CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.507 “Facility” defined. (NRS 449.0302) “Facility” means a facility for the treatment of irreversible renal disease as defined in NRS 449.0046. (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001)

NAC 449.508 “Hemodialysis” defined. (NRS 449.0302) “Hemodialysis” means dialysis of the blood. (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001)

NAC 449.510 “Immediate supervision” defined. (NRS 449.0302) “Immediate supervision” means the supervision of a task or activity that is provided by a person who: 1. Is present on the premises of a facility during the period in which the task or activity is performed at the facili…

NAC 449.511 “Intermediate level disinfection” defined. (NRS 449.0302) “Intermediate level disinfection” means to treat a surface using a chemical germicide or other disinfectant that, when used in accordance with the instructions of the manufacturer of the chemical germicide or o…

NAC 449.513 “Licensed practical nurse” defined. (NRS 449.0302) “Licensed practical nurse” means a nurse who may collect data and perform a skill, intervention or other duty in accordance with the provisions of NAC 632.242. (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001)

NAC 449.516 “Product water” defined. (NRS 449.0302) “Product water” means the effluent that is obtained from the final component of the water treatment system of a facility. (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001)

NAC 449.517 “Supervision” defined. (NRS 449.0302) “Supervision” means the guidance and direction provided by a qualified person for the accomplishment of a task or activity, including the initial direction and periodic inspection by that person of the actual accomplishment of the…

NAC 449.519 “Training” defined. (NRS 449.0302) “Training” means to learn a task or activity through experience or instruction that is received during employment at a facility by a person who is capable of learning that task or activity through education or experience. (Added to N…

NAC 449.520 New construction or remodeling: Notification; increase in number of stations for which facility is licensed. (NRS 449.0302, 449.050) 1. A facility shall notify the Bureau in writing at least 30 days before beginning any construction, renovation or modification of the …

NAC 449.5205 New construction or remodeling: Submission of plans and specifications; minor changes; inspection. (NRS 449.0302) 1. To determine compliance with the provisions of NAC 449.501 to 449.5795, inclusive, each facility may submit to the Bureau for its approval any plans a…

NAC 449.522 Construction, space and design; physical environment; restrictions for treatment of patients with hepatitis B. (NRS 449.0302) 1. The Bureau shall consider a facility to be in compliance with the provisions of NAC 449.501 to 449.5795, inclusive, relating to the constru…

NAC 449.5225 Safety and comfort of patients during construction; imposition of more stringent design and space requirements. (NRS 449.0302) 1. If any construction occurs in or near an area of the facility that is occupied by a patient of the facility, the facility shall ensure th…

NAC 449.523 Safety requirements. (NRS 449.0302) 1. Each facility shall install a system for lighting the facility that is capable of providing sufficient illumination to allow safe evacuation from each building of the facility during an emergency at the facility. Each battery pac…

NAC 449.5235 Maintenance and repair of equipment. (NRS 449.0302) 1. Any equipment that is used by a facility, including any equipment used for backup, must be maintained free from any defect that may be hazardous to the patients or members of the staff of the facility or any visi…

NAC 449.525 Water treatment system: General requirements. (NRS 449.0302) 1. The design for the water treatment system of a facility must be: (a) Based on considerations of the source of water for the facility; and (b) Prepared by a person who, as determined by the Bureau, has obt…

NAC 449.5255 Water treatment system: Chemical testing of product water; records. (NRS 449.0302) 1. Except as otherwise provided in this section, each facility shall, at least once every 6 months, conduct a chemical test of a sample of the product water of the water treatment syst…

NAC 449.526 Water treatment system: Microbiological testing of product water. (NRS 449.0302) 1. Each facility shall, at least once each month or immediately after any repair or change is made to the water product treatment system of the facility, conduct a microbiological test of…

NAC 449.5265 Reuse of hemodialyzer; transport of used dialyzer. (NRS 449.0302) 1. If a facility reuses any hemodialyzer in providing treatment to a patient of the facility, the facility shall: (a) Ensure that the reuse of the hemodialyzer is conducted in accordance with the provi…

NAC 449.528 Adoption of more stringent requirements for treatment of water and reuse of hemodialyzers. (NRS 449.0302) A facility may adopt more stringent requirements for the treatment of water and the reuse of hemodialyzers than the requirements set forth in NAC 449.525 to 449.5…

NAC 449.5285 Sanitation: Precautions regarding blood and bodily fluids. (NRS 449.0302) 1. Any activity relating to the care of a patient of a facility must be provided in accordance with the provisions of 29 C.F.R. § 1910.1030(d)(1)-(3), relating to bloodborne pathogens. 2. Each …

NAC 449.529 Sanitation: Control of infections; nonsmoking policy. (NRS 449.0302) 1. Each facility shall designate a person to monitor and coordinate the activities occurring at the facility concerning the control of infections at the facility. 2. Each facility shall develop and m…

NAC 449.5295 Sanitation: Provision of sanitary environment; walls, floors and ceilings; blood spills. (NRS 449.0302) 1. Each facility shall provide a sanitary environment that minimizes or prevents transmission of infectious diseases at the facility. 2. The base of each wall that…

NAC 449.531 Sanitation: Disinfection of dialysis machines; culturing dialysate; cleaning of machines and equipment; handling of waste. (NRS 449.0302) 1. Each facility shall periodically disinfect each active and backup dialysis machine in accordance with the policy of the facilit…

NAC 449.5315 Hepatitis B: Vaccinations for certain staff members; postvaccination screening; adoption of related provisions. (NRS 449.0302) 1. If any member of the staff of a facility is susceptible to hepatitis B and has not been vaccinated for that disease, the facility shall o…

NAC 449.532 Hepatitis B: Vaccinations for certain patients. (NRS 449.0302) 1. If advised by and with the consent of a patient’s attending nephrologist, each facility shall offer hepatitis B vaccine to each patient who is susceptible to hepatitis B. 2. Each facility shall, upon re…

NAC 449.5325 Hepatitis B surface antigen: Screening of patients; additional serologic screening. (NRS 449.0302) 1. Each candidate for dialysis at a facility must, if practicable, be screened for the hepatitis B surface antigen before being admitted to the facility. The screening …

NAC 449.534 Hepatitis B surface antigen: Treatment of patients who test positive. (NRS 449.0302) 1. If a patient of a facility tests positive for the hepatitis B surface antigen, the facility shall provide treatment for the patient: (a) On a machine that is dedicated for patients…

NAC 449.5345 Tuberculosis: Screening of staff and patients. (NRS 449.0302) 1. A facility shall screen each member of the staff of the facility to determine whether the member has tuberculosis. The facility shall screen each member of the staff: (a) Upon commencement of employment…

NAC 449.540 Program of quality assurance; recordation of accidents and incidents; reporting of certain events. (NRS 449.0302) 1. Each facility shall: (a) Conduct a systematic and comprehensive review of the facility and the care provided to each patient of the facility; and (b) A…

NAC 449.5405 Rights of patients. (NRS 449.0302) 1. In addition to the requirements set forth in NRS 449A.100 to 449A.118, inclusive, each facility shall adopt and comply with a policy which ensures that each patient of the facility is: (a) Treated with respect, dignity and comple…

NAC 449.541 Interdisciplinary teams; plans for care of patients. (NRS 449.0302) 1. Each facility shall establish and comply with a policy which specifies that the services provided to each patient of the facility are coordinated using an interdisciplinary team. The interdisciplin…

NAC 449.5415 Preparations for emergencies and disasters. (NRS 449.0302) 1. Each facility shall adopt a written procedure to be followed by each patient and member of the staff of the facility if any emergency occurs at the facility, including, without limitation, any fire, equipm…

NAC 449.543 Pharmaceutical services. (NRS 449.0302) 1. Each facility shall provide pharmaceutical services in accordance with accepted professional principles and any applicable federal and state statutes and regulations. 2. Medication may be administered to a patient of a facili…

NAC 449.5435 Nursing services; physicians and other staff. (NRS 449.0302) 1. Each facility shall provide nursing services to each patient of the facility to prevent or reduce complications and to maximize the functional status of the patient. 2. Each facility shall employ a full-…

NAC 449.544 Nutrition services. (NRS 439.200, 449.0302, 449.1915) 1. Each facility shall provide nutrition services to each patient of the facility and the provider of care for that patient to maximize the nutritional status of the patient. 2. The licensed dietitian for a patient…

NAC 449.5445 Social services. (NRS 449.0302) 1. Each facility shall provide social services to each patient of the facility and to the provider of care for the patient, if required. The facility shall ensure that the social services support and maximize the adjustment, social fun…

NAC 449.546 Patient care: Advanced practice registered nurses and physician assistants; medical emergencies. (NRS 449.0302) 1. If an advanced practice registered nurse or a physician assistant provides treatment for a patient of a facility, the facility shall ensure that there is…

NAC 449.5465 Patient care: Licensed practical nurses and dialysis technicians. (NRS 449.0302) 1. The provisions of NAC 449.501 to 449.5795, inclusive, do not prohibit a licensed practical nurse from practicing in accordance with the regulations adopted by the State Board of Nursi…

NAC 449.547 Self-dialysis: Provision of training and certain services. (NRS 449.0302) 1. If a facility provides training to a patient of the facility concerning the performance of dialysis by the patient, a licensed nurse who has at least 12 months of experience in the applicable…

NAC 449.5475 Continuous ambulatory peritoneal dialysis. (NRS 449.0302) If a facility provides continuous ambulatory peritoneal dialysis for a patient of the facility, the facility shall provide the following services to the patient: 1. Consultation with a registered nurse, social…

NAC 449.549 Continuous cycling peritoneal dialysis. (NRS 449.0302) If a facility provides continuous cycling peritoneal dialysis to a patient of the facility, the facility shall provide the following services to the patient: 1. Surveillance of the patient’s home adaptation, inclu…

NAC 449.5495 Patient services by contract; laboratory. (NRS 449.0302) 1. If a facility provides services to a patient of the facility by contract, the facility remains responsible for supervising the treatment of the patient and providing adequate care for the patient in accordan…

NAC 449.550 Governing body. (NRS 449.0302) 1. Each facility shall establish a governing body that is legally responsible for developing and carrying out the policies of the facility regarding the management and operation of the facility. 2. The policies established and carried ou…

NAC 449.5505 Medical director. (NRS 449.0302) 1. The medical director of a facility: (a) Must be certified in nephrology or pediatric nephrology or be eligible for that certification by a board that is approved by the American Medical Association; or (b) During the 5 years immedi…

NAC 449.552 Physicians. (NRS 449.0302) 1. Each patient of a facility must be under the care of a physician who is a member of the medical staff of the facility. 2. If a patient of the facility receives pediatric dialysis at the facility, the treatment provided to the patient must…

NAC 449.5525 Orientation program for new employees; continuing education. (NRS 449.0302) 1. Each facility shall develop and carry out a program to orient and familiarize each new employee of the facility with: (a) The policies and operation of the facility; and (b) The responsibi…

NAC 449.553 Medical staff: Generally. (NRS 449.0302) 1. Each physician who is a member of the medical staff of a facility must be licensed to practice medicine in this State. 2. The membership of the medical staff of a facility may include a nephrologist or any other physician wh…