A.B. 368
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ASSEMBLY BILL NO. 368–ASSEMBLYMEMBER CARTER
MARCH 6, 2025
____________
Referred to Committee on Health and Human Services
SUMMARY—Revises provisions governing electronic
communication devices in certain health care
facilities. (BDR 40-878)
FISCAL NOTE: Effect on Local Government: Increases or Newly
Provides for Term of Imprisonment in County or City
Jail or Detention Facility.
Effect on the State: No.
~
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
AN ACT relating to health care; authorizing a patient in any of
certain facilities for assisted living or his or her
representative to request the installation and use of an
electronic communication device in the living quarters of
the patient; prohibiting such a facility or an employee of
such a facility from taking certain additional actions;
providing penalties; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing law authorizes a patient in a facility for skilled nursing or the 1
representative of the patient to request the installation and use of an electronic 2
communication device in the living quarters of the patient. Existing law requires 3
any roommate of the patient to consent before such a device may be installed. 4
However, if the roommate of a patient refuses to consent, existing law requires the 5
facility for skilled nursing to make reasonable attempts to accommodate the patient, 6
including by moving either the patient or the roommate with the consent of the 7
person being moved. (NRS 449A.182) If a facility for skilled nursing approves a 8
request to install an electronic communication device, existing law provides that the 9
patient or the representative of the patient who submitted the request is responsible 10
for choosing the device and paying certain costs associated with the device. (NRS 11
449A.184) Existing law limits the persons who are authorized to view or listen to 12
the images or sounds which are displayed, broadcast or recorded by an electronic 13
communication device or temporarily disable or turn off an electronic 14
communication device. Existing law also prohibits a facility for skilled nursing 15
from discriminating or retaliating against a patient because of a decision to request 16
the installation and use of an electronic communication device. (NRS 449A.186) 17
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Existing law establishes civil and criminal penalties that may be imposed against: 18
(1) a facility for skilled nursing which violates that prohibition; (2) a person, other 19
than the patient or the representative of the patient, who obstructs, tampers with or 20
destroys an electronic communication device or any recording made by an 21
electronic communication device; or (3) a person who views or listens to images or 22
sounds which are displayed, broadcast or recorded by an electronic communication 23
device without authorization. (NRS 449A.189, 449A.188) Existing law requires a 24
facility for skilled nursing to post a notice in a conspicuous place at the entrance to 25
the living quarters of a patient which contains an electronic communication device 26
stating that such a device is in that living quarters. Existing law prohibits an 27
employee of a facility for skilled nursing from refusing to enter into the living 28
quarters of a patient which contains an electronic communication device or failing 29
to perform his or her duties because such a device is in use. (NRS 449A.190) 30
Existing law: (1) authorizes the State Board of Health to adopt regulations 31
governing electronic communication devices in facilities for skilled nursing; and 32
(2) provides that the provisions governing such electronic communication devices 33
do not apply to certain devices installed by a law enforcement agency. 34
(NRS 449A.192) 35
Sections 8-14 of this bill broaden the applicability of those provisions to 36
authorize a patient in any facility for assisted living to install an electronic 37
communication device under the same conditions as existing law establishes for a 38
patient in a facility for skilled nursing. Section 3 of this bill defines the term 39
“facility for assisted living” to mean: (1) a facility for intermediate care; (2) a 40
facility for skilled nursing; (3) a home for individual residential care; (4) a unit for 41
the provision of long-term care in a hospital; (5) a residential facility for groups; (6) 42
assisted living services provided in a senior living community; or (7) a secure unit 43
in a medical facility for the provision of care to persons with dementia. Sections 4-44
6 of this bill define the terms “facility for intermediate care,” “home for individual 45
residential care” and “senior living community,” respectively, to have the meanings 46
ascribed to them in existing law. Section 7 of this bill establishes the applicability 47
of those definitions. Section 1 of this bill authorizes the Division of Public and 48
Behavioral Health of the Department of Health and Human Services to deny an 49
application for a license for or suspend or revoke the license of a facility for 50
assisted living that fails to comply with provisions governing the installation and 51
use of electronic communication devices. 52
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 449.160 is hereby amended to read as follows: 1
449.160 1. The Division may deny an application for a 2
license or may suspend or revoke any license issued under the 3
provisions of NRS 449.029 to 449.2428, inclusive, upon any of the 4
following grounds: 5
(a) Violation by the applicant or the licensee of any of the 6
provisions of NRS 439B.410, 449.029 to 449.245, inclusive, or 7
449A.100 to 449A.124, inclusive, and 449A.270 to 449A.286, 8
inclusive, or of any other law of this State or of the standards, rules 9
and regulations adopted thereunder. 10
(b) Aiding, abetting or permitting the commission of any illegal 11
act. 12
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(c) Conduct inimical to the public health, morals, welfare and 1
safety of the people of the State of Nevada in the maintenance and 2
operation of the premises for which a license is issued. 3
(d) Conduct or practice detrimental to the health or safety of the 4
occupants or employees of the facility. 5
(e) Failure of the applicant to obtain written approval from the 6
Director of the Department of Health and Human Services as 7
required by NRS 439A.100 or 439A.102 or as provided in any 8
regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, 9
and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such 10
approval is required, including, without limitation, the closure or 11
conversion of any hospital in a county whose population is 100,000 12
or more that is owned by the licensee without approval pursuant to 13
NRS 439A.102. 14
(f) Failure to comply with the provisions of NRS 441A.315 and 15
any regulations adopted pursuant thereto or NRS 449.2486. 16
(g) Violation of the provisions of NRS 458.112. 17
(h) Failure to comply with the provisions of NRS 449A.170 to 18
449A.192, inclusive, and sections 3 to 6, inclusive, of this act and 19
any regulation adopted pursuant thereto. 20
(i) Violation of the provisions of NRS 629.260. 21
2. In addition to the provisions of subsection 1, the Division 22
may revoke a license to operate a facility for the dependent if, with 23
respect to that facility, the licensee that operates the facility, or an 24
agent or employee of the licensee: 25
(a) Is convicted of violating any of the provisions of 26
NRS 202.470; 27
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 28
244.360, 244.3603 or 268.4124; or 29
(c) Is ordered by the appropriate governmental agency to correct 30
a violation of a building, safety or health code or regulation but fails 31
to correct the violation. 32
3. The Division shall maintain a log of any complaints that it 33
receives relating to activities for which the Division may revoke the 34
license to operate a facility for the dependent pursuant to subsection 35
2. The Division shall provide to a facility for the care of adults 36
during the day: 37
(a) A summary of a complaint against the facility if the 38
investigation of the complaint by the Division either substantiates 39
the complaint or is inconclusive; 40
(b) A report of any investigation conducted with respect to the 41
complaint; and 42
(c) A report of any disciplinary action taken against the facility. 43
The facility shall make the information available to the public 44
pursuant to NRS 449.2486. 45
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4. On or before February 1 of each odd-numbered year, the 1
Division shall submit to the Director of the Legislative Counsel 2
Bureau a written report setting forth, for the previous biennium: 3
(a) Any complaints included in the log maintained by the 4
Division pursuant to subsection 3; and 5
(b) Any disciplinary actions taken by the Division pursuant to 6
subsection 2. 7
Sec. 2. Chapter 449A of NRS is hereby amended by adding 8
thereto the provisions set forth as sections 3 to 6, inclusive, of this 9
act. 10
Sec. 3. “Facility for assisted living” means: 11
1. A facility for intermediate care; 12
2. A facility for skilled nursing; 13
3. A home for individual residential care; 14
4. A unit for the provision of long-term care in a hospital; 15
5. A residential facility for groups; 16
6. A unit in a senior living community for the provision of 17
assisted living services or a senior living community that provides 18
only assisted living services; or 19
7. A secure unit in a medical facility for the provision of care 20
to persons with dementia. 21
Sec. 4. “Facility for intermediate care” has the meaning 22
ascribed to it in NRS 449.0038. 23
Sec. 5. “Home for individual residential care” has the 24
meaning ascribed to it in NRS 449.0105. 25
Sec. 6. “Senior living community” has the meaning ascribed 26
to it in NRS 449.0179. 27
Sec. 7. NRS 449A.170 is hereby amended to read as follows: 28
449A.170 As used in NRS 449A.170 to 449A.192, inclusive, 29
and sections 3 to 6, inclusive, of this act, unless the context 30
otherwise requires, the words and terms defined in NRS 449A.172 31
to 449A.178, inclusive, and sections 3 to 6, inclusive, of this act 32
have the meanings ascribed to them in those sections. 33
Sec. 8. NRS 449A.180 is hereby amended to read as follows: 34
449A.180 A person may serve as the representative of a patient 35
in a facility for [skilled nursing,] assisted living, including, without 36
limitation, a patient who is the roommate of a patient who wishes to 37
submit or has submitted a request pursuant to NRS 449A.182, for 38
the purposes of NRS 449A.170 to 449A.192, inclusive, and sections 39
3 to 6, inclusive, of this act, if the person: 40
1. Is the guardian of the patient whom he or she is representing 41
and: 42
(a) The power to make decisions on behalf of the patient 43
pursuant to NRS 449A.170 to 449A.192, inclusive, and sections 3 44
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to 6, inclusive, of this act is specifically authorized under the 1
existing guardianship; or 2
(b) The guardian has separately petitioned for and been granted 3
such power by the court that has jurisdiction over the guardianship; 4
or 5
2. Has been given power of attorney to make decisions 6
concerning health care for the patient pursuant to NRS 162A.700 to 7
162A.870, inclusive, and the power to make decisions on behalf of 8
the patient pursuant to NRS 449A.170 to 449A.192, inclusive, and 9
sections 3 to 6, inclusive, of this act is specifically delegated to the 10
person in the power of attorney. 11
Sec. 9. NRS 449A.182 is hereby amended to read as follows: 12
449A.182 1. A patient in a facility for [skilled nursing] 13
assisted living or the representative of the patient may request the 14
installation and use of an electronic communication device in the 15
living quarters of the patient by submitting to the facility for [skilled 16
nursing:] assisted living: 17
(a) A completed form prescribed by the facility pursuant to 18
subsection 3; or 19
(b) If the facility has not prescribed a form pursuant to 20
subsection 3, a written request that meets the requirements of 21
subsection 2. 22
2. A request submitted pursuant to subsection 1 must include 23
or be accompanied by: 24
(a) Information regarding the type, function and expected use of 25
the electronic communication device which will be installed and 26
used; 27
(b) The name and contact information for any person other than 28
the patient or his or her representative who is authorized to view or 29
listen to the images or sounds which are displayed, broadcast or 30
recorded by the electronic communication device pursuant to 31
subsection 3 of NRS 449A.186; 32
(c) An agreement by the patient or the representative of the 33
patient to, except as otherwise provided by NRS 449A.186: 34
(1) Waive the patient’s right to privacy in connection with 35
use of the electronic communication device; and 36
(2) Release the facility for [skilled nursing] assisted living 37
and any employee of the facility from any administrative, civil or 38
criminal liability for a violation of the patient’s right to privacy in 39
connection with use of the electronic communication device; 40
(d) If the patient has a roommate: 41
(1) The written consent of the roommate or the representative 42
of the roommate to the installation and use of an electronic 43
communication device in the living quarters of the patient; and 44
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(2) An agreement by the roommate or the representative of 1
the roommate to, except as otherwise provided in NRS 449A.186: 2
(I) Waive the roommate’s right to privacy in connection 3
with use of the electronic communication device; and 4
(II) Release the facility for [skilled nursing] assisted 5
living and any employee of the facility from any administrative, 6
civil or criminal liability for a violation of the roommate’s right to 7
privacy in connection with the use of the electronic communication 8
device; and 9
(e) If the request is submitted by the representative of the 10
patient, proof that the representative of the patient meets the 11
requirements of NRS 449A.180. 12
3. A facility for [skilled nursing] assisted living may prescribe 13
a form for use by a patient or the representative of a patient to 14
request to install and use an electronic communication device in the 15
living quarters of the patient. To the extent practicable, such a form 16
must be provided in a language chosen by the patient or the 17
representative of the patient. Such a form must include, without 18
limitation: 19
(a) An explanation of the provisions of NRS 449A.170 to 20
449A.192, inclusive [;] , and sections 3 to 6, inclusive, of this act; 21
and 22
(b) Places to record the information, agreements and consent 23
described in paragraphs (a) to (d), inclusive, of subsection 2. 24
4. A facility for [skilled nursing] assisted living shall approve a 25
request by a patient or the representative of a patient pursuant to this 26
section if the request meets the requirements of this section. 27
5. If the roommate or the representative of the roommate of a 28
patient who wishes to submit a request pursuant to subsection 1, or 29
whose representative wishes to submit such a request, refuses to 30
provide consent and enter into the agreement required by paragraph 31
(d) of subsection 2, the facility for [skilled nursing] assisted living 32
shall make reasonable attempts to accommodate the patient. Such 33
reasonable attempts may include, without limitation, moving either 34
the patient or his or her roommate to different living quarters with 35
the consent of the person being moved or his or her representative. 36
6. A patient or the representative of a patient who has 37
submitted a request pursuant to subsection 1, a roommate who has 38
provided consent pursuant to paragraph (d) of subsection 2 or the 39
representative of such a roommate may withdraw the request or 40
consent at any time, including, without limitation, after the request 41
has been approved or after an electronic communication device has 42
been installed, by submitting a written revocation to the facility for 43
[skilled nursing.] assisted living. Not later than 24 hours after the 44
submission of such a written revocation, the facility for [skilled 45
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nursing] assisted living shall cause the removal of any electronic 1
communication device that has been installed. 2
Sec. 10. NRS 449A.184 is hereby amended to read as follows: 3
449A.184 1. If a facility for [skilled nursing] assisted living 4
approves a request to install and use an electronic communication 5
device in the living quarters of a patient pursuant to NRS 449A.182, 6
the patient or the representative of the patient is solely responsible 7
for: 8
(a) Choosing the electronic communication device, subject to 9
the limitations prescribed by subsection 3; 10
(b) The cost of the electronic communication device; 11
(c) The cost of installing, maintaining and removing the 12
electronic communication device, if applicable, other than the cost 13
of electricity used to power the electronic communication device; 14
and 15
(d) The cost of any repairs required due to the installation or 16
removal of the device. 17
2. A patient who is discharged from a facility for [skilled 18
nursing] assisted living or the representative of such a patient 19
remains solely responsible for the costs described in subsection 1, 20
including, without limitation, such costs that are incurred after the 21
discharge of the patient. 22
3. An electronic communication device chosen by a patient or 23
the representative of a patient pursuant to subsection 1 must: 24
(a) Be capable of being temporarily disabled or turned on and 25
off; and 26
(b) If the device communicates using video or other visual 27
transmission, to the greatest extent practicable, be installed: 28
(1) With a fixed viewpoint of the living quarters; or 29
(2) In a manner that avoids capturing images of activities 30
such as bathing, dressing and toileting. 31
Sec. 11. NRS 449A.186 is hereby amended to read as follows: 32
449A.186 1. Except as otherwise provided in this section, a 33
person other than the patient or the representative of the patient who 34
has requested the installation and use of an electronic 35
communication device pursuant to NRS 449A.182 shall not 36
intentionally: 37
(a) Obstruct, tamper with or destroy the electronic 38
communication device or any recording made by the electronic 39
communication device; or 40
(b) View or listen to any images or sounds which are displayed, 41
broadcast or recorded by the electronic communication device. 42
2. The following persons may view or listen to the images or 43
sounds which are displayed, broadcast or recorded by an electronic 44
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communication device installed and used pursuant to NRS 1
449A.182 or temporarily disable or turn off such a device: 2
(a) A representative of a law enforcement agency who is 3
conducting an investigation; 4
(b) A representative of the Aging and Disability Services 5
Division or the Division of Public and Behavioral Health of the 6
Department of Health and Human Services who is conducting an 7
investigation; 8
(c) The State Long-Term Care Ombudsman; and 9
(d) An attorney who is representing the patient or a roommate of 10
the patient and acting within the scope of that representation. 11
3. A patient or the representative of the patient who has 12
requested the installation and use of an electronic communication 13
device pursuant to NRS 449A.182 may authorize a person other 14
than a person described in subsection 2 to view or listen to the 15
images or sounds which are displayed, broadcast or recorded by the 16
electronic communication device. Any such authorization must be 17
made in writing. The patient or representative, as applicable, may 18
provide a copy of the authorization to the facility and the roommate 19
of the patient or the representative of the roommate, if any. 20
4. A person who temporarily disables or turns off an electronic 21
communication device pursuant to subsection 2 shall ensure that the 22
functions of the electronic communication device are appropriately 23
enabled or turned back on before exiting the living quarters of the 24
patient. 25
5. A facility for [skilled nursing] assisted living shall not deny 26
admission to or discharge a patient from the facility or otherwise 27
discriminate or retaliate against a patient because of a decision to 28
request the installation and use of an electronic communication 29
device in the living quarters of the patient pursuant to 30
NRS 449A.182. 31
Sec. 12. NRS 449A.188 is hereby amended to read as follows: 32
449A.188 1. A natural person who violates subsection 1 of 33
NRS 449A.186: 34
(a) For a first offense, is liable for a civil penalty not to exceed 35
$5,000. 36
(b) For a second and any subsequent offense: 37
(1) Is liable for a civil penalty not to exceed $10,000 for each 38
violation; and 39
(2) Is guilty of a misdemeanor. 40
2. In addition to any disciplinary action imposed pursuant to 41
chapter 449 of NRS, a facility for [skilled nursing] assisted living or 42
any person, partnership, association or corporation establishing, 43
conducting, managing or operating a facility for [skilled nursing] 44
assisted living who violates subsection 1 or 5 of NRS 449A.186: 45
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(a) For a first offense, is liable for a civil penalty not to exceed 1
$10,000. 2
(b) For a second and any subsequent offense: 3
(1) Is liable for a civil penalty not to exceed $20,000 for each 4
violation; and 5
(2) Is guilty of a misdemeanor. 6
3. The Attorney General or any district attorney may recover 7
any civil penalty assessed pursuant to this section in a civil action 8
brought in the name of the State of Nevada in any court of 9
competent jurisdiction. 10
Sec. 13. NRS 449A.190 is hereby amended to read as follows: 11
449A.190 1. A facility for [skilled nursing] assisted living 12
shall post a notice in a conspicuous place at the entrance to the 13
living quarters of a patient which contains an electronic 14
communication device stating that such a device is in use in that 15
living quarters. 16
2. An employee of a facility of [skilled nursing] assisted living 17
shall not refuse to enter the living quarters of a patient which 18
contains an electronic communication device installed pursuant to 19
NRS 449A.182 or fail to perform any of the duties of the employee 20
on the grounds that such a device is in use. 21
Sec. 14. NRS 449A.192 is hereby amended to read as follows: 22
449A.192 1. The State Board of Health may adopt 23
regulations necessary to carry out the provisions of NRS 449A.170 24
to 449A.192, inclusive [.] , and sections 3 to 6, inclusive, of this 25
act. 26
2. The provisions of NRS 449A.170 to 449A.192, inclusive, 27
and sections 3 to 6, inclusive, of this act, do not apply if an 28
electronic communication device is installed by a law enforcement 29
agency and used solely for a legitimate law enforcement purpose. 30
Sec. 15. 1. This section becomes effective upon passage and 31
approval. 32
2. Sections 1 to 14, inclusive, of this act become effective: 33
(a) Upon passage and approval for the purpose of adopting any 34
regulations and performing any other preparatory administrative 35
tasks that are necessary to carry out the provisions of this act; and 36
(b) On or before October 1, 2025, for all other purposes. 37
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