Assembly Bill No. 323–Assemblymen McClain, Parks, Chowning, Koivisto, Gibbons, Anderson, Arberry, Atkinson, Claborn, Collins, Conklin, Giunchigliani, Hardy, Horne, Manendo, Mortenson, Ohrenschall and Pierce

 

March 14, 2003

____________

 

Referred to Committee on Health and Human Services

 

SUMMARY—Makes various changes concerning long-term care provided to persons with dementia. (BDR 38‑1194)

 

FISCAL NOTE:  Effect on Local Government: Yes.

                           Effect on the State: Yes.

 

CONTAINS UNFUNDED MANDATE (§ 1)

(Not Requested by Affected Local Government)

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to health care; requiring institutional long-term care provided by Medicaid to persons with dementia to be provided within this state; requiring employees of facilities for long-term care to receive education in the care of persons with Alzheimer’s disease; 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 422 of NRS is hereby amended by adding

1-2  thereto a new section to read as follows:

1-3  Institutional long-term care provided by Medicaid to a person

1-4  with any form of dementia, including, without limitation, dementia

1-5  caused by Alzheimer’s disease, must be provided within this state.

1-6  Sec. 2.  NRS 422.240 is hereby amended to read as follows:

1-7  422.240  1.  Money to carry out the provisions of NRS

1-8  422.001 to 422.410, inclusive, and section 1 of this act and

1-9  422.580, including, without limitation, any federal money allotted to

1-10  the State of Nevada pursuant to the program established to provide

2-1  Temporary Assistance for Needy Families and the Program for

2-2  Child Care and Development, must be provided by appropriation by

2-3  the Legislature from the State General Fund.

2-4  2.  Disbursements for the purposes of NRS 422.001 to 422.410,

2-5  inclusive, and section 1 of this act and 422.580 must be made upon

2-6  claims duly filed, audited and allowed in the same manner as other

2-7  money in the State Treasury is disbursed.

2-8  Sec. 3.  Chapter 449 of NRS is hereby amended by adding

2-9  thereto a new section to read as follows:

2-10      1.  The Board shall establish minimum continuing education

2-11  requirements concerning the care of persons with Alzheimer’s

2-12  disease for employees of facilities for skilled nursing, facilities for

2-13  intermediate care and residential facilities for groups. In

2-14  establishing such requirements, the Board shall consider any

2-15  educational requirements imposed on employees who are licensed

2-16  providers of health care to ensure that the continuing education

2-17  requirements established by the Board for those employees do not

2-18  duplicate or conflict with the existing educational requirements

2-19  imposed on those employees.

2-20      2.  The administrator of a facility for skilled nursing, a facility

2-21  for intermediate care or a residential facility for groups shall

2-22  ensure that each employee of the facility complies with the

2-23  requirements for continuing education established by the Board

2-24  pursuant to this section.

2-25      Sec. 4.  NRS 449.070 is hereby amended to read as follows:

2-26      449.070  The provisions of NRS 449.001 to 449.240, inclusive,

2-27  and section 3 of this act do not apply to:

2-28      1.  Any facility conducted by and for the adherents of any

2-29  church or religious denomination for the purpose of providing

2-30  facilities for the care and treatment of the sick who depend solely

2-31  upon spiritual means through prayer for healing in the practice of

2-32  the religion of the church or denomination, except that such a

2-33  facility [must] shall comply with all regulations relative to

2-34  sanitation and safety applicable to other facilities of a similar

2-35  category.

2-36      2.  Foster homes as defined in NRS 424.014.

2-37      3.  Any medical facility or facility for the dependent operated

2-38  and maintained by the United States Government or an agency

2-39  thereof.

2-40      Sec. 5.  NRS 449.160 is hereby amended to read as follows:

2-41      449.160  1.  The Health Division may deny an application for

2-42  a license or may suspend or revoke any license issued under the

2-43  provisions of NRS 449.001 to 449.240, inclusive, and section 3 of

2-44  this act upon any of the following grounds:

3-1  (a) Violation by the applicant or the licensee of any of the

3-2  provisions of NRS 439B.410 or 449.001 to 449.245, inclusive, and

3-3  section 3 of this act or of any other law of this state or of the

3-4  standards, rules and regulations adopted thereunder.

3-5  (b) Aiding, abetting or permitting the commission of any illegal

3-6  act.

3-7  (c) Conduct inimical to the public health, morals, welfare and

3-8  safety of the people of the State of Nevada in the maintenance and

3-9  operation of the premises for which a license is issued.

3-10      (d) Conduct or practice detrimental to the health or safety of the

3-11  occupants or employees of the facility.

3-12      (e) Failure of the applicant to obtain written approval from the

3-13  Director of the Department of Human Resources as required by

3-14  NRS 439A.100 or as provided in any regulation adopted pursuant to

3-15  this chapter, if such approval is required.

3-16      2.  In addition to the provisions of subsection 1, the Health

3-17  Division may revoke a license to operate a facility for the dependent

3-18  if, with respect to that facility, the licensee that operates the facility,

3-19  or an agent or employee of the licensee:

3-20      (a) Is convicted of violating any of the provisions of

3-21  NRS 202.470;

3-22      (b) Is ordered to but fails to abate a nuisance pursuant to NRS

3-23  244.360, 244.3603 or 268.4124; or

3-24      (c) Is ordered by the appropriate governmental agency to correct

3-25  a violation of a building, safety or health code or regulation but fails

3-26  to correct the violation.

3-27      3.  The Health Division shall maintain a log of any complaints

3-28  that it receives relating to activities for which the Health Division

3-29  may revoke the license to operate a facility for the dependent

3-30  pursuant to subsection 2.

3-31      4.  On or before February 1 of each odd-numbered year, the

3-32  Health Division shall submit to the Director of the Legislative

3-33  Counsel Bureau a written report setting forth, for the previous

3-34  biennium:

3-35      (a) Any complaints included in the log maintained by the Health

3-36  Division pursuant to subsection 3; and

3-37      (b) Any disciplinary actions taken by the Health Division

3-38  pursuant to subsection 2.

3-39      Sec. 6.  NRS 449.163 is hereby amended to read as follows:

3-40      449.163  1.  If a medical facility or facility for the dependent

3-41  violates any provision related to its licensure, including any

3-42  provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

3-43  section 3 of this act or any condition, standard or regulation adopted

3-44  by the Board, the Health Division in accordance with the regulations

3-45  adopted pursuant to NRS 449.165 may:

4-1  (a) Prohibit the facility from admitting any patient until it

4-2  determines that the facility has corrected the violation;

4-3  (b) Limit the occupancy of the facility to the number of beds

4-4  occupied when the violation occurred, until it determines that the

4-5  facility has corrected the violation;

4-6  (c) Impose an administrative penalty of not more than $1,000

4-7  per day for each violation, together with interest thereon at a rate not

4-8  to exceed 10 percent per annum; and

4-9  (d) Appoint temporary management to oversee the operation of

4-10  the facility and to ensure the health and safety of the patients of the

4-11  facility, until:

4-12          (1) It determines that the facility has corrected the violation

4-13  and has management which is capable of ensuring continued

4-14  compliance with the applicable statutes, conditions, standards and

4-15  regulations; or

4-16          (2) Improvements are made to correct the violation.

4-17      2.  If the facility fails to pay any administrative penalty imposed

4-18  pursuant to paragraph (c) of subsection 1, the Health Division may:

4-19      (a) Suspend the license of the facility until the administrative

4-20  penalty is paid; and

4-21      (b) Collect court costs, reasonable attorney’s fees and other

4-22  costs incurred to collect the administrative penalty.

4-23      3.  The Health Division may require any facility that violates

4-24  any provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

4-25  section 3 of this act or any condition, standard or regulation adopted

4-26  by the Board, to make any improvements necessary to correct the

4-27  violation.

4-28      4.  Any money collected as administrative penalties pursuant to

4-29  this section must be accounted for separately and used to protect the

4-30  health or property of the residents of the facility in accordance with

4-31  applicable federal standards.

4-32      Sec. 7.  NRS 654.170 is hereby amended to read as follows:

4-33      654.170  1.  The Board shall issue a numbered license, in such

4-34  form as it may prescribe, to each applicant who meets the

4-35  requirements of NRS 654.150 or 654.155 and shall affix its official

4-36  seal to the license.

4-37      2.  Each license issued by the Board pursuant to this chapter

4-38  expires 2 years after the last day of the calendar month in which it

4-39  was issued and may be renewed on or before that date biennially.

4-40      3.  Any licensed nursing facility administrator or administrator

4-41  of a residential facility for groups may renew his license by applying

4-42  for renewal in the manner prescribed by the Board, submitting the

4-43  statement required pursuant to NRS 654.145 and paying the renewal

4-44  fee fixed by the Board.

5-1  4.  The Board shall, as a prerequisite for the renewal of a

5-2  license, require each holder to comply with [the] :

5-3  (a) The requirements for continuing education adopted by the

5-4  Board[.] ; and

5-5  (b) The duties of the administrator set forth in section 3 of this

5-6  act.

5-7  Sec. 8.  NRS 654.170 is hereby amended to read as follows:

5-8  654.170  1.  The Board shall issue a numbered license, in such

5-9  form as it may prescribe, to each applicant who meets the

5-10  requirements of NRS 654.150 or 654.155 and shall affix its official

5-11  seal to the license.

5-12      2.  Each license issued by the Board pursuant to this chapter

5-13  expires 2 years after the last day of the calendar month in which it

5-14  was issued and may be renewed on or before that date biennially.

5-15      3.  Any licensed nursing facility administrator or administrator

5-16  of a residential facility for groups may renew his license by applying

5-17  for renewal in the manner prescribed by the Board and paying the

5-18  renewal fee fixed by the Board.

5-19      4.  The Board shall, as a prerequisite for the renewal of a

5-20  license, require each holder to comply with [the] :

5-21      (a) The requirements for continuing education adopted by the

5-22  Board [.] ; and

5-23      (b) The duties of the administrator set forth in section 3 of this

5-24  act.

5-25      Sec. 9.  NRS 654.190 is hereby amended to read as follows:

5-26      654.190  1.  The Board may, after notice and hearing, impose

5-27  an administrative fine of not more than $2,500 on and suspend or

5-28  revoke the license of any nursing facility administrator or

5-29  administrator of a residential facility for groups who:

5-30      (a) Is convicted of a felony, or of any offense involving moral

5-31  turpitude.

5-32      (b) Has obtained his license by the use of fraud or deceit.

5-33      (c) Violates any of the provisions of this chapter.

5-34      (d) Aids or abets any person in the violation of any of the

5-35  provisions of NRS 449.001 to 449.240, inclusive, and section 3 of

5-36  this act as those provisions pertain to a facility for skilled nursing,

5-37  facility for intermediate care or residential facility for groups.

5-38      (e) Violates any regulation of the Board prescribing additional

5-39  standards of conduct for nursing facility administrators or

5-40  administrators of residential facilities for groups.

5-41      2.  The Board shall give a licensee against whom proceedings

5-42  are brought pursuant to this section written notice of a hearing not

5-43  less than 10 days before the date of the hearing.

6-1  3.  If discipline is imposed pursuant to this section, the costs of

6-2  the proceeding, including investigative costs and attorney’s fees,

6-3  may be recovered by the Board.

6-4  Sec. 10.  The provisions of NRS 354.599 do not apply to any

6-5  additional expenses of a local government that are related to the

6-6  provisions of this act.

6-7  Sec. 11.  1.  This act becomes effective on July 1, 2003.

6-8  2.  Section 7 of this act expires by limitation on the date on

6-9  which the provisions of 42 U.S.C. § 666 requiring each state to

6-10  establish procedures under which the state has authority to withhold

6-11  or suspend, or to restrict the use of professional, occupational and

6-12  recreational licenses of persons who:

6-13      (a) Have failed to comply with a subpoena or warrant relating to

6-14  a proceeding to determine the paternity of a child or to establish or

6-15  enforce an obligation for the support of a child; or

6-16      (b) Are in arrears in the payment for the support of one or more

6-17  children,

6-18  are repealed by the Congress of the United States.

6-19      3.  Section 8 of this act becomes effective on the date on which

6-20  the provisions of 42 U.S.C. § 666 requiring each state to establish

6-21  procedures under which the state has authority to withhold or

6-22  suspend, or to restrict the use of professional, occupational and

6-23  recreational licenses of persons who:

6-24      (a) Have failed to comply with a subpoena or warrant relating to

6-25  a proceeding to determine the paternity of a child or to establish or

6-26  enforce an obligation for the support of a child; or

6-27      (b) Are in arrears in the payment for the support of one or more

6-28  children,

6-29  are repealed by the Congress of the United States.

 

6-30  H