A.B. 50
- *AB50*
ASSEMBLY BILL NO. 50–COMMITTEE
ON GOVERNMENT AFFAIRS
(ON BEHALF OF CLARK COUNTY)
PREFILED NOVEMBER 19, 2024
____________
Referred to Committee on Government Affairs
SUMMARY—Revises provisions relating to victims of a mass
casualty incident. (BDR 20-466)
FISCAL NOTE: Effect on Local Government: No.
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 public safety; authorizing a board of county
commissioners to establish an electronic database
containing information concerning victims of mass
casualty incidents; exempting certain persons from civil
liability related to such an electronic database, under
certain circumstances; providing for the confidentiality of
information contained in such an electronic database;
requiring a hospital and an independent center for
emergency medical care in a county in which such an
electronic database is established to report to the database
certain information concerning a victim of a mass
casualty incident; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Section 1 of this bill authorizes a board of county commissioners to establish 1
and maintain an electronic database containing information concerning victims of 2
mass casualty incidents to coordinate the provision of reunification and 3
identification services and other appropriate follow-up services for such victims. 4
Section 1 sets forth certain requirements for such an electronic database and 5
requires a board of county commissioners that establishes such an electronic 6
database to determine certain matters concerning the information contained in the 7
database, the reporting of certain information to the database and the persons and 8
governmental entities that may participate in the database. Under sections 1 and 2 9
of this bill, the information contained in the electronic database is confidential and 10
may be disclosed only by participants in the database for certain purposes. 11
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Section 1 grants a county in which the board of county commissioners has 12
established such an electronic database and the officers, employees and agents of 13
the county immunity from civil liability for any act or omission related to the 14
establishment or maintenance of the database not amounting to willful misconduct, 15
gross negligence or bad faith. 16
Existing law provides for the licensure and regulation of medical facilities, 17
including hospitals and independent centers for emergency medical care, by the 18
Division of Public and Behavioral Health of the Department of Health and Human 19
Services. (Chapter 449 of NRS) Section 3 of this bill requires a hospital or 20
independent center for emergency medical care located in a county in which an 21
electronic database is established pursuant to section 1 and which is notified or 22
becomes aware of a mass casualty incident to report to the database certain 23
information about a victim of the mass casualty incident. Section 3 grants a 24
hospital, an independent center for emergency medical care and their agents and 25
employees immunity from civil liability for any such report made in good faith and 26
for any unauthorized acquisition of the information reported that may occur after a 27
report was made by the hospital or independent center for emergency medical care 28
in accordance with the requirements of section 3. Sections 4-9 of this bill make 29
conforming changes to provide for the administration and enforcement of the 30
requirements of section 3 in the same manner as other requirements imposed on 31
hospitals and independent centers for emergency medical care by existing law. 32
(NRS 449.029, 449.0301, 449.0302, 449.160, 449.163, 449.240) 33
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 244 of NRS is hereby amended by adding 1
thereto a new section to read as follows: 2
1. A board of county commissioners may establish and 3
maintain an electronic database containing information 4
concerning victims of mass casualty incidents to coordinate the 5
provision of reunification and identification services and other 6
appropriate follow-up services for such victims. 7
2. A board of county commissioners that establishes an 8
electronic database pursuant to subsection 1 shall determine: 9
(a) The information that must be contained in the electronic 10
database, which must include, without limitation, the information 11
reported by a hospital or an independent center for emergency 12
medical care pursuant to section 3 of this act. 13
(b) The form and manner in which a hospital or an 14
independent center for emergency medical care must report the 15
information required by section 3 of this act to the electronic 16
database, which must require the information to be reported in 17
such a form and in such a manner so as to protect the security of 18
the information. 19
(c) Each person or governmental entity that may participate in 20
the electronic database and the extent of that participation, 21
including, without limitation, whether the person or governmental 22
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entity may input information into the electronic database and the 1
type of information contained in the electronic database to which 2
the person or governmental entity has access. 3
3. Any information contained in an electronic database 4
established pursuant to subsection 1 is confidential and may only 5
be disclosed by a participant in the database as necessary for the 6
provision of reunification and identification services and other 7
appropriate follow-up services for victims of mass casualty 8
incidents. 9
4. An electronic database established pursuant to subsection 10
1 and the disclosure of information therefrom must comply with 11
the applicable provisions of the Health Insurance Portability and 12
Accountability Act of 1996, Public Law 104-191, as amended, and 13
the applicable regulations adopted pursuant thereto. 14
5. A county in which the board of county commissioners has 15
established an electronic database pursuant to subsection 1 and 16
any officer, employee or agent of the county are immune from 17
civil liability for any act or omission related to the establishment 18
or maintenance of the database not amounting to willful 19
misconduct, gross negligence or bad faith. 20
6. As used in this section: 21
(a) “Hospital” has the meaning ascribed to it in NRS 449.012. 22
(b) “Independent center for emergency medical care” has the 23
meaning ascribed to it in NRS 449.013. 24
(c) “Mass casualty incident” has the meaning ascribed to it in 25
NRS 616C.180. 26
Sec. 2. NRS 239.010 is hereby amended to read as follows: 27
239.010 1. Except as otherwise provided in this section and 28
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 29
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 30
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 31
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 32
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 33
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 34
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 35
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 36
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 37
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 38
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 39
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 40
176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 41
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 42
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 43
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 44
213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 45
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218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 1
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 2
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 3
239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 4
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 5
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 6
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 7
250.140, 250.145, 250.150, 268.095, 268.0978, 268.490, 268.910, 8
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 9
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 10
286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 11
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 12
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 13
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 14
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 15
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240, 16
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 17
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 18
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 19
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 20
388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 21
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 22
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 23
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 24
396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 25
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 26
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 27
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 28
432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 29
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 30
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 31
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 32
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 33
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 34
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 35
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 36
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 37
463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 38
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 39
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 40
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 41
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 42
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 43
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 44
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 45
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624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 1
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 2
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 3
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 4
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 5
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 6
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 7
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 8
639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 9
640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 10
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 11
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 12
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 13
642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 14
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 15
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 16
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 17
654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 18
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 19
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 20
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 21
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 22
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 23
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 24
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 25
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 26
696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 27
711.600, and section 1 of this act, sections 35, 38 and 41 of chapter 28
478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes 29
of Nevada 2013 and unless otherwise declared by law to be 30
confidential, all public books and public records of a governmental 31
entity must be open at all times during office hours to inspection by 32
any person, and may be fully copied or an abstract or memorandum 33
may be prepared from those public books and public records. Any 34
such copies, abstracts or memoranda may be used to supply the 35
general public with copies, abstracts or memoranda of the records or 36
may be used in any other way to the advantage of the governmental 37
entity or of the general public. This section does not supersede or in 38
any manner affect the federal laws governing copyrights or enlarge, 39
diminish or affect in any other manner the rights of a person in any 40
written book or record which is copyrighted pursuant to federal law. 41
2. A governmental entity may not reject a book or record 42
which is copyrighted solely because it is copyrighted. 43
3. A governmental entity that has legal custody or control of a 44
public book or record shall not deny a request made pursuant to 45
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subsection 1 to inspect or copy or receive a copy of a public book or 1
record on the basis that the requested public book or record contains 2
information that is confidential if the governmental entity can 3
redact, delete, conceal or separate, including, without limitation, 4
electronically, the confidential information from the information 5
included in the public book or record that is not otherwise 6
confidential. 7
4. If requested, a governmental entity shall provide a copy of a 8
public record in an electronic format by means of an electronic 9
medium. Nothing in this subsection requires a governmental entity 10
to provide a copy of a public record in an electronic format or by 11
means of an electronic medium if: 12
(a) The public record: 13
(1) Was not created or prepared in an electronic format; and 14
(2) Is not available in an electronic format; or 15
(b) Providing the public record in an electronic format or by 16
means of an electronic medium would: 17
(1) Give access to proprietary software; or 18
(2) Require the production of information that is confidential 19
and that cannot be redacted, deleted, concealed or separated from 20
information that is not otherwise confidential. 21
5. An officer, employee or agent of a governmental entity who 22
has legal custody or control of a public record: 23
(a) Shall not refuse to provide a copy of that public record in the 24
medium that is requested because the officer, employee or agent has 25
already prepared or would prefer to provide the copy in a different 26
medium. 27
(b) Except as otherwise provided in NRS 239.030, shall, upon 28
request, prepare the copy of the public record and shall not require 29
the person who has requested the copy to prepare the copy himself 30
or herself. 31
Sec. 3. Chapter 449 of NRS is hereby amended by adding 32
thereto a new section to read as follows: 33
1. Except as otherwise provided in subsection 2, if a hospital 34
or an independent center for emergency medical care is located in 35
a county in which the board of county commissioners has 36
established an electronic database pursuant to section 1 of this act 37
and is notified or otherwise becomes aware of a mass casualty 38
incident, the hospital or independent center for emergency 39
medical care shall, not later than 4 hours after receiving and 40
registering a victim of the mass casualty incident as a patient at 41
the hospital or independent center for emergency medical care, 42
report to the electronic database the following information 43
concerning the victim in the form and manner determined by the 44
board of county commissioners: 45
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(a) The name of the victim, if known. 1
(b) The date of birth of the victim, if known. 2
(c) The contact information of the victim, if known. 3
(d) Any identifying physical characteristics of the victim. 4
2. If an unforeseen circumstance prevents a hospital or an 5
independent center for emergency medical care from reporting to 6
the electronic database the information concerning a victim of a 7
mass casualty incident specified in subsection 1 within the time 8
required by subsection 1, the hospital or independent center for 9
emergency medical care must report the information to the 10
electronic database, in the form and manner determined by the 11
board of county commissioners, as soon as reasonably possible, 12
but in no event later than 12 hours after receiving and registering 13
the victim as a patient at the hospital or independent center for 14
emergency medical care. 15
3. A hospital, an independent center for emergency medical 16
care and any agent or employee thereof are immune from civil 17
liability for any report made in good faith in accordance with the 18
requirements of this section and for any unauthorized acquisition 19
of any information reported that may occur after the hospital or 20
independent center for emergency medical care made a report in 21
accordance with the requirements of this section. 22
4. As used in this section, “mass casualty incident” has the 23
meaning ascribed to it in NRS 616C.180. 24
Sec. 4. NRS 449.029 is hereby amended to read as follows: 25
449.029 As used in NRS 449.029 to 449.240, inclusive, and 26
section 3 of this act, unless the context otherwise requires, “medical 27
facility” has the meaning ascribed to it in NRS 449.0151 and 28
includes a program of hospice care described in NRS 449.196. 29
Sec. 5. NRS 449.0301 is hereby amended to read as follows: 30
449.0301 The provisions of NRS 449.029 to 449.2428, 31
inclusive, and section 3 of this act do not apply to: 32
1. Any facility conducted by and for the adherents of any 33
church or religious denomination for the purpose of providing 34
facilities for the care and treatment of the sick who depend solely 35
upon spiritual means through prayer for healing in the practice of 36
the religion of the church or denomination, except that such a 37
facility shall comply with all regulations relative to sanitation and 38
safety applicable to other facilities of a similar category. 39
2. Foster homes as defined in NRS 424.014. 40
3. Any medical facility, facility for the dependent or facility 41
which is otherwise required by the regulations adopted by the Board 42
pursuant to NRS 449.0303 to be licensed that is operated and 43
maintained by the United States Government or an agency thereof. 44
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Sec. 6. NRS 449.0302 is hereby amended to read as follows: 1
449.0302 1. The Board shall adopt: 2
(a) Licensing standards for each class of medical facility or 3
facility for the dependent covered by NRS 449.029 to 449.2428, 4
inclusive, and section 3 of this act and for programs of hospice 5
care. 6
(b) Regulations governing the licensing of such facilities and 7
programs. 8
(c) Regulations governing the procedure and standards for 9
granting an extension of the time for which a natural person may 10
provide certain care in his or her home without being considered a 11
residential facility for groups pursuant to NRS 449.017. The 12
regulations must require that such grants are effective only if made 13
in writing. 14
(d) Regulations establishing a procedure for the indemnification 15
by the Division, from the amount of any surety bond or other 16
obligation filed or deposited by a facility for refractive surgery 17
pursuant to NRS 449.068 or 449.069, of a patient of the facility who 18
has sustained any damages as a result of the bankruptcy of or any 19
breach of contract by the facility. 20
(e) Regulations that prescribe the specific types of 21
discrimination prohibited by NRS 449.101. 22
(f) Regulations requiring a hospital or independent center for 23
emergency medical care to provide training to each employee who 24
provides care to victims of sexual assault or attempted sexual assault 25
concerning appropriate care for such persons, including, without 26
limitation, training concerning the requirements of NRS 449.1885. 27
(g) Any other regulations as it deems necessary or convenient to 28
carry out the provisions of NRS 449.029 to 449.2428, inclusive [.] , 29
and section 3 of this act. 30
2. The Board shall adopt separate regulations governing the 31
licensing and operation of: 32
(a) Facilities for the care of adults during the day; and 33
(b) Residential facilities for groups, 34
which provide care to persons with Alzheimer’s disease or other 35
severe dementia, as described in paragraph (a) of subsection 2 of 36
NRS 449.1845. 37
3. The Board shall adopt separate regulations for: 38
(a) The licensure of rural hospitals and rural emergency 39
hospitals which take into consideration the unique problems of 40
operating such a facility in a rural area. 41
(b) The licensure of facilities for refractive surgery which take 42
into consideration the unique factors of operating such a facility. 43
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(c) The licensure of mobile units which take into consideration 1
the unique factors of operating a facility that is not in a fixed 2
location. 3
4. The Board shall require that the practices and policies of 4
each medical facility or facility for the dependent provide 5
adequately for the protection of the health, safety and physical, 6
moral and mental well-being of each person accommodated in the 7
facility. 8
5. In addition to the training requirements prescribed pursuant 9
to NRS 449.093, the Board shall establish minimum qualifications 10
for administrators and employees of residential facilities for groups. 11
In establishing the qualifications, the Board shall consider the 12
related standards set by nationally recognized organizations which 13
accredit such facilities. 14
6. The Board shall adopt separate regulations regarding the 15
assistance which may be given pursuant to NRS 453.375 and 16
454.213 to an ultimate user of controlled substances or dangerous 17
drugs by employees of residential facilities for groups. The 18
regulations must require at least the following conditions before 19
such assistance may be given: 20
(a) The ultimate user’s physical and mental condition is stable 21
and is following a predictable course. 22
(b) The amount of the medication prescribed is at a maintenance 23
level and does not require a daily assessment. 24
(c) A written plan of care by a physician or registered nurse has 25
been established that: 26
(1) Addresses possession and assistance in the administration 27
of the medication; and 28
(2) Includes a plan, which has been prepared under the 29
supervision of a registered nurse or licensed pharmacist, for 30
emergency intervention if an adverse condition results. 31
(d) Except as otherwise authorized by the regulations adopted 32
pursuant to NRS 449.0304, the prescribed medication is not 33
administered by injection or intravenously. 34
(e) The employee has successfully completed training and 35
examination approved by the Division regarding the authorized 36
manner of assistance. 37
7. The Board shall adopt separate regulations governing the 38
licensing and operation of residential facilities for groups which 39
provide assisted living services. The Board shall not allow the 40
licensing of a facility as a residential facility for groups which 41
provides assisted living services and a residential facility for groups 42
shall not claim that it provides “assisted living services” unless: 43
(a) Before authorizing a person to move into the facility, the 44
facility makes a full written disclosure to the person regarding what 45
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services of personalized care will be available to the person and the 1
amount that will be charged for those services throughout the 2
resident’s stay at the facility. 3
(b) The residents of the facility reside in their own living units 4
which: 5
(1) Except as otherwise provided in subsection 8, contain 6
toilet facilities; 7
(2) Contain a sleeping area or bedroom; and 8
(3) Are shared with another occupant only upon consent of 9
both occupants. 10
(c) The facility provides personalized care to the residents of the 11
facility and the general approach to operating the facility 12
incorporates these core principles: 13
(1) The facility is designed to create a residential 14
environment that actively supports and promotes each resident’s 15
quality of life and right to privacy; 16
(2) The facility is committed to offering high-quality 17
supportive services that are developed by the facility in 18
collaboration with the resident to meet the resident’s individual 19
needs; 20
(3) The facility provides a variety of creative and innovative 21
services that emphasize the particular needs of each individual 22
resident and the resident’s personal choice of lifestyle; 23
(4) The operation of the facility and its interaction with its 24
residents supports, to the maximum extent possible, each resident’s 25
need for autonomy and the right to make decisions regarding his or 26
her own life; 27
(5) The operation of the facility is designed to foster a social 28
climate that allows the resident to develop and maintain personal 29
relationships with fellow residents and with persons in the general 30
community; 31
(6) The facility is designed to minimize and is operated in a 32
manner which minimizes the need for its residents to move out of 33
the facility as their respective physical and mental conditions change 34
over time; and 35
(7) The facility is operated in such a manner as to foster a 36
culture that provides a high-quality environment for the residents, 37
their families, the staff, any volunteers and the community at large. 38
8. The Division may grant an exception from the requirement 39
of subparagraph (1) of paragraph (b) of subsection 7 to a facility 40
which is licensed as a residential facility for groups on or before 41
July 1, 2005, and which is authorized to have 10 or fewer beds and 42
was originally constructed as a single-family dwelling if the 43
Division finds that: 44
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(a) Strict application of that requirement would result in 1
economic hardship to the facility requesting the exception; and 2
(b) The exception, if granted, would not: 3
(1) Cause substantial detriment to the health or welfare of 4
any resident of the facility; 5
(2) Result in more than two residents sharing a toilet facility; 6
or 7
(3) Otherwise impair substantially the purpose of that 8
requirement. 9
9. The Board shall, if it determines necessary, adopt 10
regulations and requirements to ensure that each residential facility 11
for groups and its staff are prepared to respond to an emergency, 12
including, without limitation: 13
(a) The adoption of plans to respond to a natural disaster and 14
other types of emergency situations, including, without limitation, 15
an emergency involving fire; 16
(b) The adoption of plans to provide for the evacuation of a 17
residential facility for groups in an emergency, including, without 18
limitation, plans to ensure that nonambulatory patients may be 19
evacuated; 20
(c) Educating the residents of residential facilities for groups 21
concerning the plans adopted pursuant to paragraphs (a) and (b); and 22
(d) Posting the plans or a summary of the plans adopted 23
pursuant to paragraphs (a) and (b) in a conspicuous place in each 24
residential facility for groups. 25
10. The regulations governing the licensing and operation of 26
facilities for transitional living for released offenders must provide 27
for the licensure of at least three different types of facilities, 28
including, without limitation: 29
(a) Facilities that only provide a housing and living 30
environment; 31
(b) Facilities that provide or arrange for the provision of 32
supportive services for residents of the facility to assist the residents 33
with reintegration into the community, in addition to providing a 34
housing and living environment; and 35
(c) Facilities that provide or arrange for the provision of 36
programs for alcohol and other substance use disorders, in addition 37
to providing a housing and living environment and providing or 38
arranging for the provision of other supportive services. 39
The regulations must provide that if a facility was originally 40
constructed as a single-family dwelling, the facility must not be 41
authorized for more than eight beds. 42
11. The Board shall adopt regulations applicable to providers 43
of community-based living arrangement services which: 44
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(a) Except as otherwise provided in paragraph (b), require a 1
natural person responsible for the operation of a provider of 2
community-based living arrangement services and each employee of 3
a provider of community-based living arrangement services who 4
supervises or provides support to recipients of community-based 5
living arrangement services to complete training concerning the 6
provision of community-based living arrangement services to 7
persons with mental illness and continuing education concerning the 8
particular population served by the provider; 9
(b) Exempt a person licensed or certified pursuant to title 54 of 10
NRS from the requirements prescribed pursuant to paragraph (a) if 11
the Board determines that the person is required to receive training 12
and continuing education substantially equivalent to that prescribed 13
pursuant to that paragraph; 14
(c) Require a natural person responsible for the operation of a 15
provider of community-based living arrangement services to receive 16
training concerning the provisions of title 53 of NRS applicable to 17
the provision of community-based living arrangement services; and 18
(d) Require an applicant for a license to provide community-19
based living arrangement services to post a surety bond in an 20
amount equal to the operating expenses of the applicant for 2 21
months, place that amount in escrow or take another action 22
prescribed by the Division to ensure that, if the applicant becomes 23
insolvent, recipients of community-based living arrangement 24
services from the applicant may continue to receive community-25
based living arrangement services for 2 months at the expense of the 26
applicant. 27
12. The Board shall adopt separate regulations governing the 28
licensing and operation of freestanding birthing centers. Such 29
regulations must: 30
(a) Align with the standards established by the American 31
Association of Birth Centers, or its successor organization, the 32
accrediting body of the Commission for the Accreditation of Birth 33
Centers, or its successor organization, or another nationally 34
recognized organization for accrediting freestanding birthing 35
centers; and 36
(b) Allow the provision of supervised training to providers of 37
health care, as appropriate, at a freestanding birthing center. 38
13. If the regulations adopted pursuant to this section require a 39
physical examination to be performed on a patient or the medical 40
history of a patient to be obtained before or after the patient is 41
admitted to a hospital, those regulations must authorize a certified 42
nurse-midwife to perform such a physical examination or obtain 43
such a medical history before or after a patient is admitted to a 44
hospital for the purpose of giving birth. 45
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14. As used in this section: 1
(a) “Certified nurse-midwife” means a person who is: 2
(1) Certified as a Certified Nurse-Midwife by the American 3
Midwifery Certification Board, or its successor organization; and 4
(2) Licensed as an advanced practice registered nurse 5
pursuant to NRS 632.237. 6
(b) “Living unit” means an individual private accommodation 7
designated for a resident within the facility. 8
Sec. 7. NRS 449.160 is hereby amended to read as follows: 9
449.160 1. The Division may deny an application for a 10
license or may suspend or revoke any license issued under the 11
provisions of NRS 449.029 to 449.2428, inclusive, and section 3 of 12
this act upon any of the following grounds: 13
(a) Violation by the applicant or the licensee of any of the 14
provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and 15
section 3 of this act or NRS 449A.100 to 449A.124, inclusive, and 16
449A.270 to 449A.286, inclusive, or of any other law of this State 17
or of the standards, rules and regulations adopted thereunder. 18
(b) Aiding, abetting or permitting the commission of any illegal 19
act. 20
(c) Conduct inimical to the public health, morals, welfare and 21
safety of the people of the State of Nevada in the maintenance and 22
operation of the premises for which a license is issued. 23
(d) Conduct or practice detrimental to the health or safety of the 24
occupants or employees of the facility. 25
(e) Failure of the applicant to obtain written approval from the 26
Director of the Department of Health and Human Services as 27
required by NRS 439A.100 or 439A.102 or as provided in any 28
regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, 29
and section 3 of this act and NRS 449.435 to 449.531, inclusive, 30
and chapter 449A of NRS if such approval is required, including, 31
without limitation, the closure or conversion of any hospital in a 32
county whose population is 100,000 or more that is owned by the 33
licensee without approval pursuant to NRS 439A.102. 34
(f) Failure to comply with the provisions of NRS 441A.315 and 35
any regulations adopted pursuant thereto or NRS 449.2486. 36
(g) Violation of the provisions of NRS 458.112. 37
(h) Failure to comply with the provisions of NRS 449A.170 to 38
449A.192, inclusive, and any regulation adopted pursuant thereto. 39
(i) Violation of the provisions of NRS 629.260. 40
2. In addition to the provisions of subsection 1, the Division 41
may revoke a license to operate a facility for the dependent if, with 42
respect to that facility, the licensee that operates the facility, or an 43
agent or employee of the licensee: 44
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(a) Is convicted of violating any of the provisions of 1
NRS 202.470; 2
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 3
244.360, 244.3603 or 268.4124; or 4
(c) Is ordered by the appropriate governmental agency to correct 5
a violation of a building, safety or health code or regulation but fails 6
to correct the violation. 7
3. The Division shall maintain a log of any complaints that it 8
receives relating to activities for which the Division may revoke the 9
license to operate a facility for the dependent pursuant to subsection 10
2. The Division shall provide to a facility for the care of adults 11
during the day: 12
(a) A summary of a complaint against the facility if the 13
investigation of the complaint by the Division either substantiates 14
the complaint or is inconclusive; 15
(b) A report of any investigation conducted with respect to the 16
complaint; and 17
(c) A report of any disciplinary action taken against the facility. 18
The facility shall make the information available to the public 19
pursuant to NRS 449.2486. 20
4. On or before February 1 of each odd-numbered year, the 21
Division shall submit to the Director of the Legislative Counsel 22
Bureau a written report setting forth, for the previous biennium: 23
(a) Any complaints included in the log maintained by the 24
Division pursuant to subsection 3; and 25
(b) Any disciplinary actions taken by the Division pursuant to 26
subsection 2. 27
Sec. 8. NRS 449.163 is hereby amended to read as follows: 28
449.163 1. In addition to the payment of the amount required 29
by NRS 449.0308, if a medical facility, facility for the dependent or 30
facility which is required by the regulations adopted by the Board 31
pursuant to NRS 449.0303 to be licensed violates any provision 32
related to its licensure, including any provision of NRS 439B.410 or 33
449.029 to 449.2428, inclusive, and section 3 of this act or any 34
condition, standard or regulation adopted by the Board, the 35
Division, in accordance with the regulations adopted pursuant to 36
NRS 449.165, may: 37
(a) Prohibit the facility from admitting any patient until it 38
determines that the facility has corrected the violation; 39
(b) Limit the occupancy of the facility to the number of beds 40
occupied when the violation occurred, until it determines that the 41
facility has corrected the violation; 42
(c) If the license of the facility limits the occupancy of the 43
facility and the facility has exceeded the approved occupancy, 44
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require the facility, at its own expense, to move patients to another 1
facility that is licensed; 2
(d) Except where a greater penalty is authorized by subsection 2, 3
impose an administrative penalty of not more than $5,000 per day 4
for each violation, together with interest thereon at a rate not to 5
exceed 10 percent per annum; and 6
(e) Appoint temporary management to oversee the operation of 7
the facility and to ensure the health and safety of the patients of the 8
facility, until: 9
(1) It determines that the facility has corrected the violation 10
and has management which is capable of ensuring continued 11
compliance with the applicable statutes, conditions, standards and 12
regulations; or 13
(2) Improvements are made to correct the violation. 14
2. If an off-campus location of a hospital fails to obtain a 15
national provider identifier that is distinct from the national provider 16
identifier used by the main campus and any other off-campus 17
location of the hospital in violation of NRS 449.1818, the Division 18
may impose against the hospital an administrative penalty of not 19
more than $10,000 for each day of such failure, together with 20
interest thereon at a rate not to exceed 10 percent per annum, in 21
addition to any other action authorized by this chapter. 22
3. If the facility fails to pay any administrative penalty imposed 23
pursuant to paragraph (d) of subsection 1 or subsection 2, the 24
Division may: 25
(a) Suspend the license of the facility until the administrative 26
penalty is paid; and 27
(b) Collect court costs, reasonable attorney’s fees and other 28
costs incurred to collect the administrative penalty. 29
4. The Division may require any facility that violates any 30
provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and 31
section 3 of this act or any condition, standard or regulation adopted 32
by the Board to make any improvements necessary to correct the 33
violation. 34
5. Any money collected as administrative penalties pursuant to 35
paragraph (d) of subsection 1 or subsection 2 must be accounted for 36
separately and used to administer and carry out the provisions of 37
NRS 449.001 to 449.430, inclusive, and section 3 of this act, NRS 38
449.435 to 449.531, inclusive, and chapter 449A of NRS to protect 39
the health, safety, well-being and property of the patients and 40
residents of facilities in accordance with applicable state and federal 41
standards or for any other purpose authorized by the Legislature. 42
Sec. 9. NRS 449.240 is hereby amended to read as follows: 43
449.240 The district attorney of the county in which the facility 44
is located shall, upon application by the Division, institute and 45
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conduct the prosecution of any action for violation of any provisions 1
of NRS 449.029 to 449.245, inclusive [.] , and section 3 of this act. 2
H