CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.999452 “De minimis deficiency” defined. (NRS 449.447, 449.448) “De minimis deficiency” means a deficiency rated at a severity level of one or two and at a scope level of one or two. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999453 “Deficiency” defined. (NRS 449.447, 449.448) 1. “Deficiency” means noncompliance with any state statute or regulation of the Board. The term includes an incident concerning an outpatient facility where there are no extenuating circumstances or where the facility ha…

NAC 449.999454 “Immediate and serious threat” and “immediate jeopardy” defined. (NRS 449.447, 449.448) “Immediate and serious threat” or “immediate jeopardy” means a situation in which corrective action within 48 hours is necessary because the failure by an outpatient facility to…

NAC 449.999455 “Incident” defined. (NRS 449.447, 449.448) “Incident” means an action, practice or situation that appears to be inconsistent with a state statute or regulation of the Board. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999456 “Initial deficiency” defined. (NRS 449.447, 449.448) “Initial deficiency” means the first occurrence of a deficiency recorded by the Bureau, including, without limitation, any deficiency found during a standard inspection, during an extended inspection or in respon…

NAC 449.999457 “Severity and scope score” defined. (NRS 449.447, 449.448) “Severity and scope score” means the sum of the numerical levels of severity and scope assigned to a deficiency. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999458 Purpose of sanctions. (NRS 449.447, 449.448) The purposes of administrative sanctions are to: 1. Safeguard the rights, interests and well-being of patients, including the protection of patients from actual or potential harm resulting from deficiencies; and 2. Encou…

NAC 449.999459 Grounds for denial, suspension or revocation of permit. (NRS 449.447, 449.448) In accordance with NRS 449.447, the Division may deny an application for a permit or may suspend or revoke a permit upon any of the following grounds: 1. Offering to a patient a service …

NAC 449.99946 Appeal of denial, suspension or revocation of permit or other sanction. (NRS 449.447, 449.448) An applicant or holder of a permit who is aggrieved by an action of the Division relating to the denial, suspension or revocation of a permit or any other sanction assesse…

NAC 449.999461 Imposition of sanctions: Authority of Division and Bureau. (NRS 449.447, 449.448) Administrative sanctions authorized by NRS 449.447 may be imposed by the Division through the Bureau. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999462 Imposition of sanctions: Requirement for imposition; optional imposition; multiple sanctions; use of severity and scope factors for particular sanction. (NRS 449.447, 449.448) 1. The Bureau shall impose at least one sanction listed in NRS 449.447 upon an outpatient…

NAC 449.999463 Imposition of sanctions in emergencies: Notice; authority; exception to notice requirement. (NRS 449.447, 449.448) 1. Except as otherwise provided in this section, the Bureau shall give notice pursuant to the provisions of NAC 439.300 to 439.395, inclusive, before …

NAC 449.999464 Deficiencies: Basis for imposition of sanctions; reporting; presumption of de minimis deficiency. (NRS 449.447, 449.448) 1. The Bureau may apply one or more sanctions on the basis of deficiencies found during inspections or investigations of complaints conducted by…

NAC 449.999465 Scope of violations: Evaluation of representative sample of recipients; sample size. (NRS 449.447, 449.448) 1. In determining the scope of a violation, an inspection of an outpatient facility must evaluate a representative sample of patients as provided in this sec…

NAC 449.999466 Scope of deficiencies: Use of scope scale; basis for assessment. (NRS 449.447, 449.448) 1. The scope scale must be used to assess the scope of a particular deficiency in or by the outpatient facility. 2. The basis for the assessment is the actual or potential harm …

NAC 449.999467 Scope of deficiencies: Criteria for evaluation. (NRS 449.447, 449.448) 1. The scope of the deficiencies must be evaluated using the criteria prescribed in this section. 2. A deficiency of scope level one consists of one or an isolated number of unrelated incidents.…

NAC 449.999468 Severity of deficiencies: Use of severity scale; basis for assessment; criteria for evaluation. (NRS 449.447, 449.448) 1. The severity scale must be used to assess the severity of a particular deficiency pertaining to the outpatient facility. The basis for the asse…

NAC 449.999469 Presumption when same deficiency found on subsequent inspection; imposition of sanction for subsequent deficiency. (NRS 449.447, 449.448) If the same deficiency is found during a subsequent inspection conducted to evaluate compliance with a plan of correction, ther…

NAC 449.99947 Available sanctions. (NRS 449.447, 449.448) The sanctions available for all outpatient facilities include: 1. The assessment of monetary penalties; and 2. The denial, suspension or revocation of the permit for the outpatient facility. (Added to NAC by Bd. of Health …

NAC 449.999471 Determination of appropriate sanction: Procedure. (NRS 449.447, 449.448) To determine the appropriate sanction, the Bureau shall follow the procedures set forth in NAC 449.99945 to 449.999489, inclusive. (Added to NAC by Bd. of Health by R179-09, eff. 7-22-2010)

NAC 449.999472 Determination of appropriate sanction: Initial assessment. (NRS 449.447, 449.448) The Bureau shall initially assess individual deficiencies or clusters of deficiencies according to the following initial factors: 1. The presence or absence of an immediate and seriou…

NAC 449.999473 Determination of appropriate sanction: Consideration of secondary factors. (NRS 449.447, 449.448) After the initial assessment, the Bureau shall consider the following secondary factors in determining the sanction to impose: 1. The relationship of one deficiency or…

NAC 449.999474 Determination of appropriate sanction: Basis for selection; presumption for monetary penalties. (NRS 449.447, 449.448) 1. The selection of a sanction must be based upon the nature of the deficiencies or cluster of deficiencies and the sanction most likely to correc…

NAC 449.999475 Plan of correction: Development and submission of plan; authority of Bureau when plan is not acceptable; effect of failure to submit plan. (NRS 449.447, 449.448) 1. The outpatient facility shall develop a plan of correction for each deficiency and submit the plan t…

NAC 449.999476 Monetary penalties: Criteria for imposition; imposition of initial and daily penalties; exception for de minimis deficiency. (NRS 449.447, 449.448) 1. Except as otherwise provided in subsection 4, the Bureau may impose a monetary penalty including interest thereon …

NAC 449.999477 Monetary penalties: Imposition of initial penalty pending hearing or appeal; stay of payment of penalties pending appeal. (NRS 449.447, 449.448) 1. The Bureau shall impose an initial monetary penalty pending a hearing or appeal. The payment of the initial penalty m…

NAC 449.999478 Monetary penalties: Procedure for imposition; interest on total penalty assessed. (NRS 449.447, 449.448) 1. If the Bureau imposes a monetary penalty, the penalty must be imposed as provided in NAC 449.999478 to 449.999482, inclusive. 2. In imposing the monetary pen…

NAC 449.999479 Monetary penalties: Determination of amount of penalties. (NRS 449.447, 449.448) 1. In determining the amount of an initial monetary penalty, the Bureau shall consider the severity alone if the severity level is four. In determining the amount of the monetary penal…

NAC 449.99948 Monetary penalties: Increase in penalty for repeated deficiencies or falsely alleged compliance. (NRS 449.447, 449.448) 1. Penalties must be increased for repeated deficiencies or if compliance is falsely alleged. 2. For each repeat deficiency present within 18 mont…

NAC 449.999481 Monetary penalties: Presumption regarding deficiencies identified on subsequent inspection. (NRS 449.447, 449.448) There is a rebuttable presumption that deficiencies identified on a subsequent inspection conducted to evaluate compliance with a plan of correction w…

NAC 449.999482 Monetary penalties: Reduction of penalty. (NRS 449.447, 449.448) If an outpatient facility against which a monetary penalty is imposed: 1. Waives the right to a hearing; 2. Corrects the deficiencies that were the basis for the sanction; and 3. Pays the monetary pen…

NAC 449.999483 Monetary penalties: Effective beginning date. (NRS 449.447, 449.448) The effective beginning date of a daily monetary penalty is: 1. In the case of an immediate and serious threat, the date the deficiency occurred; or 2. In any other case, the day the deficiency is…

NAC 449.999484 Monetary penalties: Date and period of computation; notice to outpatient facility. (NRS 449.447, 449.448) 1. Daily penalties and interest must be computed after compliance has been verified or the outpatient facility has been sent notice of termination of a permit.…

NAC 449.999485 Monetary penalties: Termination of daily penalties. (NRS 449.447, 449.448) 1. The daily accrual of a monetary penalty must end if the outpatient facility demonstrates that deficiencies have been corrected and that the health, safety and well-being of patients are a…

NAC 449.999486 Monetary penalties: Time for payment. (NRS 449.447, 449.448) 1. Initial monetary penalty assessment payments are due within 15 days after the notice of the penalty and must be paid irrespective of any administrative appeal. 2. The daily monetary penalty is due and …

NAC 449.999487 Recovery of expenses incurred by Bureau or Division for implementing and enforcing administrative penalties, bringing actions for enforcement and collecting monetary penalties. (NRS 449.447, 449.448) Any expenses incurred by the Bureau or the Division in implementi…

NAC 449.999488 Failure to pay monetary penalty: Suspension of permit. (NRS 449.447, 449.448) 1. If the outpatient facility fails to pay a monetary penalty, the Division may suspend the permit of the outpatient facility. 2. The Division shall, in accordance with the requirements o…

NAC 449.999489 Disposition of money collected. (NRS 449.447, 449.448) Money collected by the Division as administrative sanctions must be deposited into a separate fund and applied to the protection of the health, safety, rights, welfare and well-being of patients. (Added to NAC …

NAC 449.99984 Definitions. (NRS 449.2425) As used in NAC 449.99984 to 449.999848, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.999842 and 449.999844 have the meanings ascribed to them in those sections. (Added to NAC by Div. of Pub. & B…

NAC 449.999842 “Deficiency” defined. (NRS 449.2425) “Deficiency” means a violation of NRS 449.241 to 449.2428, inclusive, as determined by the Division pursuant to an inspection conducted pursuant to NRS 449.132 or an investigation conducted pursuant to NRS 449.0307. (Added to NA…

NAC 449.999844 “Facility” defined. (NRS 449.2425) “Facility” means a health care facility located in a county whose population is 100,000 or more and which is licensed to have more than 70 beds. (Added to NAC by Div. of Pub. & Behavioral Health by R156-18, eff. 1-30-2019)

NAC 449.999845 “Unit” defined. (NRS 449.0302, 449.2418) As used in NRS 449.241 to 449.2428, inclusive, unless the context otherwise requires, “unit” means a component of a health care facility for providing patient care that is defined by the scope of health care service provided…

NAC 449.999846 Criteria for assignment of ratings; issuance of placard with rating. (NRS 449.2425) After each inspection or investigation described in paragraph (a) of subsection 1 of NRS 449.2425, the Division will: 1. Assign to the facility that was inspected or investigated a …

NAC 449.999848 Follow-up inspections and appeals. (NRS 449.2425) 1. A facility may request a follow-up inspection or an appeal within 30 days after an investigation or inspection described in paragraph (a) of subsection 1 of NRS 449.2425 by submitting, in the form prescribed by t…