CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.27819 “Needs assessment” defined. (NRS 449.0302, 449.0305) “Needs assessment” means an assessment of a client to document the abilities of the client to function independently, including a complete list of the areas in which the client requires assistance. (Added to NAC b…

NAC 449.27823 License not required by certain persons to make referrals; application for licensure; referral through licensed referral agency. (NRS 439.200, 449.0302, 449.0305) 1. A licensed nurse or social worker working in a medical facility or a facility for the dependent lice…

NAC 449.27827 Requirements for employees. (NRS 439.200, 449.0302, 449.0305) 1. Employees of a referral agency must have a working knowledge of the provisions of NRS and NAC that govern the licensing of group housing arrangements. 2. An employee of a referral agency who is not lic…

NAC 449.27829 Responsibilities of referral agency. (NRS 439.200, 449.0302, 449.0305) 1. A referral agency shall: (a) Complete a needs assessment and financial assessment for each client and make referrals for the services that would best meet the physical, psychosocial and financ…

NAC 449.27831 Contract for services; fees; maintenance of client records. (NRS 439.200, 449.0302, 449.0305) 1. Before a referral agency may provide any services to a client, the referral agency must obtain a written contract from the client or his or her legal representative to p…

NAC 449.279 Definitions. (NRS 439.200, 449.0302) As used in NAC 449.279 to 449.394, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.286 to 449.300, inclusive, have the meanings ascribed to them in those sections. (Supplied in codification;…

NAC 449.286 “Governing body” defined. (NRS 449.0302) “Governing body” means the person or group of persons, including a board of trustees, board of directors or other body, in whom the final authority and responsibility is vested for conduct of a hospital. (Added to NAC by Bd. of…

NAC 449.287 “Hospital” defined. (NRS 449.0302) “Hospital” has the meaning ascribed to it in NRS 449.012. (Added to NAC by Bd. of Health by R050-99, eff. 9-27-99)

NAC 449.289 “Inpatient” defined. (NRS 439.200, 449.0302) “Inpatient” means a person who has been formally admitted into a hospital for diagnosis or treatment and: 1. Is expected, at the time of admission, to receive care or occupy a bed at the hospital at midnight on at least 2 c…

NAC 449.297 “Outpatient” defined. (NRS 439.200, 449.0302) “Outpatient” means a person who has been registered or accepted for care in a hospital but who is not an inpatient. (Added to NAC by Bd. of Health by R050-99, eff. 9-27-99; A by R133-18, 12-19-2018)

NAC 449.298 “Outpatient department” defined. (NRS 449.0302) “Outpatient department” means that part of a hospital used for the treatment and diagnosis of patients not residing in the hospital. [Bd. of Health, Health Facilities Reg. Part I part Ch. III, eff. 10-9-69]

NAC 449.299 “Patient” defined. (NRS 449.0302) “Patient” means a person who: 1. Is receiving diagnostic, therapeutic or preventive health services; or 2. Is under observation or treatment for an illness or injury, or under care during and after pregnancy. (Added to NAC by Bd. of H…

NAC 449.300 “Restraint” defined. (NRS 449.0302) “Restraint” means the control of the activity of a patient to protect the patient or others from injury by the seclusion of the patient or the use of mechanical devices. The term does not include the control of the activity of a pat…

NAC 449.307 Applicability of license; coverage against certain liabilities. (NRS 449.0302) 1. A hospital must be operated and conducted in the name designated on the license, with the name of the person responsible for its operation also appearing on the face of the license. The …

NAC 449.310 Limitation on number of patients; annual on-site inspection not required under certain circumstances. (NRS 449.0302) 1. A hospital shall not have more patients than the number of beds for which it is licensed, except in emergencies. If there is an emergency, the hospi…

NAC 449.312 Change in ownership, use or construction; correction of deficiencies. (NRS 449.0302) 1. Upon a change in ownership, change of use or change in construction, a hospital shall notify the Bureau of the changes and identify all areas of noncompliance with the guidelines s…

NAC 449.313 Responsibilities and duties of governing body; bylaws; appointment and duties of chief executive officer; protocol for organ donations; annual operating budget. (NRS 449.0302) 1. A hospital shall have an effective governing body which is legally responsible for the co…

NAC 449.314 Quality of care; scope of services. (NRS 449.0302) 1. A hospital must be administered in a manner that enables the hospital to use its resources effectively and efficiently to meet the needs of and provide quality care to its patients. The governing body of a hospital…

NAC 449.3152 Quality improvement program. (NRS 449.0302) 1. The governing body of a hospital shall ensure that the hospital has an effective, comprehensive quality improvement program to evaluate the provision of care to its patients. 2. The quality improvement program must: (a) …

NAC 449.3154 Construction, remodeling, maintenance and change of use: General requirements; prerequisites to approval of licensure. (NRS 439.200, 449.0302) 1. Except as otherwise provided in this section, a hospital shall comply with the provisions of NFPA 101: Life Safety Code, …

NAC 449.3156 Compliance with certain guidelines for design and construction; correction of deficiencies. (NRS 439.200, 449.0302) 1. Notwithstanding any provision of NAC 449.3154 to the contrary, a hospital shall be deemed to be in compliance with the applicable provisions of the …

NAC 449.316 Physical environment: Safety and well-being of patients; plan for emergency preparedness; safety management. (NRS 449.0302) 1. The buildings of a hospital must be solidly constructed with adequate space and safeguards for each patient. The condition of the physical pl…

NAC 449.317 Risk management. (NRS 449.0302) Each hospital shall have in effect a comprehensive program for risk management and shall designate one person to be responsible for the implementation and maintenance of the program for risk management. (Added to NAC by Bd. of Health by…

NAC 449.318 Accreditation by national accrediting organization required; exceptions; submission of proof of accreditation to Division. (NRS 439.200, 449.0302) 1. A hospital must be accredited by an approved national accrediting organization unless the hospital: (a) Is a psychiatr…

NAC 449.319 Requirements for personal needs of patients. (NRS 449.0302) 1. A hospital shall provide patients access to their belongings as is appropriate based on the needs of the patients and the phase of treatment of the patients. 2. A hospital shall communicate and enforce a n…

NAC 449.321 Requirement to be primarily engaged in providing certain services; determination of whether requirement is met; exemption for certain hospitals. (NRS 439.200, 449.0302) 1. A hospital must be primarily engaged in providing the services described in 42 U.S.C. § 1395x(e)…

NAC 449.322 Housekeeping and laundry services. (NRS 449.0302) 1. A hospital shall establish organized housekeeping services planned, operated and maintained to provide a pleasant, safe and sanitary environment. Adequate personnel, using accepted practices and procedures, shall ke…

NAC 449.325 Prevention, control and investigation of infections and communicable diseases. (NRS 449.0302) 1. A hospital shall: (a) Provide a sanitary environment to avoid sources and transmission of infections and communicable diseases; and (b) Develop and carry out an active pro…

NAC 449.327 Preparation, sterilization, storage and distribution of sterile supplies and medical and surgical equipment. (NRS 449.0302) 1. To meet the ongoing needs of its patients, a hospital shall: (a) Provide a designated area for the preparation, sterilization and storage of …

NAC 449.329 Admission of patients. (NRS 449.0302) A hospital shall: 1. Develop and carry out policies and procedures for admitting patients to the appropriate levels of care; and 2. Ensure that each patient, or the parent, guardian or other person legally responsible for the pati…

NAC 449.331 Provision of emergency services and medical care; transfer agreements with long-term care facilities; attestation of compliance. (NRS 439.200, 449.0302) 1. A hospital shall develop and carry out policies and procedures to ensure that emergency services and medical car…

NAC 449.332 Discharge planning. (NRS 439.200, 449.0302) 1. A hospital shall: (a) Have a process for discharge planning that applies to all inpatients; and (b) Develop and carry out policies and procedures regarding the process for discharge planning. 2. The process for discharge …

NAC 449.337 Dietary services: General requirements. (NRS 449.0302) 1. A hospital shall provide each patient with a nourishing, palatable, well-balanced diet that meets the daily nutritional and dietary needs of the patient. 2. The menu for a patient must meet the nutritional need…

NAC 449.338 Dietary services: Provision for needs of patients; facilities; standards; permits; records. (NRS 449.0302) 1. A hospital shall provide for the general dietary needs of its patients, including the preparation of modified special diets. 2. Adequate space for the prepara…

NAC 449.3385 Dietary services: Personnel. (NRS 449.0302) 1. A hospital shall maintain an organized dietary service that is staffed by an adequate number of personnel. The hospital shall ensure that personnel are on duty to provide dietary services for at least 12 hours each day a…

NAC 449.339 Dietary services: Nutritional status of patients. (NRS 449.0302) 1. A hospital shall carry out a program for the systematic nutritional risk-screening of its patients to detect actual and potential malnutrition at an early stage. 2. A hospital shall ensure that each p…

NAC 449.3395 Dietary services: Sanitary conditions; supplies. (NRS 449.0302) 1. A hospital shall store, prepare, distribute and serve food under sanitary conditions. 2. A hospital shall maintain on its premises at least a 1-week supply of staple foods and at least a 2-day supply …

NAC 449.340 Pharmaceutical services. (NRS 449.0302) 1. A hospital shall have a pharmacy directed by a registered pharmacist, who may be a full-time, part-time or consulting pharmacist, or a drug room supervised by no less than a currently licensed professional nurse. If a hospita…

NAC 449.343 Orders for medication and biologicals. (NRS 449.0302) 1. Except as otherwise provided in this section, an order for medication or biologicals for a patient must be in writing and signed by the practitioner, or other appropriate professional person authorized by state …

NAC 449.344 Administration of medication; security. (NRS 449.0302) 1. Only members of the hospital staff who are legally authorized to administer medications may do so. 2. Security of all medications must be maintained in accordance with applicable state law. 3. The quality impro…

NAC 449.346 Rehabilitative services. (NRS 449.0302) 1. Rehabilitative services are those activities used in restoring, maintaining and improving the physical and mental well-being of a patient. A hospital shall provide rehabilitative services consistent with its overall role in t…

NAC 449.349 Emergency services. (NRS 449.0302) 1. A hospital shall meet the emergency needs of its patients in accordance with nationally recognized standards of practice. 2. If a hospital does not have an emergency department on-site, the policies and procedures for meeting the …

NAC 449.352 Social services. (NRS 449.0302) 1. A hospital shall have effective written policies and procedures for the provision of social services by the hospital staff. 2. Social services must be provided or supervised in accordance with chapter 641B of NRS by a professional, q…

NAC 449.358 Medical staff. (NRS 449.0302) 1. A hospital shall have a well-organized medical staff that operates in accordance with the bylaws approved by the governing body. 2. The medical staff must be appointed by the governing body and be composed of: (a) Doctors of medicine o…

NAC 449.361 Nursing services. (NRS 449.0302) 1. A hospital shall have a well-organized plan that provides for 24-hour nursing services. The nursing services must be furnished or supervised by a registered nurse. 2. The governing body and the hospital shall ensure that the nursing…

NAC 449.3622 Appropriate care of patients. (NRS 449.0302) 1. Each patient must receive, and the hospital shall provide or arrange for, individualized care, treatment and rehabilitation based on the assessment of the patient that is appropriate to the needs of the patient and the …

NAC 449.3624 Assessment of patients. (NRS 449.0302) 1. To provide a patient with the appropriate care at the time that the care is needed, the needs of the patient must be assessed continually by qualified hospital personnel throughout the patient’s contact with the hospital. The…