CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.395295 Hearings: Scheduling; notice. (NRS 449.4337) 1. Not later than 30 days after the Administrator receives a written request for a hearing, a hearing officer appointed by the senior hearing officer of the Hearings Division of the Department of Administration shall con…

NAC 449.3953 Hearings: Representation; evidence; rights of parties. (NRS 449.4337) 1. The complainant may be represented at the hearing by an attorney or another person designated by the complainant. 2. The hearing officer is not bound by the technical rules of evidence. Decision…

NAC 449.39531 Resolution of complaint. (NRS 449.4337) Unless otherwise provided by statute, a complaint may be resolved by arbitration, mutual agreement of the parties, settlement, consent decree or default of a party. (Added to NAC by Aging & Disability Services Div. by R197-09,…

NAC 449.39532 Final decision of hearing officer; request for judicial review. (NRS 449.4337) 1. A final decision by a hearing officer on a complaint must be in writing or stated in the record. A final decision must include findings of fact and conclusions of law. Findings of fact…

NAC 449.39533 Record of hearing. (NRS 449.4337) The record of the hearing must include: 1. The transcript of the oral testimony provided at the hearing; 2. All pleadings and motions filed by the parties; 3. Any rulings made by the hearing officer, including rulings on offers of p…

NAC 449.39534 Provision of transcript of oral proceedings of hearing. (NRS 449.4337) Upon request of a party, the Division will provide a transcript of the oral proceedings of the hearing. The Division may require payment of the cost incurred for providing the transcript. (Added …

NAC 449.39535 Definitions. (NRS 449.4336) As used in NAC 449.39535 to 449.39561, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.39536 to 449.39544, inclusive, have the meanings ascribed to them in those sections. (Added to NAC by Bd. of H…

NAC 449.39536 “Ban on enrollment” defined. (NRS 449.4336) “Ban on enrollment” means a prohibition on the provision of services to clients who are newly enrolled. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.841)

NAC 449.39537 “Cluster” defined. (NRS 449.4336) “Cluster” means a violation that involves the same or similar kinds of services as one or more other violations. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.842)

NAC 449.39538 “Compliance” defined. (NRS 449.4336) “Compliance” means that no major violation is present and that effective steps have been taken to resolve all violations. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.843)

NAC 449.39539 “De minimis violation” defined. (NRS 449.4336) “De minimis violation” means a violation 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 R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.844)

NAC 449.3954 “Major violation” defined. (NRS 449.4336) “Major violation” means a violation with a severity and scope score of five or more. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.845)

NAC 449.39541 “Plan of correction” defined. (NRS 449.4336) “Plan of correction” means a plan developed by the intermediary service organization and approved by the Division that: 1. Describes the actions to be taken by the intermediary service organization to correct one or more …

NAC 449.39542 “Resurvey” defined. (NRS 449.4336) “Resurvey” means a survey conducted after the initial survey to evaluate compliance with a plan of correction. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.847)

NAC 449.39543 “Severity and scope score” defined. (NRS 449.4336) “Severity and scope score” means the sum of the numerical levels of severity and scope assigned to a violation. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.848)

NAC 449.39544 “Subsequent violation” defined. (NRS 449.4336) “Subsequent violation” means a violation found on a resurvey. (Added to NAC by Bd. of Health by R167-07, eff. 1-30-2008)—(Substituted in revision for NAC 427A.849)

NAC 449.39545 Imposition of sanctions generally. (NRS 449.4336) 1. The Division will impose at least one administrative sanction against an intermediary service organization for each violation by the intermediary service organization with a severity level of four and for each vio…

NAC 449.39546 Minimum sanction to be imposed. (NRS 449.4336) The Division will impose at least one sanction upon any intermediary service organization that has a violation with a severity level of four or a severity and scope score of six or more as determined pursuant to the pro…

NAC 449.39547 Available sanctions. (NRS 449.4321, 449.4335, 449.4336) 1. The Division may apply one or more sanctions as provided in NRS 449.4335, including, without limitation: (a) The imposition of a plan of correction as directed by the Division; (b) The imposition of a ban on…

NAC 449.39548 Duration of sanctions. (NRS 449.4336) Sanctions applied pursuant to NAC 449.39535 to 449.39561, inclusive, may be imposed until substantial compliance is achieved or, if compliance is not achieved, until the day before termination of the certificate becomes effectiv…

NAC 449.39549 Notice of sanction; appointment of temporary manager; ban on enrollment or suspension of certificate authorized in certain circumstances. (NRS 449.4335, 449.4336) 1. The Division will give notice of a sanction to the holder of a certificate by certified mail as requ…

NAC 449.3955 Imposition of one or more sanctions; reporting of violations; presumption of de minimis violation. (NRS 449.4336) 1. The Division may apply one or more sanctions on the basis of violations found during surveys or investigations of complaints conducted by the Division…

NAC 449.39551 Severity and scope of violations to be considered in determining sanctions to be imposed. (NRS 449.4336) In determining the sanctions to be imposed, the Division will consider the severity and scope of the violations according to the classifications of severity and …

NAC 449.39552 Scope of violations: Survey of organization; sampling of clients; use of scope relating to one client authorized. (NRS 449.4336) 1. In determining the scope of a violation by an intermediary service organization, a survey of an intermediary service organization must…

NAC 449.39553 Scope of violations: Use of scope; basis for assessment. (NRS 449.4336) 1. The scope scale must be used to assess the scope of a particular violation by the intermediary service organization. 2. The basis for the assessment is the actual or potential harm to clients…

NAC 449.39554 Scope of violations: Criteria for evaluation. (NRS 449.4336) 1. The scope of the violations must be evaluated using the criteria prescribed in this section. 2. A violation with a scope level of one consists of one or a few unrelated incidents in the sample surveyed.…

NAC 449.39555 Severity of violations: Use of severity scale; basis for assessment; criteria for evaluation. (NRS 449.4336) 1. The severity scale must be used to assess the severity of a particular violation pertaining to the intermediary service organization. The basis for the as…

NAC 449.39556 Subsequent violation on resurvey: Rebuttable presumption; imposition of sanction. (NRS 449.4336) If the same violation is found on a resurvey, there is a rebuttable presumption that the violation continued through the period between the survey and resurvey. A sancti…

NAC 449.39557 Determination of sanctions: Initial assessment. (NRS 449.4336) The Division will initially assess individual violations or clusters of violations according to the following initial factors: 1. The presence or absence of an immediate and serious threat to the health …

NAC 449.39558 Determination of sanctions: Secondary factors to be considered. (NRS 449.4336) After the initial assessment, the Division will consider the following secondary factors in determining the sanction to impose: 1. The relationship of one violation or cluster of violatio…

NAC 449.39559 Determination of sanctions: Basis for selection; restrictions upon service and monetary penalties presumed to be most effective. (NRS 449.4336) The selection of a sanction must be based upon the nature of the violations or cluster of violations and the sanction most…

NAC 449.3956 Plan of correction: Development by intermediary service organization; authority of Division when plan is not acceptable; effect of failure to submit plan. (NRS 449.4336) 1. The intermediary service organization shall develop a plan of correction for each violation an…

NAC 449.39561 Monetary penalties: Determination of initial penalty; daily penalties; maximum total penalties. (NRS 449.4335, 449.4336) 1. In determining the amount of an initial monetary penalty, the Division will consider the severity alone if the severity level is four. In dete…

NAC 449.39565 Definitions. (NRS 449.0302) As used in NAC 449.39565 to 449.39591, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.39567 to 449.39575, inclusive, have the meanings ascribed to them in those sections. (Added to NAC by Bd. of H…

NAC 449.39567 “Client” defined. (NRS 449.0302) “Client” means a person who receives the services of a community health worker. (Added to NAC by Bd. of Health by R133-15, eff. 12-19-2017)

NAC 449.39569 “Continuing education” defined. (NRS 449.0302) “Continuing education” means a course of study or training that is designed to develop and enhance the knowledge, skills and competency of a community health worker with regard to providing the services of a community h…

NAC 449.39571 “Representative of the client” defined. (NRS 449.0302) “Representative of the client” means the spouse of a client, a parent or stepparent of a client who is a minor, the legal guardian of a client and any other person required by law to provide medical support to a…

NAC 449.39573 “Service plan” defined. (NRS 449.0302) “Service plan” means a plan which includes a written description of the needs of a client for the services of a community health worker and which specifies the tasks that a community health worker is authorized to provide for t…

NAC 449.39575 “Services of a community health worker” defined. (NRS 449.0302) “Services of a community health worker” means the services provided by a community health worker at the direction of a community health worker pool which may include, without limitation, outreach, commu…

NAC 449.39577 Location to which license applies; name of administrator to appear on license; liability coverage. (NRS 449.0302) 1. Except as otherwise provided in this subsection, each license issued to operate a community health worker pool is separate and distinct and is issued…

NAC 449.39579 Qualifications and duties of administrator; access to records in absence of administrator. (NRS 449.0302) 1. The administrator of a community health worker pool must: (a) Be at least 18 years of age; (b) Have a high school diploma or its equivalent; (c) Be responsib…

NAC 449.39581 Written policies and procedures. (NRS 449.0302) A community health worker pool shall maintain written policies and procedures concerning the qualifications, responsibilities and conditions of employment for each community health worker and other members of the staff…

NAC 449.39583 Qualifications of community health worker. (NRS 449.0302) Each community health worker employed or retained pursuant to a contract by a community health worker pool must: 1. Be at least 18 years of age; 2. Demonstrate the ability to provide the services of a communi…

NAC 449.39585 Personnel files for community health workers. (NRS 449.0302) 1. A separate personnel file must be kept for each community health worker employed or retained pursuant to a contract by a community health worker pool and must include, without limitation: (a) The name, …

NAC 449.39587 Training and evaluation of community health workers. (NRS 449.0302) 1. Each community health worker employed or retained pursuant to a contract by a community health worker pool shall: (a) Obtain a working knowledge of the provisions of this chapter which govern the…

NAC 449.39589 Rights of clients: Duties of administrator; provision of written description to clients. (NRS 449.0302) 1. The administrator of a community health worker pool shall ensure that a client is not prohibited from speaking to any person who advocates for the rights of th…

NAC 449.39591 Initial screening of client. (NRS 449.0302) The administrator of a community health worker pool or the administrator’s designee shall conduct an initial screening to evaluate each prospective client’s requests for the services of a community health worker and to dev…