CHAPTER 449 - MEDICAL FACILITIES AND OTHER RELATED ENTITIES

NAC 449.74421 Procedures for emergency or disaster. (NRS 449.0302) 1. A facility for skilled nursing shall adopt written procedures to be followed by the members of the staff and patients in the case of an emergency or disaster, including, without limitation, fires, severe weathe…

NAC 449.74423 Certain conditions for admission prohibited. (NRS 449.0302) A facility for skilled nursing shall not, as a condition of admitting or providing for the expedited admission of a patient to, or allowing a patient to remain in, the facility: 1. Require a patient to waiv…

NAC 449.74425 Admission of patient with mental illness or an intellectual disability. (NRS 449.0302) 1. On or after September 27, 1999, a facility for skilled nursing shall not admit a patient with a mental illness or with an intellectual disability unless the Division has determ…

NAC 449.74427 Agreement with hospital for transfer of patients. (NRS 449.0302) 1. A facility for skilled nursing shall have in effect an agreement with at least one licensed hospital that provides for the transfer of patients from the facility to the hospital. The agreement must …

NAC 449.74429 Transfer or discharge of patient. (NRS 449.0302) 1. A facility for skilled nursing may transfer or discharge a patient from the facility only if: (a) The facility can no longer provide for the needs of the patient and the transfer or discharge is necessary for the p…

NAC 449.74431 Summary of discharge. (NRS 449.0302) 1. A facility for skilled nursing shall prepare a summary of discharge for each patient discharged from the facility. 2. A summary of discharge must include: (a) A summary of the pertinent information relating to the patient’s st…

NAC 449.74433 Comprehensive assessment of needs of patient. (NRS 449.0302) 1. A facility for skilled nursing shall conduct a comprehensive assessment of the needs of each patient in the facility using the assessment instrument specified by the Bureau. 2. A comprehensive assessmen…

NAC 449.74435 Quarterly assessment of patient. (NRS 449.0302) 1. A facility for skilled nursing shall, not less than every 3 months, conduct an assessment of each patient in the facility using the quarterly assessment instrument approved by the Bureau. 2. Each quarterly assessmen…

NAC 449.74437 Conduct of assessments. (NRS 449.0302) 1. The assessments required by NAC 449.74433 and 449.74435 must be conducted by a registered nurse or coordinated by a registered nurse with the participation of other appropriate health care professionals. Each person who comp…

NAC 449.74439 Comprehensive plan of care. (NRS 449.0302) 1. A facility for skilled nursing shall develop for each patient in the facility a comprehensive plan of care. 2. A comprehensive plan of care must include: (a) Measurable objectives and timetables to meet the physical, men…

NAC 449.74441 Maintenance. (NRS 449.0302) 1. A facility for skilled nursing shall maintain medical records for each patient in the facility in accordance with accepted professional principles. 2. A medical record must be: (a) Complete; (b) Accurate; (c) Organized; and (d) Readily…

NAC 449.74443 Inspection. (NRS 449.0302) 1. A patient in a facility for skilled nursing or his or her legal representative may submit an oral or written request to the facility to inspect all records relating to the patient maintained by the facility. The facility shall, within 2…

NAC 449.74445 Generally. (NRS 449.0302) 1. A facility for skilled nursing shall protect and promote the rights of each patient in the facility. 2. In addition to the rights set forth in NRS 449A.106 and 449A.112, a patient in a skilled nursing facility has the right to: (a) Recei…

NAC 449.74447 Communications with other persons; examination of records by advocate. (NRS 449.0302) 1. A facility for skilled nursing shall not prohibit a patient in the facility from contacting, receiving information from or speaking to: (a) A representative of the Bureau. (b) T…

NAC 449.74449 Notice to patients of rights, services and charges. (NRS 449.0302) 1. A facility for skilled nursing shall give notice to each patient admitted to the facility of: (a) His or her rights as a patient and of the policies of the facility relating to the conduct and res…

NAC 449.74451 Charges to be consistent with notice of charges. (NRS 449.0302) Any amount charged for services provided by a facility for skilled nursing must be consistent with the notice of charges provided by the facility pursuant to NAC 449.74449. (Added to NAC by Bd. of Healt…

NAC 449.74453 Notice to patients of programs available for assistance in payment of services. (NRS 449.0302) A facility for skilled nursing shall: 1. Provide to applicants for admission to the facility and to the patients in the facility oral and written information concerning st…

NAC 449.74457 Policies and procedures for advance directives by patient; information to be furnished regarding physicians. (NRS 449.0302) 1. A facility for skilled nursing shall adopt written policies and procedures authorizing the patients in the facility to establish advance di…

NAC 449.74459 Examination by patient of survey of facility and plan of correction. (NRS 449.0302) 1. A patient of a facility for skilled nursing may examine the results of the most recent survey of the facility conducted by the Bureau or a federal regulatory agency and any plan o…

NAC 449.74461 Finances of patient: System for maintenance and accounting. (NRS 449.0302) 1. A facility for skilled nursing: (a) Shall not require a patient to deposit any amount of money with the facility to be held by the facility on behalf of the patient. (b) Shall hold, safegu…

NAC 449.74463 Finances of patient: Authorization to withhold money. (NRS 449.0302) 1. A facility for skilled nursing shall not withhold from money held by the facility on behalf of a patient any amount for: (a) Services related to the maintenance of the patient’s room or bed; (b)…

NAC 449.74465 Sending and receiving mail. (NRS 449.0302) A facility for skilled nursing shall not prohibit a patient in the facility from: 1. Sending and promptly receiving mail. A patient’s mail must not be opened by the facility. 2. Obtaining stationery, postage and writing ins…

NAC 449.74467 Performance of services for facility by patient. (NRS 449.0302) 1. A facility for skilled nursing shall not require a patient in the facility to perform services for the facility. 2. A patient may perform services for the facility only if: (a) The facility has inclu…

NAC 449.74469 Standards of care. (NRS 449.0302) A facility for skilled nursing shall provide to each patient in the facility the services and treatment that are necessary to attain and maintain the patient’s highest practicable physical, mental and psychosocial well-being, in acc…

NAC 449.74471 Administration of drugs. (NRS 449.0302) 1. A facility for skilled nursing shall not administer a drug to a patient in the facility: (a) In excessive doses, including duplicate drug therapy; (b) For an excessive duration; (c) Without monitoring the patient properly; …

NAC 449.74473 Program for control of infections. (NRS 449.0302) 1. A facility for skilled nursing shall establish and maintain a program for the control of infections within the facility. 2. The program must: (a) Be designed to provide a safe, sanitary and comfortable environment…

NAC 449.74475 Vision and hearing. (NRS 449.0302) A facility for skilled nursing shall: 1. Ensure that each patient in the facility receives proper treatment and devices for his or her vision and hearing. 2. Assist a patient, if necessary, in making appointments for the treatment …

NAC 449.74477 Pressure sores. (NRS 449.0302) Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that a patient: 1. Who is admitted to the facility without pressure sores does not develop pressure sor…

NAC 449.74479 Urinary problems. (NRS 449.0302) Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that a patient: 1. Who is admitted to the facility without an indwelling catheter is not required to …

NAC 449.74481 Range of motion. (NRS 449.0302) Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that: 1. The range of motion of a patient admitted to the facility is not reduced unless the reduction…

NAC 449.74483 Mental or psychosocial behavior. (NRS 449.0302) Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that a patient: 1. Who is having difficulty adjusting to his or her environment and is…

NAC 449.74485 Nasogastric tubes. (NRS 449.0302) Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that a patient who is: 1. Able to feed himself or herself with or without assistance is not fed with…

NAC 449.74487 Nutritional health; hydration. (NRS 449.0302) 1. Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that: (a) The nutritional health of the patient is maintained, including, without lim…

NAC 449.74489 Physical or chemical restraint of patients. (NRS 449.0302) 1. A facility for skilled nursing shall not use physical or chemical restraints on a patient to discipline the patient or for the convenience of members of the staff. 2. Physical or chemical restraints may b…

NAC 449.74491 Prohibition of certain practices regarding patients; investigation of certain violations and injuries to patients; unfit employees. (NRS 449.0302) 1. A facility for skilled nursing shall adopt and carry out written policies and procedures that prohibit: (a) The mist…

NAC 449.74493 Notification of changes or condition of patient. (NRS 449.0302) 1. A facility for skilled nursing shall immediately notify a patient, the patient’s legal representative or an interested member of the patient’s family, if known, and, if appropriate, the patient’s phy…

NAC 449.74495 Development of program of activities. (NRS 449.0302) 1. A facility for skilled nursing shall provide for each patient in the facility a program of activities that is developed in accordance with the comprehensive assessment of the patient conducted pursuant to NAC 4…

NAC 449.74497 Daily activities of patient. (NRS 449.0302) 1. Based on the comprehensive assessment of a patient conducted pursuant to NAC 449.74433, a facility for skilled nursing shall ensure that: (a) The patient’s ability to carry out his or her daily activities does not dimin…

NAC 449.74499 Participation in activities. (NRS 449.0302) 1. A facility for skilled nursing shall not prohibit a patient in the facility from: (a) Participating in activities and maintaining a schedule that are consistent with the patient’s interests, assessments and plan of care…

NAC 449.74511 Personnel policies; personnel records. (NRS 449.0302) 1. A facility for skilled nursing shall adopt written policies for the personnel employed at the facility. 2. The written policies must: (a) Include the duties and responsibilities of, and the qualifications requ…

NAC 449.74513 Medical director. (NRS 449.0302) 1. A facility for skilled nursing shall employ a medical director who is licensed to practice medicine in this State. 2. The medical director shall: (a) Carry out the policies of the facility related to the medical care of its patien…

NAC 449.74515 Physicians. (NRS 449.0302) 1. A patient may be admitted to a facility for skilled nursing only upon the written approval of a physician. Upon a patient’s admission to the facility, the facility shall ensure that orders for the immediate care of the patient have been…

NAC 449.74517 Nursing staff. (NRS 449.0302) 1. A facility for skilled nursing shall ensure that there is a sufficient number of members of the nursing staff on duty at all times to provide nursing care to and attain and maintain the highest practicable physical, mental and psycho…

NAC 449.74519 Nursing assistants and nursing assistant trainees. (NRS 449.0302) 1. A facility for skilled nursing shall not employ a person as a nursing assistant trainee, full-time, temporarily or under contract: (a) Until the facility obtains from the training program required …

NAC 449.74521 Other health care professionals. (NRS 449.0302) 1. A facility for skilled nursing shall employ full-time, part-time or as consultants such health care professionals as are necessary to provide adequate care for each patient in the facility and to carry out the provi…

NAC 449.74522 Employees of facility which provides care to persons with dementia. (NRS 449.0302, 449.094) 1. Except as otherwise provided in subsection 4, each person who is employed by a facility for skilled nursing which provides care to persons with any form of dementia, inclu…

NAC 449.74523 Social services. (NRS 449.0302) 1. A facility for skilled nursing shall provide medically-related social services that are designed to assist the patients in the facility in enhancing or restoring their ability to function physically, socially and economically. 2. T…