(REPRINTED WITH ADOPTED AMENDMENTS)

 

Senate Bill No. 483–Committee on Human
Resources and Facilities

 

March 26, 2001

____________

 

Referred to Committee on Human Resources and Facilities

 

SUMMARY—Requires state board of health to license mobile medical facilities. (BDR 40‑1482)

 

FISCAL NOTE:  Effect on Local Government: No.

                             Effect on the State: Yes.

 

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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 medical facilities; requiring the state board of health to adopt regulations for the licensure of mobile units as medical facilities; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

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

1-2  new section to read as follows:

1-3    “Mobile unit” means a motor vehicle that is:

1-4    1.  Specially designed, constructed and equipped to provide for the

1-5  diagnosis, care and treatment of human diseases; and

1-6    2.  Operated by any of the medical facilities described in subsections 1

1-7  to 13, inclusive, of NRS 449.0151.

1-8    Sec. 2.  NRS 449.001 is hereby amended to read as follows:

1-9    449.001  As used in this chapter, unless the context otherwise requires,

1-10  the words and terms defined in NRS 449.0015 to 449.019, inclusive, and

1-11  section 1 of this act have the meanings ascribed to them in those sections.

1-12    Sec. 3.  NRS 449.0151 is hereby amended to read as follows:

1-13    449.0151  “Medical facility” includes:

1-14    1.  A surgical center for ambulatory patients;

1-15    2.  An obstetric center;

1-16    3.  An independent center for emergency medical care;

1-17    4.  An agency to provide nursing in the home;

1-18    5.  A facility for intermediate care;

1-19    6.  A facility for skilled nursing;

1-20    7.  A facility for hospice care;

1-21    8.  A hospital;

2-1    9.  A psychiatric hospital;

2-2    10.  A facility for the treatment of irreversible renal disease;

2-3    11.  A rural clinic;

2-4    12.  A nursing pool; [and]

2-5    13.  A facility for modified medical detoxification[.] ; and

2-6    14.  A mobile unit.

2-7    Sec. 4.  NRS 449.037 is hereby amended to read as follows:

2-8    449.037  1.  The board shall adopt:

2-9    (a) Licensing standards for each class of medical facility or facility for

2-10  the dependent covered by NRS 449.001 to 449.240, inclusive, and for

2-11  programs of hospice care.

2-12    (b) Regulations governing the licensing of such facilities and programs.

2-13    (c) Regulations governing the procedure and standards for granting an

2-14  extension of the time for which a natural person may provide certain care

2-15  in his home without being considered a residential facility for groups

2-16  pursuant to NRS 449.017. The regulations must require that such grants are

2-17  effective only if made in writing.

2-18    (d) Any other regulations as it deems necessary or convenient to carry

2-19  out the provisions of NRS 449.001 to 449.240, inclusive.

2-20    2.  The board shall adopt separate regulations governing the licensing

2-21  and operation of:

2-22    (a) Facilities for the care of adults during the day; and

2-23    (b) Residential facilities for groups,

2-24  which provide care to persons with Alzheimer’s disease.

2-25    3.  The board shall adopt separate regulations for the licensure of rural

2-26  hospitals which take into consideration the unique problems of operating

2-27  such a facility in a rural area.

2-28    4.  The board shall adopt separate regulations for the licensure of

2-29  mobile units which take into consideration the unique factors of

2-30  operating a facility that is not in a fixed location.

2-31    5.  The board shall require that the practices and policies of each

2-32  medical facility or facility for the dependent provide adequately for the

2-33  protection of the health, safety and physical, moral and mental well-being

2-34  of each person accommodated in the facility.

2-35    [5.] 6. The board shall establish minimum qualifications for

2-36  administrators and employees of residential facilities for groups. In

2-37  establishing the qualifications, the board shall consider the related

2-38  standards set by nationally recognized organizations which accredit such

2-39  facilities.

2-40    [6.] 7. The board shall adopt separate regulations regarding the

2-41  assistance which may be given pursuant to NRS 453.375 and 454.213 to an

2-42  ultimate user of controlled substances or dangerous drugs by employees of

2-43  residential facilities for groups. The regulations must require at least the

2-44  following conditions before such assistance may be given:

2-45    (a) The ultimate user’s physical and mental condition is stable and is

2-46  following a predictable course.

2-47    (b) The amount of the medication prescribed is at a maintenance level

2-48  and does not require a daily assessment.

3-1    (c) A written plan of care by a physician or registered nurse has been

3-2  established that:

3-3       (1) Addresses possession and assistance in the administration of the

3-4  medication; and

3-5       (2) Includes a plan, which has been prepared under the supervision of

3-6  a registered nurse or licensed pharmacist, for emergency intervention if an

3-7  adverse condition results.

3-8    (d) The prescribed medication is not administered by injection or

3-9  intravenously.

3-10    (e) The employee has successfully completed training and examination

3-11  approved by the health division regarding the authorized manner of

3-12  assistance.

3-13    [7.] 8. The board shall, if it determines necessary, adopt regulations

3-14  and requirements to ensure that each residential facility for groups and its

3-15  staff are prepared to respond to an emergency, including, without

3-16  limitation:

3-17    (a) The adoption of plans to respond to a natural disaster and other types

3-18  of emergency situations, including, without limitation, an emergency

3-19  involving fire;

3-20    (b) The adoption of plans to provide for the evacuation of a residential

3-21  facility for groups in an emergency, including, without limitation, plans to

3-22  ensure that nonambulatory patients may be evacuated;

3-23    (c) Educating the residents of residential facilities for groups concerning

3-24  the plans adopted pursuant to paragraphs (a) and (b); and

3-25    (d) Posting the plans or a summary of the plans adopted pursuant to

3-26  paragraphs (a) and (b) in a conspicuous place in each residential facility for

3-27  groups.

3-28    Sec. 5.  NRS 449.230 is hereby amended to read as follows:

3-29    449.230  1.  Any authorized member or employee of the health

3-30  division may enter and inspect any building or premises at any time to

3-31  secure compliance with or prevent a violation of any provision of NRS

3-32  449.001 to 449.245, inclusive. For the purposes of this subsection,

3-33  “building or premises” does not include a mobile unit that is operated by

3-34  a medical facility which is accredited by the Joint Commission on

3-35  Accreditation of Healthcare Organizations or the American Osteopathic

3-36  Association.

3-37    2.  The state fire marshal or his designee shall, upon receiving a request

3-38  from the health division or a written complaint concerning compliance with

3-39  the plans and requirements to respond to an emergency adopted pursuant to

3-40  subsection [7] 8 of NRS 449.037:

3-41    (a) Enter and inspect a residential facility for groups; and

3-42    (b) Make recommendations regarding the adoption of plans and

3-43  requirements pursuant to subsection [7] 8 of NRS 449.037,

3-44  to ensure the safety of the residents of the facility in an emergency.

3-45    3.  The state health officer or his designee shall enter and inspect at

3-46  least annually each building or the premises of a residential facility for

3-47  groups to ensure compliance with standards for health and sanitation.

3-48    4.  An authorized member or employee of the health division shall

3-49  enter and inspect any building or premises operated by a residential facility

4-1  for groups within 72 hours after the health division is notified that a

4-2  residential facility for groups is operating without a license.

4-3    Sec. 6.  NRS 449.235 is hereby amended to read as follows:

4-4    449.235  [Every]

4-5    1.  Except as otherwise provided in subsection 2, every medical

4-6  facility or facility for the dependent may be inspected at any time, with or

4-7  without notice, as often as is necessary by:

4-8    [1.] (a) The health division to [assure that there is] ensure compliance

4-9  with all applicable regulations and standards; and

4-10  [2.] (b) Any person designated by the aging services division of the

4-11  department of human resources to investigate complaints made against the

4-12  facility.

4-13  2.  The provisions of subsection 1 do not authorize the health division

4-14  to inspect a mobile unit that is operated by a medical facility which is

4-15  accredited by the Joint Commission on Accreditation of Healthcare

4-16  Organizations or the American Osteopathic Association, unless the

4-17  health division has reasonable cause to believe that the mobile unit has

4-18  violated any provision of NRS 449.001 to 449.240, inclusive, or any

4-19  regulation or standard adopted pursuant thereto.

4-20    Sec. 7.  This act becomes effective on July 1, 2001.

 

4-21  H