Read the full stored bill text
- 83rd Session (2025)
Assembly Bill No. 50–Committee
on Government Affairs
CHAPTER..........
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;
setting forth certain requirements for suc h an electronic
database; 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
and maintain an electronic database containing information concerning victims of
mass casualty incidents to coordinate the provision of r eunification and
identification services and long-term support services for such victims. Section 1
sets forth certain requirements for such an electronic database and requires a board
of county commissioners that establishes such an electronic database to determine
certain matters concerning the information contained in the database, the reporting
of ce rtain information to the database and the persons and governmental entities
that may participate in the database. Under sections 1 and 2 of this bill, the
information contained in the electronic database is confidential and may be
disclosed only by partici pants in the database for certain purposes. Additionally,
section 1 requires that, except for a victim of a mass casualty incident who has
provided written authorization for his or her information to remain in the database
for the purpose of receiving long -term support services, all information contained
in the database concerning a victim of a mass casualty incident must be delete d
after all victims of the mass casualty incident have been identified and reunified.
Section 1 grants a county in which the boa rd of county commissioners has
established such an electronic database and the officers, employees and agents of
the county immunity from civil liability for any act or omission related to the
establishment or maintenance of the database not amounting to w illful misconduct,
gross negligence or bad faith.
Existing law provides for the licensure and regulation of medical facilities,
including hospitals and independent centers for emergency medical care, by the
Division of Public and Behavioral Health of the Department of Health and Human
Services. (Chapter 449 of NRS) Section 3 of this bill requires a hospital or
independent center for emergency medical care located in a county in which an
electronic database is established pursuant to section 1 and which is notified or
becomes aware of a mass casualty incident to report to the database certain
information about a victim of the mass casualty incident. Section 3 additionally
requires a hospital or independent center for emergency medical care to : (1) inquire
whether such a victim wishes to receive long -term support services and , if so,
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request that the victim provide written authorization for his or her information to
remain in the electronic database; and (2) include a unique identifier in the medical
record of such a victim. Section 3 grants a hospital, an independent center for
emergency medical care and their agents and employees immunity from civil
liability for any such report made in good faith and for any unauthorized acquisition
of the information report ed that may occur after a report was made by the hospital
or independent center for emergency medical care in accordance with the
requirements of section 3. Sections 4-6 of this bill make conforming changes to
provide for the administration of the requirements of section 3 in the same manner
as other requirements imposed on hospitals and independent centers for emergency
medical care by existing law, except for the penalties imposed for violation of those
requirements. (NRS 449.029, 449.0301, 449.0302) Under section 3, a hospital or
independent center for emergency medical care that fails to comply with the
requirements of section 3 is not subject to any penalty for that failure. Sections 7-9
of this bill make conforming changes so that the penalties imposed for violations of
other requirements imposed on hospitals and independent centers for emergency
medical care by existing law do not apply to a failure to comply with the provisions
of section 3.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
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
thereto a new section to read as follows:
1. A board of county commissioners may establish and
maintain an electronic database containing information
concerning victims of mass casualty incidents to coordinate the
provision of reunification and identification services and long-
term support services for such victims.
2. A board of county commissioners that establishes an
electronic database pursuant to subsection 1 shall determine:
(a) The information that must be contained in the electronic
database, which must include, without limitation, the information
reported by a hospital or an independent center for emergency
medical care pursuant to section 3 of this act.
(b) The form and manner in which a hospital or an
independent center for emergency medical care must report the
information required by section 3 of this act to the electronic
database, which must require the information to be reported in
such a form and i n such a manner so as to protect the security of
the information.
(c) Each person or governmental entity that may participate in
the electronic database , which must include, without limitation,
each person or governmental entity in the county whose dutie s or
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responsibilities include the support of carrying out emergency
functions, as determined by the county emergency manager.
(d) The extent to which a person or governmental entity
described in paragraph (c) may participate in the electronic
database, including, without limitation, whether the person or
governmental entity may input information into the electronic
database and the type of information contained in the electronic
database to which the person or governmental entity has access.
3. If a board of county commissioners establishes an
electronic database pursuant to subsection 1, the board of county
commissioners shall implement and maintain security measures to
protect the personally identifiable information contained within
the database. Such security measures must:
(a) Comply with all applicable provisions of 45 C.F.R. Parts
160, 162 and 164, NRS 603A.210 and any other applicable federal
and state law.
(b) Include, without limitation:
(1) The performance of vulnerability and risk assessments;
(2) The imposition of restrictions on access by a participant
to the information contained in the database based on the role of
the participant; and
(3) Reasonable measures for authentication, monitoring
and auditing to prevent unauthorized acces s to the information
contained in the database or misuse of that information.
4. Any information contained in an electronic database
established pursuant to subsection 1 is confidential and may only
be disclosed by a participant in the database as neces sary for the
provision of reunification and identification services and long-
term support services for victims of mass casualty incidents.
Except for a victim of a mass casualty incident who has provided a
written authorization for his or her information to remain in the
electronic database for the purpose of receiving long-term support
services, all information contained in the database concerning a
victim of a mass casualty incident must be deleted after all victims
of the mass casualty incident have been identified and reunified.
5. An electronic database established pursuant to subsection
1 and the disclosure of information therefrom must comply with
the applicable provisions of the Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, as amended, and
the applicable regulations adopted pursuant thereto.
6. A county in which the board of county commissioners has
established an electronic database pursuant to subsection 1 and
any officer, employee or agent of the county are immune from
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civil liability for any act or omission related to the establishment
or maintenance of the database not amounting to willful
misconduct, gross negligence or bad faith.
7. As used in this section:
(a) “Hospital” has the meaning ascribed to it in NRS 449.012.
(b) “Independent center for emergency medical care” has the
meaning ascribed to it in NRS 449.013.
(c) “Long-term support services” means the support services
provided pursuant to NRS 217.096, financial aid services, services
which prov ide compensation to victims and medical or
psychological services provided in a trauma -informed manner, as
defined in NRS 422.2734.
(d) “Mass casualty incident” has the meaning ascribed to the
term “mass casualty event” in 34 U.S.C. § 10281(o)(1)(A).
Sec. 2. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and
NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095,
49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030,
62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152,
80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.54 13,
87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345,
88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270,
116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280,
119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640,
120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730,
127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312,
130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245,
176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156,
176A.630, 178. 39801, 178.4715, 178.5691, 178.5717, 179.495,
179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772,
200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923,
209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040,
213.095, 213.131, 217.105, 2 17.110, 217.464, 217.475, 218A.350,
218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615,
224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570,
231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300,
239.0105, 239.0113, 239.014, 239B.026, 2 39B.030, 239B.040,
239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270,
239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264,
244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130,
250.140, 250.145, 250.150, 268.095, 268.0978, 268. 490, 268.910,
269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680,
281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086,
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286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830,
293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870,
293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110,
332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593,
338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205,
353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240,
360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138,
366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300,
379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626,
387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750,
388A.247, 3 88A.249, 391.033, 391.035, 391.0365, 391.120,
391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317,
392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975,
394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143,
396.159, 396.329 5, 396.405, 396.525, 396.535, 396.9685,
398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153,
414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350,
425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205,
432B.175, 432B.280, 432B.290, 432B.4018, 4 32B.407, 432B.430,
432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360,
439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116,
439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170,
441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735,
442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245,
449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164,
453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056,
459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407,
463.790, 467.1005, 4 80.535, 480.545, 480.935, 480.940, 481.063,
481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363,
483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833,
484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285,
571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110,
598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710,
604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315,
616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137,
624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230,
628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671,
630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327,
630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415,
632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716,
633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169,
634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085,
637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183,
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639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220,
640B.405, 640B.73 0, 640C.580, 640C.600, 640C.620, 640C.745,
640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090,
641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170,
641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320,
642.524, 643.189, 644A.870, 645.180 , 645.625, 645A.050,
645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130,
645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947,
648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900,
654.110, 656.105, 657A.510, 661.115, 665.130, 665.13 3, 669.275,
669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480,
675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710,
678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190,
679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410,
681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306,
687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480,
688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536,
692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550,
696C.120, 703 .196, 704B.325, 706.1725, 706A.230, 710.159,
711.600, and section 1 of this act, sections 35, 38 and 41 of chapter
478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes
of Nevada 2013 and unless otherwise declared by law to be
confidential, all public books and public records of a governmental
entity must be open at all times during office hours to inspection by
any person, and may be fully copied or an abstract or memorandum
may be prepared from those public books and public records. Any
such copies, abstracts or memoranda may be used to supply the
general public with copies, abstracts or memoranda of the records or
may be used in any other way to the advantage of the governmental
entity or of the general public. This section does not supersed e or in
any manner affect the federal laws governing copyrights or enlarge,
diminish or affect in any other manner the rights of a person in any
written book or record which is copyrighted pursuant to federal law.
2. A governmental entity may not reject a book or record
which is copyrighted solely because it is copyrighted.
3. A governmental entity that has legal custody or control of a
public book or record shall not deny a request made pursuant to
subsection 1 to inspect or copy or receive a copy of a public book or
record on the basis that the requested public book or record contains
information that is confidential if the governmental entity can
redact, delete, conceal or separate, including, without limitation,
electronically, the confidential infor mation from the information
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included in the public book or record that is not otherwise
confidential.
4. If requested, a governmental entity shall provide a copy of a
public record in an electronic format by means of an electronic
medium. Nothing in this subsection requires a governmental entity
to provide a copy of a public record in an electronic format or by
means of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by
means of an electronic medium would:
(1) Give access to proprietary software; or
(2) Require the production of information that is confidential
and that cannot be redacted, deleted, concealed or separated from
information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who
has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the
medium that is requested because the officer, employee or agent has
already prepared or would prefer to provide the copy in a different
medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon
request, prepare the copy of the public record and shall not require
the person who has requested the copy to prepare the copy himself
or herself.
Sec. 3. Chapter 449 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. If a hospital or an independent center for emergency
medical care is located in a county in which the board of county
commissioners has established an electronic database pursuant to
section 1 of this act and is notified or otherwise becomes aware of
a mass c asualty incident, the hospital or independent center for
emergency medical care shall, as soon as possible but not later
than 24 hours after receiving and registering a victim of the mass
casualty incident as a patient at the hospital or independent center
for emergency medical care, report to the electronic database the
following information concerning the victim in accordance with
45 C.F.R. § 164.510(b)(4) and in the form and manner determined
by the board of county commissioners:
(a) The name of the victim, if known.
(b) The date of birth of the victim, if known.
(c) Any identifying physical characteristics of the victim.
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2. A hospital or an independent center for emergency medical
care shall:
(a) Include in the medical record of each patient who is the
victim of a mass casualty incident a unique identifier established
by the hospital or independent center for emergency medical care
which allows the hospital or center to identify the patient as a
victim of a mass casualty incident in the event tha t the patient
wishes to receive long -term support services after discharge from
the hospital or center; and
(b) Before discharging a patient who is the victim of a mass
casualty incident, inquire whether the patient wishes to receive
long-term support se rvices and, if so, request that the patient
provide written authorization for his or her information to remain
in the electronic database established pursuant to section 1 of this
act for the purpose of receiving such services.
3. A hospital, an indepen dent center for emergency medical
care and any agent or employee thereof are immune from civil
liability for any report made in good faith in accordance with the
requirements of this section and for any unauthorized acquisition
of any information reported that may occur after the hospital or
independent center for emergency medical care made a report in
accordance with the requirements of this section.
4. A hospital or independent center for emergency medical
care that fails to comply with the provisions of this section is not
subject to any penalty imposed pursuant to this chapter for such
failure to comply.
5. As used in this section:
(a) “Long-term support services” has the meaning ascribed to
it in section 1 of this act.
(b) “Mass casualty incident” has the meaning ascribed to the
term “mass casualty event” in 34 U.S.C. § 10281(o)(1)(A).
Sec. 4. NRS 449.029 is hereby amended to read as follows:
449.029 As used in NRS 449.029 to 449.240, inclusive, and
section 3 of this act, unless the context otherwise requires, “medical
facility” has the meaning ascribed to it in NRS 449.0151 and
includes a program of hospice care described in NRS 449.196.
Sec. 5. NRS 449.0301 is hereby amended to read as follows:
449.0301 The provisions of NRS 449.029 to 449.2428,
inclusive, and section 3 of this act do not apply to:
1. Any facility conducted by and for the adherents of any
church or religious denomination for the purpose of providing
facilities for the care and treatment of the sick who depend solely
upon spiritual means through prayer for healing in the practice of
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the religion of the church or denomination, except that such a
facility shall comply with all regulations relative to sanitatio n and
safety applicable to other facilities of a similar category.
2. Foster homes as defined in NRS 424.014.
3. Any medical facility , facility for the dependent or facility
which is otherwise required by the regulations adopted by the Board
pursuant t o NRS 449.0303 to be licensed that is operated and
maintained by the United States Government or an agency thereof.
Sec. 6. NRS 449.0302 is hereby amended to read as follows:
449.0302 1. The Board shall adopt:
(a) Licensing standards for each class of medical facility or
facility for the dependent covered by NRS 449.029 to 449.2428,
inclusive, and section 3 of this act and for programs of hospice
care.
(b) Regulations governing the licensing of such facilities and
programs.
(c) Regulations governing the procedure and standards for
granting an extension of the time for which a natural person may
provide certain care in his or her home without being considered a
residential facility for groups pursuant to NRS 449.017 . The
regulations must require that such grants are effective only if made
in writing.
(d) Regulations establishing a procedure for the indemnification
by the Division, from the amount of any surety bond or other
obligation filed or deposited by a facilit y for refractive surgery
pursuant to NRS 449.068 or 449.069, of a patient of the facility who
has sustained any damages as a result of the bankruptcy of or any
breach of contract by the facility.
(e) Regulations that prescribe the specific types of
discrimination prohibited by NRS 449.101.
(f) Regulations requiring a hospital or independent center for
emergency medical care to provide training to each employee who
provides care to victims of sexual assault or attempted sexual assault
concerning appropriat e care for such persons, including, without
limitation, training concerning the requirements of NRS 449.1885.
(g) Any other regulations as it deems necessary or convenient to
carry out the provisions of NRS 449.029 to 449.2428, inclusive [.] ,
and section 3 of this act.
2. The Board shall adopt separate regulations governing the
licensing and operation of:
(a) Facilities for the care of adults during the day; and
(b) Residential facilities for groups,
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which provide care to persons with Alzheimer’s disease or other
severe dementia, as described in paragraph (a) of subsection 2 of
NRS 449.1845.
3. The Board shall adopt separate regulations for:
(a) The licensure of rural hospitals and rural emergency
hospitals which take into consideration the unique problems of
operating such a facility in a rural area.
(b) The licensure of facilities for refractive surgery which take
into consideration the unique factors of operating such a facility.
(c) The licensure of mobile units which take into consideration
the unique factors of operating a facility that is not in a fixed
location.
4. The Board shall require that the practices and policies of
each medical facility or facility for the dependent provide
adequately for the protection of the health, safety and physical,
moral and mental well -being of each person accommodated in the
facility.
5. In addition to the training requirements prescribed pursuant
to NRS 449.093, the Board shall establish minimum qualifi cations
for administrators and employees of residential facilities for groups.
In establishing the qualifications, the Board shall consider the
related standards set by nationally recognized organizations which
accredit such facilities.
6. The Board shal l adopt separate regulations regarding the
assistance which may be given pursuant to NRS 453.375 and
454.213 to an ultimate user of controlled substances or dangerous
drugs by employees of residential facilities for groups. The
regulations must require at least the following conditions before
such assistance may be given:
(a) The ultimate user’s physical and mental condition is stable
and is following a predictable course.
(b) The amount of the medication prescribed is at a maintenance
level and does not require a daily assessment.
(c) A written plan of care by a physician or registered nurse has
been established that:
(1) Addresses possession and assistance in the administration
of the medication; and
(2) Includes a plan, which has been prepared unde r the
supervision of a registered nurse or licensed pharmacist, for
emergency intervention if an adverse condition results.
(d) Except as otherwise authorized by the regulations adopted
pursuant to NRS 449.0304, the prescribed medication is not
administered by injection or intravenously.
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(e) The employee has successfully completed training and
examination approved by the Division regarding the authorized
manner of assistance.
7. The Board shall adopt separate regulations governing the
licensing and oper ation of residential facilities for groups which
provide assisted living services. The Board shall not allow the
licensing of a facility as a residential facility for groups which
provides assisted living services and a residential facility for groups
shall not claim that it provides “assisted living services” unless:
(a) Before authorizing a person to move into the facility, the
facility makes a full written disclosure to the person regarding what
services of personalized care will be available to the per son and the
amount that will be charged for those services throughout the
resident’s stay at the facility.
(b) The residents of the facility reside in their own living units
which:
(1) Except as otherwise provided in subsection 8, contain
toilet facilities;
(2) Contain a sleeping area or bedroom; and
(3) Are shared with another occupant only upon consent of
both occupants.
(c) The facility provides personalized care to the residents of the
facility and the general approach to operating the facility
incorporates these core principles:
(1) The facility is designed to create a residential
environment that actively supports and promotes each resident’s
quality of life and right to privacy;
(2) The facility is committed to offering high -quality
supportive services that are developed by the facility in
collaboration with the resident to meet the resident’s individual
needs;
(3) The facility provides a variety of creative and innovative
services that emphasize the particular needs of each indi vidual
resident and the resident’s personal choice of lifestyle;
(4) The operation of the facility and its interaction with its
residents supports, to the maximum extent possible, each resident’s
need for autonomy and the right to make decisions regardin g his or
her own life;
(5) The operation of the facility is designed to foster a social
climate that allows the resident to develop and maintain personal
relationships with fellow residents and with persons in the general
community;
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(6) The facility is designed to minimize and is operated in a
manner which minimizes the need for its residents to move out of
the facility as their respective physical and mental conditions change
over time; and
(7) The facility is operated in such a manner as to foster a
culture that provides a high -quality environment for the residents,
their families, the staff, any volunteers and the community at large.
8. The Division may grant an exception from the requirement
of subparagraph (1) of paragraph (b) of subsection 7 to a facility
which is licensed as a residential facility for groups on or before
July 1, 2005, and which is authorized to have 10 or fewer beds and
was originally constructed as a single -family dwelling if the
Division finds that:
(a) Strict application of that requirement would result in
economic hardship to the facility requesting the exception; and
(b) The exception, if granted, would not:
(1) Cause substantial detriment to the health or welfare of
any resident of the facility;
(2) Result in more than two residents sharing a toilet facility;
or
(3) Otherwise impair substantially the purpose of that
requirement.
9. The Board shall, if it determines necessary, adopt
regulations and requirements to ensure that each residential facility
for groups an d its staff are prepared to respond to an emergency,
including, without limitation:
(a) The adoption of plans to respond to a natural disaster and
other types of emergency situations, including, without limitation,
an emergency involving fire;
(b) The ad option of plans to provide for the evacuation of a
residential facility for groups in an emergency, including, without
limitation, plans to ensure that nonambulatory patients may be
evacuated;
(c) Educating the residents of residential facilities for grou ps
concerning the plans adopted pursuant to paragraphs (a) and (b); and
(d) Posting the plans or a summary of the plans adopted
pursuant to paragraphs (a) and (b) in a conspicuous place in each
residential facility for groups.
10. The regulations govern ing the licensing and operation of
facilities for transitional living for released offenders must provide
for the licensure of at least three different types of facilities,
including, without limitation:
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(a) Facilities that only provide a housing and living
environment;
(b) Facilities that provide or arrange for the provision of
supportive services for residents of the facility to assist the residents
with reintegration into the community, in addition to providing a
housing and living environment; and
(c) Facilities that provide or arrange for the provision of
programs for alcohol and other substance use disorders, in addition
to providing a housing and living environment and providing or
arranging for the provision of other supportive services.
The regulations must provide that if a facility was originally
constructed as a single -family dwelling, the facility must not be
authorized for more than eight beds.
11. The Board shall adopt regulations applicable to providers
of community-based living arrangement services which:
(a) Except as otherwise provided in paragraph (b), require a
natural person responsible for the operation of a provider of
community-based living arrangement services and each employee of
a provider of community -based living arran gement services who
supervises or provides support to recipients of community -based
living arrangement services to complete training concerning the
provision of community -based living arrangement services to
persons with mental illness and continuing education concerning the
particular population served by the provider;
(b) Exempt a person licensed or certified pursuant to title 54 of
NRS from the requirements prescribed pursuant to paragraph (a) if
the Board determines that the person is required to recei ve training
and continuing education substantially equivalent to that prescribed
pursuant to that paragraph;
(c) Require a natural person responsible for the operation of a
provider of community-based living arrangement services to receive
training concerning the provisions of title 53 of NRS applicable to
the provision of community-based living arrangement services; and
(d) Require an applicant for a license to provide community -
based living arrangement services to post a surety bond in an
amount e qual to the operating expenses of the applicant for 2
months, place that amount in escrow or take another action
prescribed by the Division to ensure that, if the applicant becomes
insolvent, recipients of community -based living arrangement
services from t he applicant may continue to receive community -
based living arrangement services for 2 months at the expense of the
applicant.
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12. The Board shall adopt separate regulations governing the
licensing and operation of freestanding birthing centers. Such
regulations must:
(a) Align with the standards established by the American
Association of Birth Centers, or its successor organization, the
accrediting body of the Commission for the Accreditation of Birth
Centers, or its successor organization, or another n ationally
recognized organization for accrediting freestanding birthing
centers; and
(b) Allow the provision of supervised training to providers of
health care, as appropriate, at a freestanding birthing center.
13. If the regulations adopted pursuant t o this section require a
physical examination to be performed on a patient or the medical
history of a patient to be obtained before or after the patient is
admitted to a hospital, those regulations must authorize a certified
nurse-midwife to perform such a physical examination or obtain
such a medical history before or after a patient is admitted to a
hospital for the purpose of giving birth.
14. As used in this section:
(a) “Certified nurse-midwife” means a person who is:
(1) Certified as a Certifie d Nurse-Midwife by the American
Midwifery Certification Board, or its successor organization; and
(2) Licensed as an advanced practice registered nurse
pursuant to NRS 632.237.
(b) “Living unit” means an individual private accommodation
designated for a resident within the facility.
Sec. 7. NRS 449.160 is hereby amended to read as follows:
449.160 1. [The] Except as otherwise provided in section 3
of this act, the Division may deny an application for a license or
may suspend or revoke any license issued under the provisions of
NRS 449.029 to 449.2428, inclusive, and section 3 of this act upon
any of the following grounds:
(a) Violation by the applicant or the licensee of any of the
provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and
section 3 of this act or NRS 449A.100 to 449A.124, inclusive, and
449A.270 to 449A.286, inclusive, or of any other law of this State
or of the standards, rules and regulations adopted thereunder.
(b) Aiding, abetting or permitti ng the commission of any illegal
act.
(c) Conduct inimical to the public health, morals, welfare and
safety of the people of the State of Nevada in the maintenance and
operation of the premises for which a license is issued.
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(d) Conduct or practice detrimental to the health or safety of the
occupants or employees of the facility.
(e) Failure of the applicant to obtain written approval from the
Director of the Department of Health and Human Services as
required by NRS 439A.100 or 439A.102 or as provided i n any
regulation adopted pursuant to NRS 449.001 to 449.430, inclusive,
and section 3 of this act and NRS 449.435 to 449.531, inclusive,
and chapter 449A of NRS if such approval is required, including,
without limitation, the closure or conversion of any h ospital in a
county whose population is 100,000 or more that is owned by the
licensee without approval pursuant to NRS 439A.102.
(f) Failure to comply with the provisions of NRS 441A.315 and
any regulations adopted pursuant thereto or NRS 449.2486.
(g) Violation of the provisions of NRS 458.112.
(h) Failure to comply with the provisions of NRS 449A.170 to
449A.192, inclusive, and any regulation adopted pursuant thereto.
(i) Violation of the provisions of NRS 629.260.
2. In addition to the provisions of subsection 1, the Division
may revoke a license to operate a facility for the dependent if, with
respect to that facility, the licensee that operates the facility, or an
agent or employee of the licensee:
(a) Is convicted of violating any of the provis ions of
NRS 202.470;
(b) Is ordered to but fails to abate a nuisance pursuant to NRS
244.360, 244.3603 or 268.4124; or
(c) Is ordered by the appropriate governmental agency to correct
a violation of a building, safety or health code or regulation but fa ils
to correct the violation.
3. The Division shall maintain a log of any complaints that it
receives relating to activities for which the Division may revoke the
license to operate a facility for the dependent pursuant to subsection
2. The Division shal l provide to a facility for the care of adults
during the day:
(a) A summary of a complaint against the facility if the
investigation of the complaint by the Division either substantiates
the complaint or is inconclusive;
(b) A report of any investigation conducted with respect to the
complaint; and
(c) A report of any disciplinary action taken against the facility.
The facility shall make the information available to the public
pursuant to NRS 449.2486.
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4. On or before February 1 of each odd-numbered year, the
Division shall submit to the Director of the Legislative Counsel
Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained by the
Division pursuant to subsection 3; and
(b) Any disciplinary actions taken by the Division pursuant to
subsection 2.
Sec. 8. NRS 449.163 is hereby amended to read as follows:
449.163 1. [In] Except as otherwise provided in section 3 of
this act, in addition to the payment of the amount required by NRS
449.0308, if a medical facility, facility for the dependent or facility
which is required by the regulations adopted by the Board pursuant
to NRS 449.0303 to be licensed violates any provision related to its
licensure, including any provision of NRS 439B.410 or 449.029 to
449.2428, inclusive, and section 3 of this act or any condition,
standard or regulation adopted by the Board, the Division, in
accordance with the regulations adopted pursuant to NRS 4 49.165,
may:
(a) Prohibit the facility from admitting any patient until it
determines that the facility has corrected the violation;
(b) Limit the occupancy of the facility to the number of beds
occupied when the violation occurred, until it determines t hat the
facility has corrected the violation;
(c) If the license of the facility limits the occupancy of the
facility and the facility has exceeded the approved occupancy,
require the facility, at its own expense, to move patients to another
facility that is licensed;
(d) Except where a greater penalty is authorized by subsection 2,
impose an administrative penalty of not more than $5,000 per day
for each violation, together with interest thereon at a rate not to
exceed 10 percent per annum; and
(e) Appoint temporary management to oversee the operation of
the facility and to ensure the health and safety of the patients of the
facility, until:
(1) It determines that the facility has corrected the violation
and has management which is capable of ensuring continued
compliance with the applicable statutes, conditions, standards and
regulations; or
(2) Improvements are made to correct the violation.
2. If an off -campus location of a hospital fails to obtain a
national provider identifier that is distinct from the national provider
identifier used by the main campus and any other off -campus
location of the hospital in violation of NRS 449.1818, the Division
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may impose against the hospital an administrative penalty of not
more than $10,000 for each day of su ch failure, together with
interest thereon at a rate not to exceed 10 percent per annum, in
addition to any other action authorized by this chapter.
3. If the facility fails to pay any administrative penalty imposed
pursuant to paragraph (d) of subsectio n 1 or subsection 2, the
Division may:
(a) Suspend the license of the facility until the administrative
penalty is paid; and
(b) Collect court costs, reasonable attorney’s fees and other
costs incurred to collect the administrative penalty.
4. [The] Except as otherwise provided in section 3 of this act,
the Division may require any facility that violates any provision of
NRS 439B.410 or 449.029 to 449.2428, inclusive, and section 3 of
this act or any condition, standard or regulation adopted by the
Board to make any improvements necessary to correct the violation.
5. Any money collected as administrative penalties pursuant to
paragraph (d) of subsection 1 or subsection 2 must be accounted for
separately and used to administer and carry out the provis ions of
NRS 449.001 to 449.430, inclusive, and section 3 of this act, NRS
449.435 to 449.531, inclusive, and chapter 449A of NRS to protect
the health, safety, well -being and property of the patients and
residents of facilities in accordance with applicable state and federal
standards or for any other purpose authorized by the Legislature.
Sec. 9. NRS 449.240 is hereby amended to read as follows:
449.240 [The] Except as otherwise provided in section 3 of
this act, the district attorney of the county in which the facility is
located shall, upon application by the Division, institute and conduct
the prosecution of any action for violation of any provisions of NRS
449.029 to 449.245, inclusive [.] , and section 3 of this act.
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