EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Section 1. Chapter 449 of NRS is hereby amended by adding thereto

1-2 the provisions set forth as sections 2 to 5, inclusive, of this act.

1-3 Sec. 2. A person who operates a residential facility for groups shall:

1-4 1. Post his license to operate the residential facility for groups; and

1-5 2. Post the rates for services provided by the residential facility for

1-6 groups,

1-7 in a conspicuous place in the residential facility for groups.

1-8 Sec. 3. 1. Except as otherwise provided in subsection 5, a person

1-9 must obtain a license from the board to operate a business that provides

1-10 referrals to residential facilities for groups.

1-11 2. The board shall adopt:

1-12 (a) Standards for the licensing of businesses that provide referrals to

1-13 residential facilities for groups;

2-1 (b) Standards relating to the fees charged by such businesses;

2-2 (c) Regulations governing the licensing of such businesses; and

2-3 (d) Regulations establishing requirements for training the employees

2-4 of such businesses.

2-5 3. A licensed nurse, social worker, physician or hospital, or a

2-6 provider of geriatric care who is licensed as a nurse or social worker,

2-7 may provide referrals to residential facilities for groups through a

2-8 business that is licensed pursuant to this section. The board may, by

2-9 regulation, authorize a public guardian or any other person it determines

2-10 appropriate to provide referrals to residential facilities for groups

2-11 through a business that is licensed pursuant to this section.

2-12 4. A business that is licensed pursuant to this section or an employee

2-13 of such a business shall not:

2-14 (a) Refer a person to a residential facility for groups that is not

2-15 licensed.

2-16 (b) Refer a person to a residential facility for groups that is owned by

2-17 the same person who owns the business.

2-18 A person who violates the provisions of this subsection is liable for a civil

2-19 penalty to be recovered by the attorney general in the name of the state

2-20 board of health for the first offense of not more than $10,000 and for a

2-21 second or subsequent offense of not less than $10,000 nor more than

2-22 $20,000. Unless otherwise required by federal law, the state board of

2-23 health shall deposit all civil penalties collected pursuant to this section

2-24 into a separate account in the state general fund to be used for the

2-25 enforcement of this section and the protection of the health, safety,

2-26 well-being and property of residences of residential facilities for groups.

2-27 5. This section does not apply to a medical facility that is licensed

2-28 pursuant to NRS 449.001 to 449.240, inclusive, this section and sections

2-29 2 and 4 of this act, on October 1, 1999.

2-30 Sec. 4. If the health division suspends or revokes the license of a

2-31 person who operates a residential facility for groups for abuse, neglect or

2-32 isolation of the occupants of the facility, the division shall suspend or

2-33 revoke the license of all residential facilities for groups operated by that

2-34 person. The person who operates the facility shall move all of the persons

2-35 who are receiving services in the residential facilities for groups to other

2-36 licensed residential facilities for groups at his own expense.

2-37 Sec. 5. The provisions of NRS 449.249, 449.2493 and 449.2496

2-38 apply to homes for individual residential care in a county whose

2-39 population is less than 100,000.

2-40 Sec. 6. NRS 449.017 is hereby amended to read as follows:

2-41 449.017 1. Except as otherwise provided in subsection 2, "residential

2-42 facility for groups" means an establishment that furnishes food, shelter,

3-1 assistance and limited supervision to an aged, infirm, mentally retarded or

3-2 handicapped person.

3-3 2. The term does not include:

3-4 (a) An establishment which provides care only during the day;

3-5 (b) [A natural person who provides care for no more than two persons in

3-6 his own home;

3-7 (c)] A natural person who provides care for one or more persons related

3-8 to him within the third degree of consanguinity or affinity; [or

3-9 (d)] (c) A facility funded by a division or program of the department of

3-10 human resources [.] ; or

3-11 (d) A home for individual residential care in a county whose

3-12 population is less than 100,000.

3-13 Sec. 7. NRS 449.030 is hereby amended to read as follows:

3-14 449.030 1. No person, state or local government or agency thereof

3-20 without first obtaining a license for the program from the board.

3-21 Sec. 8. NRS 449.037 is hereby amended to read as follows:

3-22 449.037 1. The board shall adopt:

3-43 medical facility or facility for the dependent provide adequately for the

4-1 protection of the health, safety and physical, moral and mental well-being

4-2 of each person accommodated in the facility.

4-3 5. The board shall establish minimum qualifications for administrators

4-4 and employees of residential facilities for groups. In establishing the

4-5 qualifications, the board shall consider the related standards set by

4-6 nationally recognized organizations which accredit such facilities.

4-7 6. The board shall adopt separate regulations regarding the assistance

4-8 which may be given pursuant to NRS 453.375 and 454.213 to an ultimate

4-9 user of controlled substances or dangerous drugs by employees of

4-10 residential facilities for groups. The regulations must require at least the

4-11 following conditions before such assistance may be given:

4-12 (a) The ultimate user’s physical and mental condition is stable and is

4-13 following a predictable course.

4-14 (b) The amount of the medication prescribed is at a maintenance level

4-15 and does not require a daily assessment.

4-16 (c) A written plan of care by a physician or registered nurse has been

4-17 established that:

4-18 (1) Addresses possession and assistance in the administration of the

4-19 medication; and

4-20 (2) Includes a plan, which has been prepared under the supervision of

4-21 a registered nurse or licensed pharmacist, for emergency intervention if an

4-22 adverse condition results.

4-23 (d) The prescribed medication is not administered by injection or

4-24 intravenously.

4-25 (e) The employee has successfully completed training and examination

4-26 approved by the health division regarding the authorized manner of

4-27 assistance.

4-28 7. The board shall, if it determines necessary, adopt regulations and

4-29 requirements to ensure that each residential facility for groups and its

4-30 staff are prepared to respond to an emergency, including, without

4-31 limitation:

4-32 (a) The adoption of plans to respond to a natural disaster and other

4-33 types of emergency situations, including, without limitation, an

4-34 emergency involving fire;

4-35 (b) The adoption of plans to provide for the evacuation of a residential

4-36 facility for groups in an emergency, including, without limitation, plans

4-37 to ensure that nonambulatory patients may be evacuated;

4-38 (c) Educating the residents of residential facilities for groups

4-39 concerning the plans adopted pursuant to paragraphs (a) and (b); and

4-40 (d) Posting the plans or a summary of the plans adopted pursuant to

4-41 paragraphs (a) and (b) in a conspicuous place in each residential facility

4-42 for groups.

5-1 Sec. 9. NRS 449.210 is hereby amended to read as follows:

5-2 449.210 [Any]

5-18 3. Unless otherwise required by federal law, the health division shall

5-19 deposit all civil penalties collected pursuant to this section into a separate

5-20 account in the state general fund to be used for the protection of the

5-21 health, safety and well-being of patients including residents of residential

5-22 facilities for groups.

5-23 Sec. 10. NRS 449.230 is hereby amended to read as follows:

5-24 449.230 1. Any authorized member or employee of the health

5-42 that a residential facility for groups is operating without a license.

6-1 Sec. 11. NRS 654.190 is hereby amended to read as follows:

6-2 654.190 1. The board may, after notice and hearing, impose an

6-21 recovered by the board.

6-22 Sec. 11.5. Section 1 of Assembly Bill No. 167 of this session is hereby

6-23 amended to read as follows:

6-24 Section 1. NRS 449.017 is hereby amended to read as follows:

6-25 449.017 1. Except as otherwise provided in subsection 2,

6-26 "residential facility for groups" means an establishment that

6-27 furnishes food, shelter, assistance and limited supervision to [:

6-28 (a) Any] an aged, infirm, mentally retarded or handicapped

6-29 person . [; or

6-30 (b) Four or more females during pregnancy or after delivery.]

6-31 2. The term does not include:

6-32 (a) An establishment which provides care only during the day;

6-33 (b) A natural person who provides care for no more than two

6-34 persons in his own home;

6-35 (c) A natural person who provides care for one or more persons

6-36 related to him within the third degree of consanguinity or affinity;

6-37 or

6-38 (d) A facility funded by [the welfare] a division or [the division

6-39 of mental health and developmental services] program of the

6-40 department of human resources.

6-41 Sec. 12. 1. Notwithstanding the provisions of NRS 449.017, as

6-42 amended by this act, and NRS 449.030, a person who is operating a home

6-43 for individual residential care on October 1, 1999, in a county whose

7-1 population is 100,000 or more, which is registered with the health division

7-2 of the department of human resources pursuant to NRS 449.249, may

7-3 continue to operate the home for individual residential care pursuant to the

7-4 provisions of NRS 449.0105 to 449.2496, inclusive, and the regulations

7-5 adopted pursuant thereto, as those provisions existed on October 1, 1999,

7-6 until January 1, 2000, without becoming licensed as a residential facility for

7-7 groups, but must either become licensed as a residential facility for groups

7-8 on or before January 1, 2000, or cease operation on that date.

7-9 2. On or before November 1, 1999, the health division of the

7-10 department of human resources shall provide a copy of the provisions of

7-11 subsection 1 to each home for individual residential care that is registered

7-12 pursuant to NRS 449.249 on October 1, 1999, in a county whose

7-13 population is 100,000 or more.

7-14 3. The health and aging services divisions of the department of human

7-15 resources shall continue to perform the duties prescribed by the provisions

7-16 of NRS 449.0105 to 449.2496, inclusive, and the regulations adopted

7-17 pursuant thereto, as those provisions existed on October 1, 1999, as to each

7-18 home for individual residential care which continues to operate after

7-19 October 1, 1999, in a county whose population is 100,000 or more,

7-20 pursuant to subsection 1 until January 1, 2000, or the date on which there

7-21 are no such homes remaining in such counties, whichever is earlier.

7-22 Sec. 13. 1. This section and sections 1, 2, 4, 5 and 7 to 12, inclusive,

7-23 of this act become effective on October 1, 1999.

7-24 2. Section 6 of this act becomes effective at 12:01 a.m. on October 1,

7-25 1999.

7-26 3. Section 3 of this act becomes effective upon passage and approval

7-27 for the purpose of adopting standards and regulations, and on January 1,

7-28 2000, for all other purposes.