(Reprinted with amendments adopted on April 21, 2025)
FIRST REPRINT S.B. 408
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SENATE BILL NO. 408–COMMITTEE ON
HEALTH AND HUMAN SERVICES
MARCH 20, 2025
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Referred to Committee on Health and Human Services
SUMMARY—Revises provisions relating to county hospitals and
county hospital districts. (BDR 40-559)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.
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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; revising provisions governing the
employment and training of certain providers of health
care by a county hospital or county hospital district;
authorizing a county or district hospital to contract for the
provision of certain services; authorizing a county or
district hospital to form a separate organization for certain
purposes; and providing other matters properly relating
thereto.
Legislative Counsel’s Digest:
Existing law authorizes a county or group of counties to establish a public 1
hospital. (NRS 450.020) Existing law also authorizes a board of county 2
commissioners to establish a county hospital district to operate a district hospital or 3
otherwise provide the services of a hospital to the residents of this State. (NRS 4
450.590, 450.610, 450.630, 450.710) Existing law authorizes the governing body of 5
a county hospital to: (1) employ physicians, interns and dentists, on a full-time or 6
part-time basis, and fix their compensations; and (2) control the admission of such 7
physicians and interns to the staff of the hospital by promulgating appropriate rules, 8
regulations and standards governing those appointments. (NRS 450.180) Existing 9
law similarly authorizes the governing body of a county hospital district to take 10
such actions with regard to physicians and interns. (NRS 450.640) Existing law 11
further authorizes the governing body of a county hospital to institute and maintain 12
training programs in the county hospital for resident physicians, interns and 13
postgraduates that meet certain accreditation standards. (NRS 450.455) Section 3 14
of this bill additionally authorizes the governing body of a county hospital district 15
to employ and fix the compensation of dentists. Sections 1 and 3 of this bill 16
remove interns from the list of persons that the governing body of a county hospital 17
or county hospital district may employ, and instead, authorizes such a governing 18
body to employ and control the admission of medical and dental residents and 19
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fellows. Section 2 of this bill makes a conforming change to authorize a county 20
hospital to institute and maintain training programs for fellows in addition to 21
resident physicians. Section 2 also updates the name of an accrediting organization 22
for medical residencies. 23
Existing law authorizes a county or district hospital to enter into a contract to 24
provide certain services in connection with or related to the operation of certain 25
hospitals or necessary for the health and welfare of the general public. (NRS 26
450.800) Section 4 of this bill specifies that such services include certain mental or 27
behavioral health services performed in connection with or related to a crisis 28
stabilization center, which is a hospital with an endorsement to provide such 29
services. (NRS 449.0915) Section 4 also authorizes a county or district hospital to 30
form a separate organization to provide or contract for the provision of certain 31
services. 32
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 450.180 is hereby amended to read as follows: 1
450.180 The board of hospital trustees or any hospital 2
governing board appointed pursuant to NRS 450.175 may: 3
1. Appoint a chief executive officer and necessary assistants, 4
and fix their compensations. 5
2. Employ physicians, [interns and dentists,] surgeons and 6
dentists, including, without limitation, medical and dental 7
residents and fellows, either full-time or part-time, as the board 8
determines necessary, and fix their compensations. 9
3. Remove those appointees and employees. 10
4. Control the admission of physicians , surgeons and dentists, 11
including, without limitation, medical and dental residents and 12
[interns] fellows, to the staff by promulgating appropriate rules, 13
regulations and standards governing those appointments. 14
5. Contract with individual physicians or private medical 15
associations for the provision of certain medical services as may be 16
required by the hospital. 17
Sec. 2. NRS 450.455 is hereby amended to read as follows: 18
450.455 A board of hospital trustees may institute and maintain 19
training programs in the county hospital for resident physicians, 20
[including interns] fellows and postgraduates. Such programs must 21
meet the standards for recognition by the American Medical 22
Association , or its successor organization, and for accreditation by 23
the [Liaison Committee on] Accreditation Council for Graduate 24
Medical Education [.] , or its successor organization. 25
Sec. 3. NRS 450.640 is hereby amended to read as follows: 26
450.640 The board of trustees may: 27
1. After the board is formed pursuant to the provisions of NRS 28
450.620 or 450.625, increase the number of members who serve on 29
the board by appointing, as a voting member of the board, one 30
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physician who is the chief of staff of physicians for a district 1
hospital. The term of office of a member who is appointed pursuant 2
to this subsection is 2 years, commencing on the date of 3
appointment by the board of trustees. A vacancy in the term of a 4
member appointed pursuant to this subsection must be filled in the 5
same manner as the original appointment for the remainder of the 6
unexpired term. 7
2. Appoint a chief executive officer and necessary assistants 8
for each hospital, and fix the compensations of such persons. 9
3. Employ physicians, surgeons and dentists, including, 10
without limitation, medical and dental residents and [interns,] 11
fellows, as the board determines necessary, and fix their 12
compensation. 13
4. Remove such appointees and employees. 14
5. Remove persons who are appointed or employed pursuant to 15
this section. 16
6. Control the admission of physicians, surgeons and dentists, 17
including, without limitation, medical and dental residents and 18
[interns] fellows, to the staff by promulgating rules, regulations and 19
standards governing such appointments. 20
Sec. 4. NRS 450.800 is hereby amended to read as follows: 21
450.800 1. In addition to having the powers conferred under 22
chapter 277 of NRS, a county or district hospital may contract with 23
a private hospital or other organization for emergency medical 24
services, including the transportation of patients, or any other 25
services performed in connection with or related to the operation of 26
a hospital. The services may be performed by the parties to the 27
contract or the parties may establish a separate organization for that 28
purpose. 29
2. A county or district hospital may enter into a contract to 30
provide [services:] or form a separate organization to provide or 31
enter into a contract to provide: 32
(a) [For] Crisis stabilization services or any other mental or 33
behavioral health services performed in connection with a facility 34
that has received or is seeking an endorsement as a crisis 35
stabilization center pursuant to NRS 449.0915. 36
(b) Other services for persons, whether or not admitted to the 37
hospital, if those services are performed in connection with or 38
related to the operation of the hospital. 39
[(b) Necessary] 40
(c) Other services necessary for the health and welfare of the 41
general public. 42
3. As used in this section, “crisis stabilization services” has 43
the meaning ascribed to it in NRS 449.0915. 44
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Sec. 5. This act becomes effective on July 1, 2025. 1
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