exempt

                                                 (Reprinted with amendments adopted on April 16, 2003)

 

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.

 

~

 

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

 

AN ACT relating to health care; requiring certain employees of facilities for long-term care to receive education in the care of persons with dementia; requiring the Department of Human Resources to develop a plan for increasing the number of beds in this state that are used to provide long-term care to persons with dementia; 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

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

1-3  1.  The Board shall establish minimum continuing education

1-4  requirements concerning the care of persons with any form of

1-5  dementia, including, without limitation, dementia caused by

1-6  Alzheimer’s disease, for each person who is:

1-7  (a) Employed by a facility for skilled nursing, facility for

1-8  intermediate care or residential facility for groups which provides

1-9  care to persons with any form of dementia; and

1-10      (b) Licensed or certified by an occupational licensing board.

2-1  2.  In establishing continuing education requirements

2-2  pursuant to subsection 1, the Board shall consider any other

2-3  educational requirements imposed on such employees to ensure

2-4  that the continuing education requirements established by the

2-5  Board do not duplicate or conflict with the existing educational

2-6  requirements imposed on those employees.

2-7  3.  The administrator of a facility for skilled nursing, facility

2-8  for intermediate care or residential facility for groups which

2-9  provides care to persons with any form of dementia, including,

2-10  without limitation, dementia caused by Alzheimer’s disease, shall

2-11  ensure that each employee of the facility who is required to comply

2-12  with the requirements for continuing education established by the

2-13  Board pursuant to this section complies with such requirements.

2-14      Sec. 2.  NRS 449.070 is hereby amended to read as follows:

2-15      449.070  The provisions of NRS 449.001 to 449.240, inclusive,

2-16  and section 1 of this act do not apply to:

2-17      1.  Any facility conducted by and for the adherents of any

2-18  church or religious denomination for the purpose of providing

2-19  facilities for the care and treatment of the sick who depend solely

2-20  upon spiritual means through prayer for healing in the practice of

2-21  the religion of the church or denomination, except that such a

2-22  facility [must] shall comply with all regulations relative to

2-23  sanitation and safety applicable to other facilities of a similar

2-24  category.

2-25      2.  Foster homes as defined in NRS 424.014.

2-26      3.  Any medical facility or facility for the dependent operated

2-27  and maintained by the United States Government or an agency

2-28  thereof.

2-29      Sec. 3.  NRS 449.160 is hereby amended to read as follows:

2-30      449.160  1.  The Health Division may deny an application for

2-31  a license or may suspend or revoke any license issued under the

2-32  provisions of NRS 449.001 to 449.240, inclusive, and section 1 of

2-33  this act upon any of the following grounds:

2-34      (a) Violation by the applicant or the licensee of any of the

2-35  provisions of NRS 439B.410 or 449.001 to 449.245, inclusive, and

2-36  section 1 of this act or of any other law of this state or of the

2-37  standards, rules and regulations adopted thereunder.

2-38      (b) Aiding, abetting or permitting the commission of any illegal

2-39  act.

2-40      (c) Conduct inimical to the public health, morals, welfare and

2-41  safety of the people of the State of Nevada in the maintenance and

2-42  operation of the premises for which a license is issued.

2-43      (d) Conduct or practice detrimental to the health or safety of the

2-44  occupants or employees of the facility.

3-1  (e) Failure of the applicant to obtain written approval from the

3-2  Director of the Department of Human Resources as required by

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

3-4  this chapter, if such approval is required.

3-5  2.  In addition to the provisions of subsection 1, the Health

3-6  Division may revoke a license to operate a facility for the dependent

3-7  if, with respect to that facility, the licensee that operates the facility,

3-8  or an agent or employee of the licensee:

3-9  (a) Is convicted of violating any of the provisions of

3-10  NRS 202.470;

3-11      (b) Is ordered to but fails to abate a nuisance pursuant to NRS

3-12  244.360, 244.3603 or 268.4124; or

3-13      (c) Is ordered by the appropriate governmental agency to correct

3-14  a violation of a building, safety or health code or regulation but fails

3-15  to correct the violation.

3-16      3.  The Health Division shall maintain a log of any complaints

3-17  that it receives relating to activities for which the Health Division

3-18  may revoke the license to operate a facility for the dependent

3-19  pursuant to subsection 2.

3-20      4.  On or before February 1 of each odd-numbered year, the

3-21  Health Division shall submit to the Director of the Legislative

3-22  Counsel Bureau a written report setting forth, for the previous

3-23  biennium:

3-24      (a) Any complaints included in the log maintained by the Health

3-25  Division pursuant to subsection 3; and

3-26      (b) Any disciplinary actions taken by the Health Division

3-27  pursuant to subsection 2.

3-28      Sec. 4.  NRS 449.163 is hereby amended to read as follows:

3-29      449.163  1.  If a medical facility or facility for the dependent

3-30  violates any provision related to its licensure, including any

3-31  provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

3-32  section 1 of this act or any condition, standard or regulation adopted

3-33  by the Board, the Health Division in accordance with the regulations

3-34  adopted pursuant to NRS 449.165 may:

3-35      (a) Prohibit the facility from admitting any patient until it

3-36  determines that the facility has corrected the violation;

3-37      (b) Limit the occupancy of the facility to the number of beds

3-38  occupied when the violation occurred, until it determines that the

3-39  facility has corrected the violation;

3-40      (c) Impose an administrative penalty of not more than $1,000

3-41  per day for each violation, together with interest thereon at a rate not

3-42  to exceed 10 percent per annum; and

3-43      (d) Appoint temporary management to oversee the operation of

3-44  the facility and to ensure the health and safety of the patients of the

3-45  facility, until:

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

4-2  and has management which is capable of ensuring continued

4-3  compliance with the applicable statutes, conditions, standards and

4-4  regulations; or

4-5       (2) Improvements are made to correct the violation.

4-6  2.  If the facility fails to pay any administrative penalty imposed

4-7  pursuant to paragraph (c) of subsection 1, the Health Division may:

4-8  (a) Suspend the license of the facility until the administrative

4-9  penalty is paid; and

4-10      (b) Collect court costs, reasonable attorney’s fees and other

4-11  costs incurred to collect the administrative penalty.

4-12      3.  The Health Division may require any facility that violates

4-13  any provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

4-14  section 1 of this act or any condition, standard or regulation adopted

4-15  by the Board, to make any improvements necessary to correct the

4-16  violation.

4-17      4.  Any money collected as administrative penalties pursuant to

4-18  this section must be accounted for separately and used to protect the

4-19  health or property of the residents of the facility in accordance with

4-20  applicable federal standards.

4-21      Sec. 5.  NRS 654.170 is hereby amended to read as follows:

4-22      654.170  1.  The Board shall issue a numbered license, in such

4-23  form as it may prescribe, to each applicant who meets the

4-24  requirements of NRS 654.150 or 654.155 and shall affix its official

4-25  seal to the license.

4-26      2.  Each license issued by the Board pursuant to this chapter

4-27  expires 2 years after the last day of the calendar month in which it

4-28  was issued and may be renewed on or before that date biennially.

4-29      3.  Any licensed nursing facility administrator or administrator

4-30  of a residential facility for groups may renew his license by applying

4-31  for renewal in the manner prescribed by the Board, submitting the

4-32  statement required pursuant to NRS 654.145 and paying the renewal

4-33  fee fixed by the Board.

4-34      4.  The Board shall, as a prerequisite for the renewal of a

4-35  license, require each holder to comply with [the] :

4-36      (a) The requirements for continuing education adopted by the

4-37  Board[.] ; and

4-38      (b) The duties of the administrator set forth in section 1 of this

4-39  act.

4-40      Sec. 6.  NRS 654.170 is hereby amended to read as follows:

4-41      654.170  1.  The Board shall issue a numbered license, in such

4-42  form as it may prescribe, to each applicant who meets the

4-43  requirements of NRS 654.150 or 654.155 and shall affix its official

4-44  seal to the license.

5-1  2.  Each license issued by the Board pursuant to this chapter

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

5-3  was issued and may be renewed on or before that date biennially.

5-4  3.  Any licensed nursing facility administrator or administrator

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

5-6  for renewal in the manner prescribed by the Board and paying the

5-7  renewal fee fixed by the Board.

5-8  4.  The Board shall, as a prerequisite for the renewal of a

5-9  license, require each holder to comply with [the] :

5-10      (a) The requirements for continuing education adopted by the

5-11  Board [.] ; and

5-12      (b) The duties of the administrator set forth in section 1 of this

5-13  act.

5-14      Sec. 7.  NRS 654.190 is hereby amended to read as follows:

5-15      654.190  1.  The Board may, after notice and hearing, impose

5-16  an administrative fine of not more than $2,500 on and suspend or

5-17  revoke the license of any nursing facility administrator or

5-18  administrator of a residential facility for groups who:

5-19      (a) Is convicted of a felony, or of any offense involving moral

5-20  turpitude.

5-21      (b) Has obtained his license by the use of fraud or deceit.

5-22      (c) Violates any of the provisions of this chapter.

5-23      (d) Aids or abets any person in the violation of any of the

5-24  provisions of NRS 449.001 to 449.240, inclusive, and section 1 of

5-25  this act as those provisions pertain to a facility for skilled nursing,

5-26  facility for intermediate care or residential facility for groups.

5-27      (e) Violates any regulation of the Board prescribing additional

5-28  standards of conduct for nursing facility administrators or

5-29  administrators of residential facilities for groups.

5-30      2.  The Board shall give a licensee against whom proceedings

5-31  are brought pursuant to this section written notice of a hearing not

5-32  less than 10 days before the date of the hearing.

5-33      3.  If discipline is imposed pursuant to this section, the costs of

5-34  the proceeding, including investigative costs and attorney’s fees,

5-35  may be recovered by the Board.

5-36      Sec. 8.  1.  The Department of Human Resources shall

5-37  develop a plan for increasing the number of beds in this state that

5-38  are used to provide long-term care to persons with any form of

5-39  dementia, including, without limitation, dementia caused by

5-40  Alzheimer’s disease. The plan must include various methods for

5-41  increasing the number of such beds, including, without limitation:

5-42      (a) Changing the rate at which Medicaid reimburses facilities for

5-43  providing long-term care to persons with any form of dementia;

5-44      (b) The use of financial policies and incentives to encourage and

5-45  facilitate the development and creation of such beds; and

6-1  (c) The use or modification of existing public and private

6-2  facilities in this state for providing long-term care to persons with

6-3  any form of dementia.

6-4  2.  The Department of Human Resources shall submit the plan

6-5  to the Interim Finance Committee and the Legislative Committee on

6-6  Health Care on or before June 30, 2004.

6-7  Sec. 9.  1.  This act becomes effective on July 1, 2003.

6-8  2.  Section 5 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 6 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