[Rev. 9/23/2024 10:26:27 AM]
[NAC-433A Revised Date: 8-24]
CHAPTER 433A - ADMISSION TO MENTAL HEALTH FACILITIES OR ASSISTED OUTPATIENT TREATMENT; HOSPITALIZATION
433A.150 Definitions.
433A.160 “Hospital” defined.
433A.170 “Public or private mental health facility” defined.
433A.180 “Emergency services or care” interpreted.
433A.200 Examination before emergency admission of person in mental health crisis to facility.
433A.210 Emergency admission of person with medical condition other than psychiatric condition to facility.
433A.220 Mandatory reports of admissions.
NAC 433A.150 Definitions. (NRS 433.324, 433A.165, 433A.713, 439.200) As used in NAC 433A.150 to 433A.220, inclusive, unless the context otherwise requires, the words and terms defined in NAC 433A.160 and 433A.170 have the meanings ascribed to them in those sections.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
NAC 433A.160 “Hospital” defined. (NRS 433.324, 433A.165, 433A.713, 439.200) “Hospital” has the meaning ascribed to it in NRS 449.012.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
NAC 433A.170 “Public or private mental health facility” defined. (NRS 433.324, 433A.165, 433A.713, 439.200) “Public or private mental health facility” means:
1. A community triage center, as defined in NRS 449.0031;
2. A psychiatric hospital, as defined in NRS 449.0165, including, without limitation, a psychiatric hospital endorsed as a crisis stabilization center pursuant to NRS 449.0915; or
3. Any other facility for the diagnosis, care and treatment of persons with mental illness which provides 24-hour care.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
NAC 433A.180 “Emergency services or care” interpreted. (NRS 433.324, 433A.165, 439.200) As used in NRS 433A.165, “emergency services or care” has the meaning ascribed to “emergency services and care” in NRS 439B.410.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
NAC 433A.200 Examination before emergency admission of person in mental health crisis to facility. (NRS 433.324, 433A.165, 439.200)
1. An examination conducted pursuant to NRS 433A.165 must include, without limitation, an assessment of whether the person alleged to be a person in a mental health crisis is experiencing the symptoms of intoxication or withdrawal from alcohol or another drug. If so, the physician, physician assistant or advanced practice registered nurse conducting the examination may include in the examination a quantitative measurement of the concentration of alcohol in the blood of the person alleged to be a person in a mental health crisis.
2. If a person alleged to be a person in a mental health crisis is being transferred after receiving acute inpatient care, which may include, without limitation, emergency services or care, at a hospital, other than a psychiatric hospital, the examination conducted pursuant to NRS 433A.165 must include, upon the request of the public or private mental health facility:
(a) A test of the urine of the person alleged to be a person in a mental health crisis to detect the presence of a drug; and
(b) A test to determine whether the person alleged to be a person in a mental health crisis is pregnant, except that such a test is not required if:
(1) The person is not capable of becoming pregnant; or
(2) The physician, physician assistant or advanced practice registered nurse conducting the examination determines that the test is not medically appropriate.
3. After completing the examination of a person alleged to be a person in a mental health crisis pursuant to NRS 433A.165, a physician, physician assistant or advanced practice registered nurse shall attest on the form for admission to a mental health facility submitted pursuant to NRS 433A.130 whether the person has a medical condition, other than a psychiatric condition, which requires immediate treatment.
4. Except as otherwise provided in this subsection, a public or private mental health facility shall not refuse to admit a person alleged to be a person in a mental health crisis under an emergency admission based on the results of a medical examination conducted pursuant to NRS 433A.165 or pending the results of a test conducted pursuant to paragraph (a) of subsection 2 if the physician, physician assistant or advanced practice registered nurse who conducted the examination attests on the form completed pursuant to NRS 433A.130 that the person does not have a medical condition, other than a psychiatric condition, which requires immediate treatment. This subsection shall not be construed to require a mental health facility to admit any person who does not meet the criteria established by the facility for admission.
5. An employee or independent contractor of a public or private mental health facility who is not informed whether a person alleged to be a person in a mental health crisis has a medical condition, other than a psychiatric condition, which requires immediate treatment shall contact the physician, physician assistant or advanced practice registered nurse who examined the person pursuant to NRS 433A.165 to request that information.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
REVISER’S NOTE.
Following the 2021 Legislative Session, NRS 433A.085 was substituted in revision for NRS 433A.130.
NAC 433A.210 Emergency admission of person with medical condition other than psychiatric condition to facility. (NRS 433.324, 433A.165, 439.200) If a physician, physician assistant or advanced practice registered nurse determines that a person examined pursuant to NRS 433A.165 has a medical condition, other than a psychiatric condition, which requires immediate treatment but that the person is not in need of emergency services or care, the person may be admitted to:
1. A public or private mental health facility; or
2. A psychiatric hospital or a distinct unit of a hospital that provides acute long-term care to persons who are in a mental health crisis.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)
NAC 433A.220 Mandatory reports of admissions. (NRS 433.324, 433A.713, 439.200)
1. Not later than 48 hours after receiving an application for the emergency admission of a person alleged to be a person in a mental health crisis pursuant to NRS 433A.160, the director of a public or private mental health facility or hospital or his or her designee must submit to the Division in the form prescribed by the Division:
(a) The date and time on which the application was initiated;
(b) The date and time that the person arrived at the public or private mental health facility or hospital;
(c) The manner in which the person arrived at or was transported to the public or private mental health facility or hospital;
(d) Any known source of payment for services provided to the person; and
(e) The gender and age of the person.
2. Not later than 48 hours after discharging a person who has been admitted to a public or private mental health facility or hospital on an emergency admission or 48 hours after the expiration of the period prescribed by subsection 2 of NRS 433A.150, whichever is sooner, the director of the public or private mental health facility or hospital or his or her designee shall submit to the Division in the form prescribed by the Division:
(a) The date and time of the discharge, if applicable;
(b) The final disposition of the application for emergency admission;
(c) Any public or private mental health facility or hospital to which the person was referred, the date and time of the referral, whether the referral was accepted or denied and, if the referral was denied, the reason for the denial;
(d) The final disposition of the emergency admission; and
(e) If applicable, the information described in subsection 3.
3. If a petition for the involuntary court-ordered admission of the person is filed pursuant to NRS 433A.200, the information submitted pursuant to subsection 2 must include, without limitation:
(a) The date and time on which the petition was filed and the determination of the court concerning the petition;
(b) If the petition is denied, whether the admission was converted to voluntary status after the denial; and
(c) If the petition is denied and a new application for the emergency admission of the person based on new evidence is filed within 24 hours after the denial, the date and time of the new application and a description of the new evidence.
4. For each calendar quarter, the director of a public or private mental health facility shall submit to each regional behavioral health policy board created by NRS 433.429 a summary of data concerning admissions to the public or private mental health facility which includes, without limitation:
(a) The number of voluntary admissions to the public or private mental health facility during the quarter; and
(b) The combined number of emergency admissions and involuntary court-ordered admissions to the public or private mental health facility during the quarter.
5. As used in this section, “director” means:
(a) The administrative officer of a division facility; or
(b) The person in charge of the provision of care to patients at any other public or private mental health facility or hospital.
(Added to NAC by Bd. of Health by R011-20, eff. 8-26-2020)