CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.3963 “Attendant” defined. (NRS 449.0302) “Attendant” means a person who is employed by or retained pursuant to a contract by an agency for the purpose of providing personal care services to a client. (Added to NAC by Bd. of Health by R182-07, eff. 1-30-2008)

NAC 449.3964 “Client” defined. (NRS 449.0302) “Client” means an elderly person or a person with a disability who desires the provision of personal care services in the home in which the person lives. (Added to NAC by Bd. of Health by R182-07, eff. 1-30-2008)

NAC 449.3965 “Personal care services” defined. (NRS 449.0302) “Personal care services” means the nonmedical services described in NRS 449.0021. (Added to NAC by Bd. of Health by R182-07, eff. 1-30-2008)

NAC 449.3966 “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 449.3967 “Service plan” defined. (NRS 449.0302) “Service plan” means a plan which includes a written description of the needs of a client for personal care services and which specifies the tasks that an attendant is authorized to provide for the client. (Added to NAC by Bd. o…

NAC 449.3968 “Work station” defined. (NRS 449.0302) “Work station” means a satellite office of an agency that is established for the sole purposes of providing a location where copies of records may be sent to an agency and providing a location from which an attendant may work to…

NAC 449.3972 Location to which license applies; agency to retain proof of liability coverage and compliance with certain statutory provisions. (NRS 449.0302) 1. Except as otherwise provided in this subsection, each license issued to operate an agency is separate and distinct and …

NAC 449.3973 Qualifications and duties of administrator; appointment of designee to act in administrator’s absence. (NRS 439.200, 449.0302) 1. The administrator of an agency must: (a) Be at least 18 years of age; (b) Have a high school diploma or its equivalent; (c) Be responsibl…

NAC 449.39735 Training of employees: Provision or arranging for provision of training; costs; payment of salary or hourly wage; exceptions; documentation. (NRS 439.200, 449.0302) 1. To comply with the requirements of paragraph (a) of subsection 2 of NAC 449.3973 concerning the tr…

NAC 449.3974 Maintenance of policies and procedures concerning qualifications, responsibilities and conditions of employment for staff members. (NRS 449.0302) An agency shall maintain written policies and procedures concerning the qualifications, responsibilities and conditions o…

NAC 449.3975 Attendants: Qualifications; annual training. (NRS 449.0302) Each attendant of an agency must: 1. Be at least 18 years of age; 2. Be responsible and mature and have the personal qualities which will enable the attendant to understand the problems of elderly persons an…

NAC 449.3976 Attendants: Maintenance of personnel file; evaluation of competency. (NRS 449.0302) 1. A separate personnel file must be kept for each attendant of an agency and must include, without limitation: (a) The name, address and telephone number of the attendant; (b) The da…

NAC 449.3977 Attendants: Required knowledge and training. (NRS 449.0302) 1. Each attendant of an agency shall: (a) Obtain a working knowledge of the provisions of this chapter which govern the licensing of agencies before providing personal care services to the clients of the age…

NAC 449.39775 Attendants: Performance of certain tasks. (NRS 439.200, 449.0302, 449.0304) 1. An attendant may perform a task described in NRS 449.0304 if the attendant: (a) Before performing the task, annually thereafter and when any device used for performing the task is changed…

NAC 449.3978 Attendants: Prohibition on provision of certain types of services to clients. (NRS 439.200, 449.0302, 449.0304) 1. The administrator of an agency shall ensure that each attendant working for the agency is working within the attendant’s scope of service and conducts h…

NAC 449.3979 Provision of written disclosure statement to client upon acceptance for services by agency. (NRS 449.0302) 1. When a person is accepted as a client by an agency, the agency shall: (a) Provide a written disclosure statement to the client; (b) Require the client or a r…

NAC 449.398 Rights of clients: Duties of administrator; provision of written description to clients. (NRS 449.0302) 1. The administrator of an agency shall ensure that a client is not prohibited from speaking to any person who advocates for the rights of the clients of the agency…

NAC 449.3981 Initial screening of client and development or acceptance of service plan; requirements before providing personal care to client. (NRS 449.0302) 1. The administrator of an agency or the administrator’s designee shall conduct an initial screening to evaluate each pros…

NAC 449.3982 Supervisory home visits or telephone calls required to ensure quality of care provided; documentation of evaluation. (NRS 449.0302) 1. The administrator of an agency or the administrator’s designee shall conduct supervisory home visits or telephone calls to the home …

NAC 449.4061 Definitions. (NRS 439.200, 449.0302, 449.0304) As used in NAC 449.4061 to 449.4089, inclusive, unless the context otherwise requires: 1. “Division” means the Division of Public and Behavioral Health of the Department of Health and Human Services. 2. “Facility” means …

NAC 449.4063 Design, construction, equipment and maintenance of facility: General requirements; prerequisites to approval for licensure. (NRS 449.0302) 1. A facility must be designed, constructed, equipped and maintained in a manner that protects the health and safety of the clie…

NAC 449.4065 Consultation with representative of Division; notice of nonconformity. (NRS 449.0302) 1. A representative of the Division will be available upon request for consultation to assure compliance with applicable regulations. 2. If a licensed facility does not conform to a…

NAC 449.4067 Operation in combination with other medical facility or facility for the dependent. (NRS 449.0302) A facility must not be operated in combination with any other medical facility or facility for the dependent unless it is licensed as a separate and distinct unit. (Add…

NAC 449.4069 Insurance. (NRS 449.0302) 1. A facility must maintain a contract of insurance for protection against liability to third persons in amounts appropriate for the protection of clients, employees, volunteers and visitors to the facility. 2. A certificate of insurance mus…

NAC 449.407 Advertising and promotional materials. (NRS 449.0302) Advertising and promotional materials for the facility must be accurate and represent the accommodations, programs or other services actually offered by the facility. (Added to NAC by Bd. of Health, eff. 6-23-86)

NAC 449.4071 Policies and procedures; accounting. (NRS 449.0302) 1. Every facility must have a written policy concerning: (a) Admission, discharge and care of clients; (b) Employees of the facility; and (c) Fiscal and administrative procedures for the facility, Ê which must be ev…

NAC 449.4072 Director and employees: Qualifications and duties; physical and mental health; personnel files. (NRS 449.0302) 1. Each facility must have the number and kind of employees required by the physical characteristics of the facility, the number of clients and the services…

NAC 449.40723 Supervision of clients; volunteers. (NRS 449.0302) 1. A client must be supervised by an employee of the facility at all times during the operating hours of the facility. The employee shall report a change in any physical, mental, emotional or social function of the …

NAC 449.40725 Orientation and training of employees and volunteers. (NRS 449.0302) All employees and volunteers at the facility: 1. Shall participate in a program of general orientation to inform them of the programs, policies and services of the facility; 2. Must receive a copy …

NAC 449.4073 Files concerning employees. (NRS 449.0302) A separate file must be maintained and kept current on each employee. The file must include the following: 1. The employee’s: (a) Name, address and telephone number; (b) Social security number; (c) Date of birth; (d) Date of…

NAC 449.4074 Requirements of facility; health and sanitation; medications; exits. (NRS 449.0302) 1. The facility must: (a) Provide proper access for each client to all activities and services; (b) Have furniture and equipment appropriate for use by the clients; (c) Have free loca…

NAC 449.4075 Preparations for fires and other emergencies; reporting of fire or disaster. (NRS 449.0302) 1. Each facility must have a plan in case of a fire or other emergency. The plan must be: (a) Understood by all employees; (b) Posted in a conspicuous place; and (c) Reviewed …

NAC 449.4076 First aid. (NRS 449.0302) A first-aid kit must be available at the facility. (Added to NAC by Bd. of Health, eff. 6-23-86)

NAC 449.4077 Policy for admissions; retention of signed copy. (NRS 449.0302) 1. A facility’s written policy on admissions must include: (a) A statement of nondiscrimination regarding admission to the facility and treatment after admission; and (b) The requirements for eligibility…

NAC 449.4078 Requirements for admission; designation of physician. (NRS 449.0302) 1. Each client shall, before being admitted to the facility, provide the facility with: (a) The results of a physical examination conducted by a physician, physician assistant or advanced practice r…

NAC 449.4079 Required services. (NRS 449.0302) The facility must: 1. Provide each client with such assistance as necessary for the activities of daily living; 2. Provide activities for a client which are suited to his or her interests and capacities; 3. Observe the health of the …

NAC 449.408 Housekeeping and maintenance. (NRS 449.0302) Each facility must have adequate and regular services for housekeeping and the maintenance of the facility. (Added to NAC by Bd. of Health, eff. 6-23-86)

NAC 449.4081 Administration of medication; notification of accidents, injuries or illnesses; treatment with dignity; use of restraints or sedatives. (NRS 439.200, 449.0302, 449.0304) 1. Except as otherwise authorized by NAC 449.40815, if the facility accepts a client who cannot a…

NAC 449.40815 Performance of certain tasks by employee. (NRS 439.200, 449.0302, 449.0304) 1. An employee of a facility may perform a task described in NRS 449.0304 if the employee: (a) Before performing the task, annually thereafter and when any device used for performing the tas…

NAC 449.4082 Service of food; dietary consultants. (NRS 449.0302) 1. Adequate facilities and equipment for the preparation, service and storage of food must be provided and meet the standards of the Division. 2. The dining area must be separated from the area used to prepare food…

NAC 449.40833 Summary of client’s care; referrals. (NRS 449.0302) When a client permanently discontinues his or her use of a facility, the client must receive a: 1. Written summary of his or her care at the facility, including any recommendations for care in the future; and 2. Re…

NAC 449.40835 Records. (NRS 449.0302) 1. Each facility must have a written policy regarding the records of clients. The policy must include a description of the procedures governing the use and removal of records and the release of information contained in the records. 2. An indi…

NAC 449.4084 Contract for provision by another person. (NRS 449.0302) 1. A medical or ancillary service not directly provided by the facility may be provided by another person pursuant to a contract. 2. The contract must: (a) Be in writing; (b) Designate the service provided, the…

NAC 449.4085 Provision by facility authorized. (NRS 449.0302) A facility which otherwise meets the requirements of NAC 449.4061 to 449.4084, inclusive, may provide medical or ancillary services if the requirements of NAC 449.4086 to 449.4089, inclusive, are met. (Added to NAC by …

NAC 449.4086 Evaluation of programs and policies. (NRS 449.0302) 1. Every facility must have a written plan for the annual evaluation of its programs and policies. The plan must describe the: (a) Schedule for the annual evaluation; (b) Subjects covered by the evaluation; and (c) …

NAC 449.4087 Written assessments of clients. (NRS 449.0302) Upon admission, an initial written assessment must be made of any person admitted to the facility. Within 30 days after admission, another written assessment must be completed which must include: 1. An evaluation of the …

NAC 449.4088 Plan of care; periodic assessment. (NRS 449.0302) 1. A written plan of care must be prepared for each client that provides a balance of activities to meet the client’s needs and interests. The client, his or her next of kin or guardian or other person responsible for…