REQUIRES TWO-THIRDS MAJORITY VOTE
(§ 2 & NRS 439.150)
A.B. 326
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ASSEMBLY BILL NO. 326–ASSEMBLYMEMBERS
KOENIG; COLE AND TORRES-FOSSETT
MARCH 3, 2025
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Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to the designation of
hospitals as centers for the treatment of trauma.
(BDR 40-153)
FISCAL NOTE: Effect on Local Government: May have Fiscal Impact.
Effect on the State: Yes.
CONTAINS UNFUNDED MANDATE (§ 2)
(NOT REQUESTED BY AFFECTED LOCAL GOVERNMENT)
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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to health care; requiring the State Board of Health
to adopt regulations establishing the designation of
centers for the treatment of trauma as level I, II, III or IV;
authorizing the State Board to adopt regulations
establishing additional designations; requiring approval
before a center for the treatment of trauma increases its
designated level; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing law requires that before operating a center for the treatment of trauma, 1
a hospital must obtain the approval of the Administrator of the Division of Public 2
and Behavioral Health of the Department of Health and Human Services and, if the 3
hospital is located in a county whose population is 700,000 or more (currently only 4
Clark County), the district board of health. (NRS 450B.236, 450B.237) Existing 5
law also requires the Administrator to verify that a hospital meets certain standards 6
and complete a comprehensive assessment of needs before approving a proposal to 7
designate a hospital as a center for the treatment of trauma. (NRS 450B.237) 8
Existing regulations authorize the Administrator to designate a center for the 9
treatment of trauma as level I, II or III. (NAC 450B.780-450B.875) Section 2 of 10
this bill incorporates those designations into existing law and additionally 11
authorizes the designation of a critical access hospital as a level IV center for the 12
treatment of trauma. Section 2 additionally requires a hospital that wishes to 13
increase the level of treatment provided by an existing center for the treatment of 14
trauma to submit to a similar application and approval process as a hospital 15
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applying for initial designation as a center for the treatment of trauma. Section 1 of 16
this bill prohibits the operator of a center for the treatment of trauma from 17
representing that the center for the treatment of trauma provides a level of treatment 18
unless the center has been designated by the Administrator to provide that level of 19
treatment. 20
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 450B.236 is hereby amended to read as 1
follows: 2
450B.236 A person shall not [operate] : 3
1. Operate a center for the treatment of trauma without first 4
applying for and obtaining the written approval of the Administrator 5
of the Division. 6
2. Represent that a center for the treatment of trauma 7
operated by the person provides a level of treatment unless the 8
center for the treatment of trauma has been designated by the 9
Administrator of the Division to provide that level of treatment. 10
Sec. 2. NRS 450B.237 is hereby amended to read as follows: 11
450B.237 1. The board shall establish a program for treating 12
persons who require treatment for trauma and for transporting and 13
admitting such persons to centers for the treatment of trauma. The 14
program must provide for the development, operation and 15
maintenance of a system of communication to be used in 16
transporting such persons to the appropriate centers. 17
2. The State Board of Health shall adopt regulations which 18
establish the standards for the designation of hospitals as centers for 19
the treatment of trauma. The State Board of Health shall consider 20
the standards adopted by the American College of Surgeons for a 21
center for the treatment of trauma as a guide for such regulations. 22
The regulations must: 23
(a) Provide for the designation of centers for the treatment of 24
trauma as level I, II, III and IV and may establish additional 25
designations. 26
(b) Limit the designation of level IV to critical access hospitals. 27
3. The Administrator of the Division shall not approve a 28
proposal to designate a hospital as a center for the treatment of 29
trauma or to increase the level of the designation of an existing 30
center for the treatment of trauma unless: 31
(a) The hospital meets the applicable standards established 32
pursuant to this subsection; and 33
(b) The Administrator determines, after conducting a 34
comprehensive assessment of needs, that the proposed center for the 35
treatment of trauma or the existing center for the treatment of 36
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trauma which proposes to increase the level of its designation, as 1
applicable, will operate in an area that is experiencing a shortage of 2
trauma care. Such an assessment of needs must include, without 3
limitation, consideration of: 4
(1) The impact of the proposed center for the treatment of 5
trauma or the increase in the level of treatment provided by the 6
existing center of the treatment of trauma, as applicable, on the 7
capacity of existing hospitals to provide for the treatment of trauma; 8
(2) The number and locations of cases of trauma that have 9
occurred during the previous 5 calendar years in the county in which 10
the proposed center for the treatment of trauma will be located or in 11
which the existing center for the treatment of trauma is located, as 12
applicable, and the level of treatment that was required for those 13
cases; 14
(3) Any identified need for an additional center for the 15
treatment of trauma or an increase in the level of treatment 16
provided by the existing center for the treatment of trauma, as 17
applicable, in the county in which the proposed center for the 18
treatment of trauma will be located [;] or in which the existing 19
center for the treatment of trauma is located, as applicable; and 20
(4) Any additional criteria recommended by the American 21
College of Surgeons or its successor organization, other than criteria 22
related to community support for the proposed or existing trauma 23
center. 24
[3.] 4. Each district board of health in a county whose 25
population is 700,000 or more shall adopt: 26
(a) Regulations which establish the standards for the designation 27
of hospitals in the county as centers for the treatment of trauma 28
which are consistent with the regulations adopted by the State Board 29
of Health pursuant to subsection 2; and 30
(b) A plan for a comprehensive trauma system concerning the 31
treatment of trauma in the county, which includes, without 32
limitation, consideration of the future trauma needs of the county, 33
consideration of and plans for the development and designation of 34
new centers for the treatment of trauma in the county based on the 35
demographics of the county and the manner in which the county 36
may most effectively provide trauma services to persons in the 37
county. 38
[4.] 5. A district board of health in a county whose population 39
is 700,000 or more shall not approve a proposal to designate a 40
hospital as a center for the treatment of trauma or to increase the 41
level of the designation of an existing center of the treatment of 42
trauma unless: 43
(a) The hospital meets the standards established pursuant to 44
subsection [3;] 4; 45
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(b) The proposal has been approved by the Administrator of the 1
Division pursuant to subsection [2;] 3; and 2
(c) The district board of health concludes, based on the plan 3
adopted pursuant to paragraph (b) of subsection [3,] 4, that the 4
proposed center for the treatment of trauma or the proposed 5
increase in the level of treatment provided by the existing center 6
for the treatment of trauma, as applicable, will not negatively 7
impact the capacity of existing centers for the treatment of trauma in 8
the county. 9
[5.] 6. Upon approval by the Administrator of the Division 10
and, if the hospital is located in a county whose population is 11
700,000 or more, the district board of health of the county in which 12
the hospital is located, of a proposal to designate a hospital as a 13
center for the treatment of trauma, the Administrator of the Division 14
shall issue written approval which designates the hospital as such a 15
center. As a condition of continuing designation of the hospital as a 16
center for the treatment of trauma, the hospital must comply with 17
the following requirements: 18
(a) The hospital must admit any injured person who requires 19
medical care. 20
(b) Any physician who provides treatment for trauma must be 21
qualified to provide that treatment. 22
(c) The hospital must maintain the standards specified in the 23
regulations adopted pursuant to subsections 2 and [3.] 4. 24
7. As used in this section, “critical access hospital” means a 25
hospital which has been certified as a critical access hospital by 26
the Secretary of Health and Human Services pursuant to 42 27
U.S.C. 1395i-4(e). 28
Sec. 3. The provisions of NRS 354.599 do not apply to any 29
additional expenses of a local government that are related to the 30
provisions of this act. 31
Sec. 4. 1. This section and section 3 of this act become 32
effective upon passage and approval. 33
2. Sections 1 and 2 of this act become effective: 34
(a) Upon passage and approval for the purpose of adopting any 35
regulations and performing any other preparatory administrative 36
tasks that are necessary to carry out the provisions of this act; and 37
(b) On January 1, 2026, for all other purposes. 38
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