NAC 449.99936 Withholding of monetary penalties from payments owed to facility. (NRS 449.0302) 1. The amount of any monetary penalty owed by a Medicaid facility, if it has been determined, may be deducted from any money otherwise owed to the facility by the Division of Health Car…

NAC 449.99937 Denial of payments for new admissions generally. (NRS 449.0302) 1. The Bureau may request the Division of Health Care Financing and Policy to deny Medicaid payment to a facility for new admissions if: (a) The facility does not substantially correct the deficiencies …

NAC 449.99938 Denial of payments for new admissions who have certain specified diagnoses or special care needs. (NRS 449.0302) 1. The Bureau may request the Division of Health Care Financing and Policy to deny payment to a facility for new admissions who have certain specified di…

NAC 449.99939 Suspension of payments for services furnished to Medicaid recipient on or after date of deficiency. (NRS 449.0302) 1. The Bureau may request the Division of Health Care Financing and Policy to suspend all or part of the Medicaid payments to a facility for services f…

NAC 449.9994 Definitions. (NRS 449.448) As used in NAC 449.9994 to 449.999489, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.99941 to 449.999419, inclusive, have the meanings ascribed to them in those sections. (Added to NAC by Bd. of He…

NAC 449.99941 “Bureau” defined. (NRS 449.448) “Bureau” means the Bureau of Health Care Quality and Compliance of the Division. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999413 “Division” defined. (NRS 449.448) “Division” means the Division of Public and Behavioral Health of the Department of Health and Human Services. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999415 “Inspection” defined. (NRS 449.448) “Inspection” means the inspection of an outpatient facility conducted by employees of the Bureau pursuant to NRS 449.443 or 449.446. The term includes a follow-up inspection to renew the permit of an outpatient facility or evalua…

NAC 449.999417 “Outpatient facility” defined. (NRS 449.448) “Outpatient facility” means an office of a physician or a facility that provides health care, other than a medical facility, which offers to a patient a service of general anesthesia, conscious sedation or deep sedation.…

NAC 449.999419 “Treatment” defined. (NRS 449.448) “Treatment” means any medication, drug, test or procedure conducted or administered to diagnose or remedy a physical or mental illness or condition. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010) Permitting

NAC 449.99942 Application; general requirements; proof of national accreditation; fee; period for validity; application required for each location. (NRS 449.442, 449.443, 449.448) 1. Before offering to a patient a service of general anesthesia, conscious sedation or deep sedation…

NAC 449.999421 Inspection by Division of applicant and outpatient facility; prerequisite of satisfactory fire inspection. (NRS 449.443, 449.446, 449.448) 1. Upon receipt of a properly completed application for a permit, proof of the identity of the applicant, if applicable, that …

NAC 449.999422 Term of permit; circumstances under which permit deemed invalid. (NRS 449.442, 449.444, 449.448) 1. Except as otherwise provided in subsection 2, a permit is valid for 1 year after the date of issuance, and the holder of the permit may apply for renewal of the perm…

NAC 449.999423 Renewal of permit: Application; additional inspection by Division authorized; fees; untimely filing or failure to file application. (NRS 449.444, 449.448) 1. Except as otherwise provided in subsection 3, a holder of a permit to operate an outpatient facility who wi…

NAC 449.999424 Outpatient facility required to provide proof of national accreditation; submission of reports to Division; application by accrediting organization for recognition by State Board of Health; maintenance of list by Division of approved accrediting organizations. (NRS…

NAC 449.999425 Display of permit; maintenance of outpatient facility in compliance with law; notification of transfer of real property; notification of change of ownership, location or services provided. (NRS 449.448) 1. Upon receipt of a permit, the holder shall display the perm…

NAC 449.999426 Additional grounds for denial, suspension or revocation of permit. (NRS 449.447, 449.448) In addition to the grounds set forth in NRS 449.447 and NAC 449.999459, the Division may deny an application for a permit or may suspend or revoke a permit upon any of the fol…

NAC 449.99943 Definitions. (NRS 441A.120, 449.448) As used in NAC 449.99943 to 449.999448, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.999431 to 449.99944, inclusive, have the meanings ascribed to them in those sections. (Added to NAC …

NAC 449.999431 “Biologic indicator test” defined. (NRS 441A.120, 449.448) “Biologic indicator test” means a test used in every ethylene oxide cycle and in every sterilization load of implantable devices to demonstrate through the destruction of highly resistant bacterial spores w…

NAC 449.999432 “Cleaning” defined. (NRS 441A.120, 449.448) “Cleaning” means the physical removal of organic material or soil from objects by using water, with or without detergents, that is designed to remove, rather than kill, microorganisms. (Added to NAC by Bd. of Health by R1…

NAC 449.999433 “High-level disinfection” defined. (NRS 441A.120, 449.448) “High-level disinfection” means a type of disinfection which destroys all microorganisms with the exception of high levels of bacterial spores. Such disinfection may be accomplished through the use of proce…

NAC 449.999434 “Implantable device” defined. (NRS 441A.120, 449.448) “Implantable device” means a medical device that is implanted in the human body, including, without limitation, a pacemaker, defibrillator, heart valve, hearing device or joint replacement. (Added to NAC by Bd. …

NAC 449.999435 “Invasive procedure” defined. (NRS 441A.120, 449.448) “Invasive procedure” means a medical procedure involving entry into the human body by puncture or incision or by insertion of an instrument. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999436 “Low-level disinfection” defined. (NRS 441A.120, 449.448) “Low-level disinfection” means a type of disinfection which eliminates most bacteria, some viruses and some fungi, but which may not kill resistant microorganisms. Such disinfection may be accomplished throu…

NAC 449.999437 “Multidose vial” defined. (NRS 441A.120, 449.448) “Multidose vial” means a vial, including, without limitation, a sealed sterile vial, which may be accessed by insertion of a needle and which, according to the manufacturer’s instructions: 1. Contains more than one …

NAC 449.999438 “Reprocess” defined. (NRS 441A.120, 449.448) “Reprocess” means the process of subjecting a single-use medical device that has been previously used on a patient to additional cleaning, disinfection or sterilization, manufacturing steps, including, without limitation…

NAC 449.999439 “Single-dose vial” defined. (NRS 441A.120, 449.448) “Single-dose vial” means a vial, including, without limitation, a sealed sterile vial, which may be accessed by insertion of a needle and which, according to the manufacturer’s instructions: 1. Contains only one d…

NAC 449.99944 “Sterilization” defined. (NRS 441A.120, 449.448) “Sterilization” means a process using medical equipment, including, without limitation, a dry heat sterilizer or an autoclave, to destroy all forms of microbial life. (Added to NAC by Bd. of Health by R179-09, eff. 7-…

NAC 449.999441 Adoption of guidelines by holder of permit for establishment of program. (NRS 441A.120, 449.448) 1. The holder of a permit issued pursuant to NAC 449.99942 shall adopt guidelines which must be used by the outpatient facility in establishing the program for the prev…

NAC 449.999442 General requirements of program. (NRS 441A.120, 449.448) 1. Each outpatient facility 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 449.999441 to …

NAC 449.999443 Program required to include policies and procedures for prevention of exposure to blood-borne and other potentially infectious pathogens. (NRS 441A.120, 449.448) Each program for the prevention and control of infections and communicable diseases must include polici…

NAC 449.999444 Program required to include policies and procedures for single-dose vials and multidose vials. (NRS 441A.120, 449.448) 1. Each program for the prevention and control of infections and communicable diseases must include policies and procedures for single-dose vials …

NAC 449.999445 Sterilization and disinfection of surgical instruments, items and equipment; training required for employees and contractors responsible for sterilization or disinfection. (NRS 441A.120, 449.448) 1. All surgical instruments, items or equipment used in the care of p…

NAC 449.999446 Outpatient facility required to designate employee or enter into contract for overseeing and managing program; qualifications and duties of employee or contractor. (NRS 441A.120, 449.448) 1. Each outpatient facility shall designate an employee or enter into a contr…

NAC 449.999447 Mandatory training and evaluation of employees and other persons. (NRS 441A.120, 449.448) 1. Each employee of an outpatient facility and each person under contract with an outpatient facility who works at the facility and has exposure to patients at the facility sh…