NAC: CHAPTER 640C - MASSAGE THERAPISTS

[Rev. 9/10/2019 10:50:33 AM]

[NAC-640C Revised Date: 8-19]

CHAPTER 640C - MASSAGE THERAPISTS

GENERAL PROVISIONS

640C.001 Definitions.

640C.005 “Certificate” defined.

640C.008 “Hour of instruction” defined.

640C.010 “Massage establishment” defined.

640C.020 “Reflexology establishment” defined.

640C.025 “Structural integration establishment” defined.

640C.040 Applicability: Exemption for students enrolled in school recognized by Board.

LICENSING OF MASSAGE THERAPISTS, REFLEXOLOGISTS AND STRUCTURAL INTEGRATION PRACTITIONERS; CERTIFICATION OF MASSAGE, REFLEXOLOGY AND STRUCTURAL INTEGRATION ESTABLISHMENTS

640C.050 Examination of applicants for licensure.

640C.052 License to practice massage therapy: Requirements for recognition of program by Board.

640C.055 License to practice reflexology: Requirements for recognition of program by Board.

640C.057 License to practice structural integration: Requirements for recognition of program by Board.

640C.060 Requirements for request for recognition of massage therapy, reflexology or structural integration program not already recognized by statute; consideration of request.

640C.070 Reporting results of investigation of applicant for licensure.

640C.075 Issuance of license to applicant and immediate placement on probation; terms of probation.

640C.080 Validity of license restored after expiration.

640C.083 Certificate of operation: Requirement for operation of establishment; application; fee; period of validity and renewal.

640C.085 Filing of residential address by licensee with Board; filing of establishment address by certificate holder with Board; change of address; use of recent address by Board.

640C.090 Required notification to Board of certain actions filed or taken against licensee or certificate holder.

640C.093 Additional notifications to Board required of certificate holder.

640C.095 Fees.

CONTINUING EDUCATION

640C.100 Massage therapists and structural integration practitioners: Requirements to maintain license; proof of completion; request to carry over excess hours of credit; notice of noncompliance.

640C.110 Massage therapists: Approval of credits by Board.

640C.112 Structural integration practitioners: Approval of credits by Board.

640C.115 Reflexologists: Requirements to maintain license; request to carry over excess hours of credit; notice of noncompliance.

640C.117 Reflexologists: Approval of credits by Board.

640C.120 Massage therapists, reflexologists and structural integration practitioners: Request for approval of credit for attending, preparing or giving presentation; notice of approval or denial.

640C.130 Massage therapists, reflexologists and structural integration practitioners: Information and documentation required to obtain credit.

640C.140 Requirements for request of approval for course or program; notice of approval or denial.

MASSAGE, REFLEXOLOGY AND STRUCTURAL INTEGRATION ESTABLISHMENTS

640C.200 Required facilities; sanitary and safety requirements.

640C.210 Lubricants; spa treatments, muds and body wraps.

640C.220 Exterior doors and windows; walls, ceilings and floors.

640C.230 Requirements for room in which massage therapy, reflexology or structural integration is practiced.

640C.240 Towels, linens and gowns; single service items.

640C.250 Massage therapists, reflexologists and structural integration practitioners: Clothing and hygiene requirements; provision of uniforms by establishment.

640C.260 Water supply and water distribution system piping.

640C.270 Bathing facilities.

640C.280 Disposal of sewage and liquid waste.

640C.290 Garbage and refuse.

640C.300 Toilets and lavatories.

640C.310 Duties of establishment: Maintenance of establishment; ensuring no sexual or unlicensed activity occurs at establishment.

640C.320 Inspections.

STANDARDS OF PRACTICE

640C.330 Display of certificate in establishment.

640C.333 Display of license in establishment or on person.

640C.337 Annual list of licensees employed by or working in establishment required to be provided to Board.

640C.340 Massage therapist required to drape client.

640C.345 Client of reflexologist must be fully clothed; exception for portion of legs and feet.

640C.350 Advertisements to include license number of massage therapist.

640C.360 Communicable diseases.

UNPROFESSIONAL AND UNETHICAL CONDUCT; PENALTIES

640C.400 “Sexual activity” interpreted.

640C.405 Performance of structural integration along certain parts of body does not constitute “sexual activity”; prohibition on structural integration practitioner touching certain parts of body.

640C.410 “Unethical or unprofessional conduct” interpreted.

640C.420 Provisions regarding unprofessional or unethical conduct: Consent does not excuse or negate responsibility to comply; exceptions.

640C.450 Schedule of administrative fines.

640C.455 Additional factors for consideration by Board in determining administrative fine imposed against licensee for engaging in or soliciting sexual activity or for conviction of prostitution or other sexual offense.

GENERAL PROVISIONS

NAC 640C.001 Definitions. (NRS 640C.320) As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 640C.005 to 640C.025, inclusive, have the meanings ascribed to them in those sections.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.005 “Certificate” defined. (NRS 640C.320) “Certificate” means a certificate to operate a massage establishment, a certificate to operate a reflexology establishment or a certificate to operate a structural integration establishment, which is issued by the Board.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.008 “Hour of instruction” defined. (NRS 640C.320) “Hour of instruction” means not less than 50 minutes nor more than 60 minutes of instruction.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.010 “Massage establishment” defined. (NRS 640C.320) “Massage establishment” means any premises, mobile unit, building or part of a building where massage therapy is practiced.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008)

NAC 640C.020 “Reflexology establishment” defined. (NRS 640C.320) “Reflexology establishment” means any premises, mobile unit, building or part of a building where reflexology is practiced.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

NAC 640C.025 “Structural integration establishment” defined. (NRS 640C.320) “Structural integration establishment” means any premises, mobile unit, building or part of a building where structural integration is practiced.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

NAC 640C.040 Applicability: Exemption for students enrolled in school recognized by Board. (NRS 640C.100, 640C.320) For the purposes of paragraph (f) of subsection 1 of NRS 640C.100, the Board interprets the exemption in that paragraph to apply only to students enrolled in a school of massage therapy, reflexology or structural integration which is recognized by the Board while the student is performing massage therapy, reflexology or structural integration at the school or other location, provided that the student is supervised by an instructor.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

LICENSING OF MASSAGE THERAPISTS, REFLEXOLOGISTS AND STRUCTURAL INTEGRATION PRACTITIONERS; CERTIFICATION OF MASSAGE, REFLEXOLOGY AND STRUCTURAL INTEGRATION ESTABLISHMENTS

NAC 640C.050 Examination of applicants for licensure. (NRS 640C.320, 640C.400, 640C.600, 640C.620)

1. For the purposes of paragraph (c) of subsection 2 of NRS 640C.400, an applicant for a license to practice massage therapy must pass:

(a) The National Certification Examination for Therapeutic Massage administered by the National Certification Board for Therapeutic Massage and Bodywork;

(b) The National Certification Examination for Therapeutic Massage and Bodywork administered by the National Certification Board for Therapeutic Massage and Bodywork;

(c) The National Examination for State Licensing administered by the National Certification Board for Therapeutic Massage and Bodywork;

(d) The Massage and Bodywork Licensing Examination administered by the Federation of State Massage Therapy Boards; or

(e) The ITEC Examination administered by the International Therapy Examination Council.

2. For the purposes of paragraph (c) of subsection 2 of NRS 640C.600, an applicant for a license to practice reflexology must pass:

(a) The certification exam administered by the American Reflexology Certification Board;

(b) The certification exam administered by the International Institute of Reflexology;

(d) The Board Certification Exam (BCETMB) administered by the National Certification Board for Therapeutic Massage and Bodywork.

3. For the purposes of paragraph (c) of subsection 2 of NRS 640C.620, an applicant for a license to practice structural integration must pass the certification exam for structural integration administered by the Certification Board for Structural Integration.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

NAC 640C.052 License to practice massage therapy: Requirements for recognition of program by Board. (NRS 640C.320, 640C.400) The Board will recognize a program of massage therapy pursuant to paragraph (b) of subsection 3 of NRS 640C.400, if the program requires its pupils to complete a minimum of 550 hours of instruction in the following courses before receiving a certificate evidencing successful completion of the program:

1. At least 125 hours of instruction in the body’s systems, including, without limitation, anatomy, physiology and kinesiology;

2. At least 220 hours of instruction which is taken in a classroom setting with hands-on instruction in assessment, theory and application instruction, which must include at least 80 hours in clinical instruction;

3. At least 40 hours of instruction in pathology;

4. At least 40 hours of instruction in business or ethics or a combined total of at least 40 hours of instruction in business and ethics; and

5. At least 125 hours of instruction in other courses of massage therapy in a classroom setting with hands-on instruction.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018; A by R040-18, 6-26-2018)

NAC 640C.055 License to practice reflexology: Requirements for recognition of program by Board. (NRS 640C.320, 640C.600) The Board will recognize a program of reflexology pursuant to paragraph (b) of subsection 3 of NRS 640C.600, if the program requires its pupils to complete a minimum of 200 hours of instruction in the following courses before receiving a certificate evidencing successful completion of the program:

1. At least 25 hours of instruction in reflexology theory, history, zones, meridians and relaxation response;

2. At least 40 hours of instruction in body systems relating to reflexology, including, without limitation, a study of the leg and foot as a structure, hands-on palpation of landmarks with sensory identification of palpated areas, and a map of reflexes;

3. At least 30 hours of instruction in anatomy and physiology;

4. At least 15 hours of instruction in business or ethics or a combined total of at least 15 hours of instruction in business and ethics; and

5. At least 90 hours of instruction in supervised practicum or clinical work.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.057 License to practice structural integration: Requirements for recognition of program by Board. (NRS 640C.320, 640C.620) The Board will recognize a program of structural integration pursuant to paragraph (b) of subsection 3 of NRS 640C.620, if the program requires its pupils to complete a minimum of 730 hours of instruction in the following courses before receiving a certificate evidencing successful completion of the program:

1. At least 230 hours of instruction in anatomy, physiology and kinesiology; and

2. At least 500 hours of instruction which is taken in a classroom setting with hands-on instruction in assessment, theory and application instruction, which must include:

(a) At least 100 hours in clinical instruction;

(b) At least 40 hours of instruction in pathology;

(d) At least 20 hours of instruction in ethics.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.060 Requirements for request for recognition of massage therapy, reflexology or structural integration program not already recognized by statute; consideration of request. (NRS 640C.320, 640C.400, 640C.600, 640C.620)

1. If an applicant for a license to practice massage therapy, reflexology or structural integration who otherwise satisfies the requirements of NRS 640C.400, 640C.420, 640C.600, 640C.610, 640C.620 or 640C.630 wishes the Board to recognize a program of massage therapy, reflexology or structural integration other than a program listed in paragraph (a) of subsection 3 of NRS 640C.400, paragraph (a) of subsection 3 of NRS 640C.600 or paragraph (a) of subsection 3 of NRS 640C.620, as applicable, the applicant must submit to the Board a detailed outline of the training of the applicant that includes, without limitation:

(a) A list of the instructors of the training;

(b) Any texts used as study guides for the training; and

(c) Certificates of completion for the training which evidence that the applicant has satisfied the number of training hours required by the Commission on Postsecondary Education for a program of massage therapy, reflexology or structural integration.

2. Where practicable, a request for recognition of a program of massage therapy, reflexology or structural integration made pursuant to this section will be considered by the Board at the next regularly scheduled meeting of the Board immediately following the receipt of the request.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, eff. 2-27-2018; R040-18, 6-26-2018)

NAC 640C.070 Reporting results of investigation of applicant for licensure. (NRS 640C.320) The Board or its designee will report the results of an investigation of an applicant for a license to practice massage therapy, reflexology or structural integration, where practicable, at the next scheduled meeting of the Board immediately after the receipt of all the background information relating to the applicant that the Board or its designee deems necessary to conduct the investigation.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.075 Issuance of license to applicant and immediate placement on probation; terms of probation. (NRS 640C.320, 640C.710)

1. The Board may issue a license to an applicant and immediately place the licensee on probation pursuant to NRS 640C.710 if the application or background of the applicant demonstrates that the applicant has committed one or more of the acts described in NRS 640C.700.

2. The terms of probation imposed pursuant to subsection 1 may require the licensee to:

(a) Report to the Board all contact with law enforcement personnel within 48 hours after such contact occurs;

(b) Refrain from providing outcall services;

(d) Notify the Board of any changes in his or her employment;

(e) Complete an ethics course within 90 calendar days after the issuance of the license;

(f) Submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report upon renewal of his or her license;

(g) Attend a probation orientation;

(h) Take any other action that the Board deems appropriate; or

(i) Take any combination of the actions set forth in paragraphs (a) to (h), inclusive.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.080 Validity of license restored after expiration. (NRS 640C.320, 640C.500) For the purposes of subsection 2 of NRS 640C.500, a license which has been restored is valid from the day that it is issued.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

NAC 640C.083 Certificate of operation: Requirement for operation of establishment; application; fee; period of validity and renewal. (NRS 640C.320, 640C.330)

1. A person shall not operate a massage establishment, a reflexology establishment or a structural integration establishment unless the person holds a valid certificate to operate a massage establishment, a reflexology establishment or a structural integration establishment, as applicable, which has been issued by the Board.

2. To obtain a certificate, an applicant for a certificate must submit a completed application for the applicable certificate on a form prescribed by the Board and the fee set forth in NAC 640C.095. The Board will issue a certificate to an applicant who complies with the requirements of this chapter and chapter 640C of NRS.

3. A certificate is valid for 1 year after the first day of the first calendar month immediately following the date of issuance or renewal and may be renewed if, before the certificate expires, the holder of the certificate submits to the Board a completed application for renewal on a form prescribed by the Board and the fee set forth in NAC 640C.095.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018; A by R040-18, 6-26-2018)

NAC 640C.085 Filing of residential address by licensee with Board; filing of establishment address by certificate holder with Board; change of address; use of recent address by Board. (NRS 640C.320, 640C.330)

1. Each licensee shall file with the Board, using the Internet website of the Board, his or her current residential address.

2. Each holder of a certificate shall file with the Board, using the Internet website of the Board:

(a) The current address of each massage establishment, reflexology establishment or structural integration establishment operated by the holder; and

(b) A change in the name of any massage establishment, reflexology establishment or structural integration establishment operated by the holder.

3. Not later than 10 calendar days after a licensee changes his or her residential address or a holder of a certificate changes the address of the massage establishment, reflexology establishment or structural integration establishment, as applicable, the licensee or holder of the certificate shall notify the Board of the change using the Internet website of the Board.

4. If the Board is required to send or deliver any notice by mail to a licensee or a holder of a certificate, the notice shall be deemed to be sent or delivered if it is mailed to the most recent address on file with the Board by the licensee or holder of the certificate.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.090 Required notification to Board of certain actions filed or taken against licensee or certificate holder. (NRS 640C.320, 640C.330) A licensee or a holder of a certificate shall notify the Board in writing within 10 business days after:

1. An action is taken against any license, certification, registration or other credential relating to the practice of massage therapy, reflexology or structural integration that is held by the licensee or holder of a certificate and was issued by another jurisdiction;

2. A criminal charge is filed in any jurisdiction against the licensee or holder of the certificate;

3. The licensee or holder of a certificate is convicted of a criminal offense in any jurisdiction, other than a traffic offense which is a misdemeanor;

4. A civil action for malpractice is filed in any jurisdiction against the licensee or holder of a certificate; or

5. A settlement or judgment is entered in any civil action for malpractice, in any case filed in any jurisdiction against the licensee or holder of a certificate for any act relating to the practice of massage therapy, reflexology or structural integration, as applicable.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.093 Additional notifications to Board required of certificate holder. (NRS 640C.320, 640C.330) The holder of a certificate shall report to the Board:

1. Any arrest or other action taken by a law enforcement agency on the premises of the massage establishment, reflexology establishment or structural integration establishment operated by the holder, within 10 business days after the arrest or other law enforcement action. The report must include, without limitation:

(a) The name of the person or persons arrested or otherwise involved in the law enforcement action;

(b) The date of the arrest or other law enforcement action;

(d) Any other information required by the Board relating to the arrest or other law enforcement action.

2. Any statement made by a client to a massage establishment, reflexology establishment or structural integration establishment operated by the holder that the client was touched inappropriately by a massage therapist, reflexologist or structural integration practitioner.

3. The termination by a massage establishment, reflexology establishment or structural integration establishment operated by the holder of the employment of a massage therapist, reflexologist or structural integration practitioner for touching a client inappropriately.

4. Any adverse employment action taken by a massage establishment, reflexology establishment or structural integration establishment operated by the holder against a massage therapist, reflexologist or structural integration practitioner for unprofessional conduct.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.095 Fees. (NRS 640C.320, 640C.330, 640C.520) The Board will charge and collect the following nonrefundable fees:

1. For an application for a license as a massage therapist, a reflexologist or a structural integration practitioner..........................................................................	$100
2. For issuing a license as a massage therapist, a reflexologist or a structural integration practitioner........................................................................................	$295
3. For issuing a temporary license................................................................	$250
4. For conducting a background check........................................................	$85
5. For renewing a license as a massage therapist, a reflexologist or a structural integration practitioner..........................................................................	$295
6. For restoring an expired license...............................................................	$25 per each expired month, not to exceed $500
7. For reinstatement of a suspended or revoked license...............................	$500
8. For issuing a replacement license.............................................................	$50
9. For restoring an inactive license...............................................................	$295
10. For issuing a certificate for a massage establishment or a structural integration establishment:
(a) For an establishment with a single room for massage therapy or structural integration..........................................................................................................	no fee
(b) For an establishment with at least 2 but not more than 7 rooms for massage therapy or structural integration.............................................................	$15
(c) For an establishment with at least 8 but not more than 20 rooms for massage therapy or structural integration.............................................................	$25
(d) For an establishment with at least 21 but not more than 40 rooms for massage therapy or structural integration.............................................................	$35
(e) For an establishment with more than 40 rooms for massage therapy or structural integration............................................................................................	$50
11. For the renewal of a certificate for a massage establishment or a structural integration establishment:
(a) For an establishment with a single room for massage therapy or structural integration..........................................................................................................	no fee
(b) For an establishment with at least 2 but not more than 7 rooms for massage therapy or structural integration.............................................................	$15
(c) For an establishment with at least 8 but not more than 20 rooms for massage therapy or structural integration.............................................................	$25
(d) For an establishment with at least 21 but not more than 40 rooms for massage therapy or structural integration.............................................................	$35
(e) For an establishment with more than 40 rooms for massage therapy or structural integration............................................................................................	$50
12. For issuing a certificate for a massage establishment that does not have rooms for massage therapy:
(a) For an establishment with not more than 10 chairs or tables for massage therapy...............................................................................................................	$20
(b) For an establishment with more than 10 chairs or tables for massage therapy...............................................................................................................	$40
13. For the renewal of a certificate for a massage establishment that does not have rooms for massage therapy:
(a) For an establishment with not more than 10 chairs or tables for massage therapy...............................................................................................................	$20
(b) For an establishment with more than 10 chairs or tables for massage therapy...............................................................................................................	$40
14. For issuing a certificate for a reflexology establishment:
(a) For an establishment with not more than 10 chairs or tables for reflexology	$20
(b) For an establishment with more than 10 chairs or tables for reflexology.....	$40
15. For renewal of a certificate for a reflexology establishment:
(a) For an establishment with not more than 10 chairs or tables for reflexology	$20
(b) For an establishment with more than 10 chairs or tables for reflexology.....	$40

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018; A by R040-18, 6-26-2018)

CONTINUING EDUCATION

NAC 640C.100 Massage therapists and structural integration practitioners: Requirements to maintain license; proof of completion; request to carry over excess hours of credit; notice of noncompliance. (NRS 640C.320, 640C.500)

1. To maintain his or her licensure, a massage therapist or structural integration practitioner must complete, to the satisfaction of the Board, at least 24 hours of instruction in continuing education as specified in NAC 640C.110 or 640C.112, as applicable, within the licensing period immediately preceding the request for renewal of his or her license. Except as otherwise provided in subsection 2, proof of the completion of the requirement for continuing education must be submitted with an application for renewal of a license.

2. If a massage therapist or structural integration practitioner obtains more than 24 hours of instruction in continuing education in a licensing period, the massage therapist or structural integration practitioner may request that the Board carry over the excess hours of credit, not to exceed 72 hours of instruction, to apply towards completion of the requirement for continuing education set forth in subsection 1 for succeeding years, up to a maximum of 3 succeeding years.

3. If a massage therapist or structural integration practitioner fails to complete the requirements for continuing education set forth in subsection 1 before the date on which his or her license expires, the Board will send a notice to the massage therapist or structural integration practitioner indicating that the massage therapist or structural integration practitioner is not in compliance with the requirements for continuing education.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018; R040-18, 6-26-2018)

NAC 640C.110 Massage therapists: Approval of credits by Board. (NRS 640C.320, 640C.500)

1. The Board will approve credit for continuing education for a license to practice massage therapy as follows:

(a) One hour of credit will be approved for each hour of instruction that a massage therapist attends a workshop, course, conference or seminar relating to the practice of massage therapy which is provided by a person or entity that is:

(1) Accredited by the National Commission for Certifying Agencies, or an equivalent accrediting body approved or recognized by the Board;

(2) Approved by the National Certification Board for Therapeutic Massage and Bodywork;

(3) A massage therapy school, bodywork therapy school, public college, postsecondary institution or other entity which offers a program of massage therapy that is recognized by the Board pursuant to NRS 640C.400 and NAC 640C.060; or

(4) A massage therapist with at least 2 years of experience in the practice of massage therapy or a related field who has previously received approval from the Board for the workshop, course, conference or seminar.

(b) The amount of credit for authoring a publication relating to the practice of massage therapy will be determined upon receipt and evaluation by the Board of the information required to be submitted pursuant to NAC 640C.130.

(c) One hour of credit, up to a maximum of 16 hours of credit per renewal period for each activity listed in subparagraphs (1), (2) and (3), will be approved for each hour of instruction spent:

(1) Giving a presentation at a workshop, course, conference or seminar relating to the practice of massage therapy.

(2) Preparing a presentation described in subparagraph (1).

(3) Serving as a member of the Board or a member of a committee appointed by the Board or attending a meeting of the Board.

2. A massage therapist may receive credit only once for giving or preparing a presentation described in subparagraph (1) of paragraph (c) of subsection 1.

3. The Board will consider the written request of a massage therapist for approval of credit for any continuing education that is not specified in subsection 1, including credit for any continuing education that is not specifically related to massage therapy, if the request is submitted to the Board at least 90 days before the date on which the license of the massage therapist expires.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R040-18, 6-26-2018)

NAC 640C.112 Structural integration practitioners: Approval of credits by Board. (NRS 640C.320, 640C.500)

1. The Board will approve credit for continuing education for a license to practice structural integration as follows:

(a) One hour of credit will be approved for each hour of instruction that a structural integration practitioner attends a workshop, course, conference or seminar relating to the practice of structural integration which is provided by a person or entity that is:

(1) Accredited by the National Commission for Certifying Agencies, or an equivalent accrediting body approved or recognized by the Board;

(2) Approved by the International Association of Structural Integrators;

(3) A structural integration school, bodywork therapy school, public college, postsecondary institution or other entity which offers a program of structural integration that is recognized by the Board pursuant to NRS 640C.620 and NAC 640C.060; or

(4) A structural integration practitioner with at least 2 years of experience in the practice of structural integration or a related field who has previously received approval from the Board for the workshop, course, conference or seminar.

(b) The amount of credit for authoring a publication relating to the practice of structural integration will be determined upon receipt and evaluation by the Board of the information required to be submitted pursuant to NAC 640C.130.

(c) One hour of credit, up to a maximum of 16 hours of credit per renewal period for each activity listed in subparagraphs (1) to (4), inclusive, will be approved for each hour of instruction spent:

(1) Giving a presentation at a workshop, course, conference or seminar relating to the practice of structural integration.

(2) Preparing a presentation described in subparagraph (1).

(3) Serving as a member of the Board or a member of a committee appointed by the Board or attending a meeting of the Board.

(4) Serving as a member of a board or committee relating to the practice of structural integration.

2. A structural integration practitioner may receive credit only once for giving or preparing a presentation described in subparagraph (1) of paragraph (c) of subsection 1.

3. The Board will consider the written request of a structural integration practitioner for approval of credit for any continuing education that is not specified in subsection 1, including credit for any continuing education that is not specifically related to structural integration, if the request is submitted to the Board at least 90 days before the date on which the license of the structural integration practitioner expires.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.115 Reflexologists: Requirements to maintain license; request to carry over excess hours of credit; notice of noncompliance. (NRS 640C.320, 640C.500)

1. To maintain his or her license to practice reflexology, a reflexologist must complete, to the satisfaction of the Board, at least 12 hours of instruction in continuing education as specified in NAC 640C.117 within the licensing period immediately preceding the request for renewal of his or her license. Except as otherwise provided in subsection 2, proof of the completion of the requirement for continuing education must be submitted with an application for renewal of a license.

2. If a reflexologist obtains more than 12 hours of instruction in continuing education in a licensing period, the reflexologist may request that the Board carry over the excess hours of credit, not to exceed 36 hours of instruction, to apply towards completion of the requirement for continuing education set forth in subsection 1 for succeeding years, up to a maximum of 3 succeeding years.

3. If a reflexologist fails to complete the requirements for continuing education set forth in subsection 1 before the date on which his or her license expires, the Board will send a notice to the reflexologist indicating that the reflexologist is not in compliance with the requirements for continuing education.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.117 Reflexologists: Approval of credits by Board. (NRS 640C.320, 640C.500)

1. The Board will approve credit for continuing education for a license to practice reflexology as follows:

(a) One hour of credit will be approved for each hour of instruction that a reflexologist attends a workshop, course, conference or seminar relating to the practice of reflexology which is provided by a person or entity that is:

(1) Accredited by the National Commission for Certifying Agencies, or an equivalent accrediting body approved or recognized by the Board;

(2) Approved by the American Reflexology Certification Board;

(3) A reflexology school, massage therapy school, bodywork therapy school, public college, postsecondary institution or other entity which offers a program of reflexology that is recognized by the Board pursuant to NRS 640C.600 and NAC 640C.060; or

(4) A reflexologist with at least 2 years of experience in the practice of reflexology who is certified by the American Reflexology Certification Board, International Institute of Reflexology or National Certification Board for Therapeutic Massage and Bodywork or who has experience in a related field and has previously received approval from the Board for the workshop, course, conference or seminar.

(b) The amount of credit for authoring a publication relating to the practice of reflexology will be determined upon receipt and evaluation by the Board of the information required to be submitted pursuant to NAC 640C.130.

(c) One hour of credit, up to a maximum of 16 hours of credit per renewal period for each activity listed in subparagraphs (1), (2) and (3), will be approved for each hour of instruction spent:

(1) Giving a presentation at a workshop, course, conference or seminar relating to the practice of reflexology.

(2) Preparing a presentation described in subparagraph (1).

(3) Serving as a member of the Board or a member of a committee appointed by the Board or attending a meeting of the Board.

2. A reflexologist may receive credit only once for giving or preparing a presentation described in subparagraph (1) of paragraph (c) of subsection 1.

3. The Board will consider the written request of a reflexologist for approval of credit for any continuing education that is not specified in subsection 1, including credit for any continuing education that is not specifically related to reflexology, if the request is submitted to the Board at least 90 days before the date on which the license of the reflexologist expires.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.120 Massage therapists, reflexologists and structural integration practitioners: Request for approval of credit for attending, preparing or giving presentation; notice of approval or denial. (NRS 640C.320, 640C.500)

1. A massage therapist, reflexologist or structural integration practitioner may request approval of credit for continuing education from the Board before or after attending, preparing or giving a presentation at a program of continuing education.

2. A request made pursuant to subsection 1 must be accompanied by the applicable information and documentation listed in NAC 640C.130.

3. The Board will inform a massage therapist, reflexologist or structural integration practitioner of the approval or denial of credit for continuing education within 30 days after the next meeting of the Board immediately following the receipt of a request made pursuant to subsection 1.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.130 Massage therapists, reflexologists and structural integration practitioners: Information and documentation required to obtain credit. (NRS 640C.320, 640C.500)

1. To obtain credit for attending a program of continuing education relating to the practice of massage therapy, reflexology or structural integration, a massage therapist, reflexologist or structural integration practitioner must submit to the Board:

(a) The name of the program;

(b) The name of the sponsor of the program;

(d) The inclusive dates and location of attendance of the program;

(e) The number of hours awarded by the sponsor of the program for completion of the program;

(f) A certified or original copy of the signed certificate of completion; and

(g) A brief summary of the information that the massage therapist, reflexologist or structural integration practitioner learned at the program and the manner in which the massage therapist, reflexologist or structural integration practitioner will use that information in his or her practice.

2. To obtain credit for preparing or giving a presentation at a program of continuing education relating to the practice of massage therapy, reflexology or structural integration, a massage therapist, reflexologist or structural integration practitioner must submit to the Board:

(a) Biographical information regarding the massage therapist, reflexologist or structural integration practitioner who is preparing or giving the presentation at the program of continuing education;

(b) The title of the presentation;

(d) The location of the presentation;

(e) The number of hours of the presentation;

(f) The source of the information conveyed in the presentation;

(g) The inclusive dates of the presentation;

(h) A list of all the persons who attended the presentation; and

(i) A brief summary of the presentation and the information that a person who attended the presentation was expected to learn.

3. To obtain credit for authoring a publication relating to the practice of massage therapy, reflexology or structural integration, a massage therapist, reflexologist or structural integration practitioner must submit to the Board:

(a) A copy of the published material; and

(b) The title, publisher and date of publication of the published material.

4. Except as otherwise provided in subsection 5, if the credit for continuing education is for a course of study, training or performing an educational activity relating to the practice of massage therapy, reflexology or structural integration which is not specified in subsection 1 of NAC 640C.110, subsection 1 of NAC 640C.117 or subsection 1 of NAC 640C.112, as applicable, the massage therapist, reflexologist or structural integration practitioner must submit to the Board:

(a) A description of the subject matter studied, the training received or the educational activity performed;

(b) A schedule of the time spent studying, training or performing; and

(c) A brief summary of the manner in which the course, training or activity relates to massage therapy, reflexology or structural integration.

5. If the credit for continuing education is sought for:

(a) A course attended by telecommunication or on the Internet, the massage therapist, reflexologist or structural integration practitioner must submit to the Board a copy of the transcript and the certificate of completion or other proof of completion, which includes the contact information of the provider.

(b) Serving as a member of the Board or a member of a committee appointed by the Board or attending a meeting of the Board, the massage therapist, reflexologist or structural integration practitioner must submit to the Board a list of the dates on which the meetings were attended.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.140 Requirements for request of approval for course or program; notice of approval or denial. (NRS 640C.320)

1. To obtain approval for a course or program of continuing education, a presenter of the course or sponsor of the program of continuing education, other than a person or entity listed in subsection 1 of NAC 640C.110, must submit to the Board the following information concerning the course or program of continuing education, in addition to submitting the information set forth in subsection 2 of NAC 640C.130:

(a) The syllabus or outline for the course or program of continuing education; and

(b) The original draft of the certificate of completion that will be distributed to participants upon completion of the course or program of continuing education.

2. The Board will inform the presenter or sponsor of the approval or denial of credit for continuing education within 30 days after the next meeting of the Board immediately following the receipt of a request made pursuant to subsection 1.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008)

MASSAGE, REFLEXOLOGY AND STRUCTURAL INTEGRATION ESTABLISHMENTS

NAC 640C.200 Required facilities; sanitary and safety requirements. (NRS 640C.320, 640C.330)

1. A massage establishment, reflexology establishment or structural integration establishment that provides vapor baths, steam baths, saunas, steam rooms, spas or portable saunas must be equipped with adequate shower facilities.

2. A massage establishment, reflexology establishment or structural integration establishment shall ensure that:

(a) All portable saunas, showers, tubs, basins, massage or steam tables, combs, brushes, shower caps and any other equipment used in the massage establishment, reflexology establishment or structural integration establishment is cleaned and rendered free from harmful organisms;

(b) Any equipment that comes in contact with a client of the massage therapist, reflexologist or structural integration practitioner is disinfected and sanitized before the equipment is used on another client;

(c) All equipment, furniture and fixtures, including, without limitation, tables used for massage, reflexology or structural integration, are clean and well maintained;

(d) All electrical equipment used for the care of a client is clean and well maintained and is listed to applicable standards and requirements by UL LLC, or approved by another nationally recognized testing laboratory; and

(e) All hydrotherapy equipment is cleaned after each use, is well maintained and is only used in the manner prescribed by the manufacturer of the equipment.

3. A massage therapist, reflexologist or structural integration practitioner shall ensure that:

(c) All equipment, furniture and fixtures, including, without limitation, tables used for massage, reflexology or structural integration, are clean and well-maintained;

(d) All electrical equipment used for the care of a client is clean and well-maintained and is consistent with applicable standards and requirements of UL LLC, or approved by another nationally recognized testing laboratory; and

(e) All hydrotherapy equipment is cleaned after each use, is well-maintained and is only used in the manner prescribed by the manufacturer of the equipment.

4. As used in this section, “spa” means a pool primarily designed for therapeutic use which is not drained, cleaned or refilled for each user. The term includes units which employ hydrojet circulation, hot water, cold water, mineral water or air induction bubbles or any combination thereof.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.210 Lubricants; spa treatments, muds and body wraps. (NRS 640C.320, 640C.330)

1. A lubricant used in the practice of massage therapy, reflexology or structural integration, including, without limitation, oil, soap, alcohol, powder, lotion, shampoo and salts, must be:

(a) Dispensed from a suitable container that prevents contamination; and

(b) Stored:

(1) Separately from cleaning supplies; and

(2) In a manner that prevents contamination and preserves the integrity of the lubricant.

2. A massage therapist, reflexologist or structural integration practitioner shall sanitize a container used to dispense a lubricant:

(a) Between each client; and

(b) Each time before the massage therapist, reflexologist or structural integration practitioner refills the container.

3. A massage therapist or structural integration practitioner may use spa treatments, muds and body wraps while practicing massage therapy if the massage therapist or structural integration practitioner considers and follows sanitary procedures in his or her use of those materials.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.220 Exterior doors and windows; walls, ceilings and floors. (NRS 640C.320, 640C.330)

1. A massage establishment, reflexology establishment or structural integration establishment shall ensure that each exterior door and window in a massage establishment, reflexology establishment or structural integration establishment must be tight-fitting and must effectively exclude insects, rodents and other vermin.

2. The walls, ceilings and floors in a massage establishment, reflexology establishment or structural integration establishment must be well maintained and kept clean.

3. The floors of a room in a massage establishment, reflexology establishment or structural integration establishment that contains a toilet must be made of an impervious material that is nonporous or nonabsorbent.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.230 Requirements for room in which massage therapy, reflexology or structural integration is practiced. (NRS 640C.320, 640C.330)

1. A room in which massage therapy, reflexology or structural integration is practiced must:

(a) Be designed to provide privacy for the client;

(b) Have the capability of maintaining the air temperature in the room at 75 degrees Fahrenheit at a point 24 inches above the floor;

(d) Have lighting fixtures which are capable of providing a minimum of 5 foot-candles of light at the floor level. Such lighting fixtures must be used when any cleaning operations are conducted in the room.

2. A room in which massage therapy, reflexology or structural integration is practiced must not be used simultaneously for massage therapy, reflexology or structural integration and any domestic purposes.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.240 Towels, linens and gowns; single service items. (NRS 640C.320, 640C.330)

1. After a towel, linen or gown has been used once in a massage establishment, reflexology establishment or structural integration establishment, it must be deposited in a receptacle provided for soiled towels, linens and gowns and must not be used again until properly laundered and sanitized.

2. After being laundered and sanitized, all towels, linens and gowns in a massage establishment, reflexology establishment or structural integration establishment must be stored on shelves or in compartments, cabinets or sealed plastic containers that are used only for that purpose.

3. Any items designed for a single service and all towels, linens and gowns furnished for the use of a client must be clean.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.250 Massage therapists, reflexologists and structural integration practitioners: Clothing and hygiene requirements; provision of uniforms by establishment. (NRS 640C.320, 640C.330)

1. A massage therapist, reflexologist or structural integration practitioner shall:

(a) Wear clean opaque clothing and practice strict standards of personal hygiene while practicing massage therapy, reflexology or structural integration;

(b) Thoroughly wash his or her hands with soap and water or an alcohol liquid:

(1) Before and after providing massage therapy, reflexology or structural integration to each client; and

(2) After using the restroom; and

(c) Sanitize his or her hands in the room or area, as applicable, in which massage therapy, reflexology or structural integration is practiced before and after each client.

2. A massage establishment, reflexology establishment or structural integration establishment which provides its massage therapists, reflexologists or structural integration practitioners with a uniform, must provide a clean opaque uniform.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.260 Water supply and water distribution system piping. (NRS 640C.320, 640C.330)

1. A massage establishment, reflexology establishment or structural integration establishment must have an adequate supply of hot and cold running water that is safe and sanitary.

2. The interior piping in a water distribution system in a massage establishment, reflexology establishment or structural integration establishment must be installed and maintained in compliance with any applicable local building codes or ordinances prescribing standards for plumbing.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.270 Bathing facilities. (NRS 640C.320, 640C.330)

1. If a bathing facility other than a shower is used in a massage establishment, reflexology establishment or structural integration establishment, the bathing facility must:

(a) Have floors that are slip-resistant, easily cleaned and coved to a height of 4 inches;

(b) If an artificial surface made from resilient materials is used for the floor, be vacuumed with a wet vacuum frequently, to keep the floor clean and free from accumulated moisture;

(d) If there is more than one bathing facility, be separated by a nonporous, nonabsorbent floor.

2. A massage establishment, reflexology establishment or structural integration establishment shall ensure that:

(a) An effective watertight joint between the wall and the floor is maintained in a bathing facility that is used in a massage establishment, reflexology establishment or structural integration establishment; and

(b) Any rubber or impervious mats that are used in the bathing facility are cleaned, sanitized and dried between uses.

3. If a shower is provided in a massage establishment, reflexology establishment or structural integration establishment, the shower must:

(a) Have compartments which are impervious to water to a height of 6 feet above the floor;

(b) Have a floor that is furnished with a nonslip impervious surface; and

4. A massage establishment, reflexology establishment or structural integration establishment shall ensure that all bathing facilities provided for use in the massage establishment, reflexology establishment or structural integration establishment satisfy the requirements of chapters 444 of NRS and NAC.

5. As used in this section:

(a) “Bathing facility” includes, without limitation, a spa, shower, bathtub, sauna and steam bath.

(b) “Spa” means a pool primarily designed for therapeutic use which is not drained, cleaned or refilled for each user. The term includes units which employ hydrojet circulation, hot water, cold water, mineral water or air induction bubbles, or any combination thereof.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.280 Disposal of sewage and liquid waste. (NRS 640C.320, 640C.330) All sewage and liquid waste generated by a massage establishment, reflexology establishment or structural integration establishment must be disposed of in a municipal sewage system where such a system is available. If a municipal sewage system is not available, sewage and liquid waste must be collected, treated and disposed of in compliance with the provisions of chapters 444 of NRS and NAC and any applicable local regulations which govern the subsurface disposal of sewage.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.290 Garbage and refuse. (NRS 640C.320, 640C.330) Garbage and refuse on the premises of a massage establishment, reflexology establishment or structural integration establishment must be:

1. Kept in containers which are easy to clean and well maintained; and

2. Disposed of in a sanitary manner.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.300 Toilets and lavatories. (NRS 640C.320, 640C.330)

1. A sanitary toilet must be provided in each massage establishment, reflexology establishment or structural integration establishment.

2. Lavatories with an adequate supply of hot and cold water under pressure must be conveniently located for use by the employees and clients of a massage establishment, reflexology establishment or structural integration establishment.

3. Any room in a massage establishment, reflexology establishment or structural integration establishment that contains a toilet must:

(a) Have doors that are capable of being fully closed and locked from the inside; and

(b) Be kept clean, in good repair and free from flies, insects and vermin.

4. A supply of soap in a covered dispenser, single-use or disposable towels in a dispenser and a waste receptacle for proper disposal of the towels must be provided in each lavatory.

5. A supply of toilet paper on a dispenser must be available and conveniently located next to each toilet provided in a massage establishment, reflexology establishment or structural integration establishment.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.310 Duties of establishment: Maintenance of establishment; ensuring no sexual or unlicensed activity occurs at establishment. (NRS 640C.320, 640C.330) A massage establishment, reflexology establishment or structural integration establishment shall ensure that the massage establishment, reflexology establishment or structural integration establishment is:

1. Kept clean and free of litter or rubbish;

2. Maintained in a neat and orderly manner;

3. Not used to facilitate sexual activity during the course of practicing massage therapy, reflexology or structural integration; and

4. Not used to facilitate unlicensed activity.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.320 Inspections. (NRS 640C.320, 640C.330) The Board may conduct inspections of each massage establishment, reflexology establishment and structural integration establishment, and each massage therapist, reflexologist or structural integration practitioner for compliance with this chapter.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

STANDARDS OF PRACTICE

NAC 640C.330 Display of certificate in establishment. (NRS 640C.320, 640C.330) Each holder of a certificate shall prominently display the certificate issued by the Board to the holder in the massage establishment, reflexology establishment or structural integration establishment named in the certificate at all times.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.333 Display of license in establishment or on person. (NRS 640C.320, 640C.450) For the purposes of NRS 640C.450, a licensee displays his or her original license in a conspicuous manner if the licensee displays his or her original license on:

1. A wall, countertop or table that is within the treatment room used by the licensee at a massage establishment, a reflexology establishment or a structural integration establishment, as applicable, or in the reception area of the massage establishment, reflexology establishment or structural integration establishment at which the licensee engages in the practice of massage therapy, reflexology or structural integration, as applicable; or

2. His or her person in such a manner that the original license is visible to a client of the licensee.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.337 Annual list of licensees employed by or working in establishment required to be provided to Board. (NRS 640C.320, 640C.330) Each massage establishment, reflexology establishment and structural integration establishment must provide to the Board a list of each licensee employed by or working in the establishment on or before July 1 of each year.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018)

NAC 640C.340 Massage therapist required to drape client. (NRS 640C.320) A massage therapist shall drape a client by covering the client with a towel, sheet, blanket, linen or other covering in such a manner that:

1. The client’s genitals and gluteal cleft and, if the client is a female, the client’s breasts are not exposed; and

2. Neither the massage nor the movement of the body expose the client’s genitals or gluteal cleft or, if the client is a female, the client’s breasts.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.345 Client of reflexologist must be fully clothed; exception for portion of legs and feet. (NRS 640C.320) A reflexologist shall not perform reflexology on a client unless the client is fully clothed, except that the client’s legs from the knees to the feet may be exposed.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.350 Advertisements to include license number of massage therapist. (NRS 640C.320) Any advertisement for the practice of massage therapy must include the license number of the massage therapist to which the advertisement pertains.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008)

NAC 640C.360 Communicable diseases. (NRS 640C.320)

1. A massage therapist shall have sufficient knowledge of communicable diseases to protect the clients of the massage therapist and the massage therapist from the transmission of such a disease while engaging in massage therapy.

2. If a massage therapist has reason to suspect that an employee who assists the massage therapist with massage therapy or a client of the massage therapist may have a communicable disease, the massage therapist shall:

(a) Recommend to the client that the client be examined by a licensed health care provider.

(b) Request that the employee be examined by a licensed health care provider.

3. An employee who has been requested to be examined by a health care provider pursuant to subsection 2 must present a written statement from a licensed health care provider verifying that the employee is in compliance with the guidelines for prevention, suppression and control of communicable diseases set forth in chapter 441A of NAC before the employee may resume employment with the massage therapist.

4. A massage therapist and any person who works in a massage establishment and who is exposed as part of his or her employment to any bloodborne pathogens or bodily fluids shall practice universal precautions as described in 29 C.F.R. § 1910.1030(d).

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008)

UNPROFESSIONAL AND UNETHICAL CONDUCT; PENALTIES

NAC 640C.400 “Sexual activity” interpreted. (NRS 640C.320, 640C.700) As used in subsection 4 of NRS 640C.700, the Board interprets the phrase “sexual activity” to include, without limitation:

1. Sexual intercourse;

2. Examining or touching the genitals, anus or any sexualized body part except as otherwise provided in subsection 4 of NRS 640C.700;

3. Rubbing against a client for sexual gratification;

4. Kissing;

5. Hugging, touching, fondling or caressing of a romantic or sexual nature;

6. Not allowing a client privacy to dress or undress except as may be necessary in a medical emergency or custodial situation;

7. Not providing a client a gown or draping except as may be necessary in a medical emergency;

8. Removing the client’s clothing or gown or draping without consent, except as may be necessary in a medical emergency or in a custodial setting;

9. Encouraging masturbation or any other sex act in the presence of the massage therapist, reflexologist or structural integration practitioner;

10. Dressing or undressing in the presence of the client;

11. Masturbation or any other sex act by the massage therapist, reflexologist or structural integration practitioner in the presence of the client;

12. Suggesting or discussing the possibility of dating or beginning a sexual or romantic relationship before the professional relationship ends;

13. Terminating the professional relationship with the client for the purpose of dating or pursuing a romantic or sexual relationship;

14. Discussing the sexual history, preference or fantasies of the massage therapist, reflexologist or structural integration practitioner;

15. Any behavior, gesture or expression that may reasonably be interpreted as seductive or sexual;

16. Making statements regarding the client’s body, appearance, sexual history or sexual orientation other than for legitimate health care purposes;

17. Sexually demeaning behavior including any verbal or physical contact which may reasonably be interpreted as demeaning, humiliating, embarrassing, threatening or harming a client;

18. Photographing or filming the body or any body part of a client other than for legitimate health care purposes; and

19. Showing a client sexually explicit photographs other than for legitimate health care purposes.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.405 Performance of structural integration along certain parts of body does not constitute “sexual activity”; prohibition on structural integration practitioner touching certain parts of body. (NRS 640C.320, 640C.700)

1. The performance of structural integration by a structural integration practitioner along the borders of the superior and inferior pubic ramus, the borders of the coccyx, ischial tuberosity and ramus of the ischium does not constitute engaging in sexual activity in violation of subsection 4 of NRS 640C.700.

2. A structural integration practitioner shall not touch inside the bony landmarks or intracavity of the perineal diaphragm of a client.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)

NAC 640C.410 “Unethical or unprofessional conduct” interpreted. (NRS 640C.320, 640C.700)

1. As used in subsection 9 of NRS 640C.700, the Board interprets the phrase “unethical or unprofessional conduct” to include, without limitation:

(a) Offering to practice massage therapy, reflexology or structural integration on a client in exchange for sexual favors.

(b) Using health care information to contact a client for the purpose of engaging in a sexual activity with the client.

(c) Using health care information or access to health care information to meet or attempt to meet the sexual needs of the massage therapist, reflexologist or structural integration practitioner.

(d) Performing acts beyond the scope of the practice of massage therapy, reflexology or structural integration.

(e) Assuming duties and responsibilities within the practice of massage therapy, reflexology or structural integration without adequate training.

(f) Assuming duties and responsibilities within the practice of massage therapy, reflexology or structural integration if competency is not maintained or the standards of competence are not satisfied, or both.

(g) Disclosing the contents of the examination for licensure or certification, or soliciting, accepting or compiling information regarding the contents of the examination before, during or after its administration.

(h) Assigning or delegating functions, tasks or responsibilities of licensed or certified persons to unqualified persons.

(i) Failing to supervise a person to whom functions of massage therapy, reflexology or structural integration are delegated or assigned, if responsible for supervising the person.

(j) Failing to safeguard a client from the incompetent, abusive or illegal practice of any person during the practice of massage therapy, reflexology or structural integration.

(k) Practicing massage therapy, reflexology or structural integration while, with or without good cause, the physical, mental or emotional condition of the massage therapist, reflexologist or structural integration practitioner impairs his or her ability to act in a manner consistent with established or customary standards of the practice of massage therapy, reflexology or structural integration, as applicable.

(l) Practicing massage therapy, reflexology or structural integration, if any amount of alcohol or a controlled substance or dangerous drug that is not legally prescribed is present in the body of the massage therapist, reflexologist or structural integration practitioner.

(m) Failing to respect and maintain a client’s right to privacy.

(n) Performing or offering to perform the functions of a licensee or holder of a certificate by false representation or under a false or assumed name.

(o) Soliciting or borrowing money, materials or other property, or any combination thereof, from a:

(1) Client; or

(2) Family member of a client.

(p) Aiding, abetting or assisting any person in performing any acts prohibited by law.

(q) Failing to abide by any state or federal statute or regulation relating to the practice of massage therapy, reflexology or structural integration.

(r) Engaging in sexual contact with a client.

(s) Failing to report the unauthorized practice of massage therapy, reflexology or structural integration.

(t) Endangering the safety of the general public, clients or coworkers by making actual or implied threats of violence or carrying out an act of violence.

(u) Abusing a client.

(v) Misappropriating the property of a client.

(w) Failing to comply with a condition, limitation or restriction which has been placed on the license of the massage therapist, reflexologist or structural integration practitioner, or the certificate of the massage establishment, reflexology establishment or structural integration establishment.

(x) Engaging in the practice of massage therapy, reflexology or structural integration without a license issued pursuant to the provisions of this chapter and chapter 640C of NRS.

(y) Displaying a license, certificate, diploma or permit, or a copy of a license, certificate, diploma or permit, which has been fraudulently purchased, issued, counterfeited or materially altered.

(z) Engaging in a pattern of conduct that demonstrates failure to exercise the knowledge, skills and abilities to use the methods ordinarily exercised by a reasonable and prudent massage therapist, reflexologist or structural integration practitioner to protect the public.

(aa) Failing to cooperate with an investigation or inspection conducted by the Board.

(bb) Engaging in any other unprofessional conduct with a client that the Board determines is outside the professional boundaries generally considered acceptable in the profession.

2. When evaluating whether a massage therapist, reflexologist or structural integration practitioner is prohibited from engaging or attempting to engage in a sexual activity with a client or former client, the Board will consider, without limitation:

(a) Documentation of a formal termination of the professional relationship between the massage therapist, reflexologist or structural integration practitioner and the client or former client;

(b) The transfer of care of the client or former client from the massage therapist, reflexologist or structural integration practitioner to another massage therapist, reflexologist or structural integration practitioner, as applicable;

(c) The duration of the professional relationship between the massage therapist, reflexologist or structural integration practitioner and the client or former client;

(d) The amount of time that has passed since the last services related to the practice of massage therapy, reflexology or structural integration were provided to the client or former client by the massage therapist, reflexologist or structural integration practitioner;

(e) The communication between the massage therapist, reflexologist or structural integration practitioner and the client or former client after the last services related to the practice of massage therapy, reflexology or structural integration were provided to the client or former client and before the commencement of the personal relationship;

(f) The extent to which the personal or private information of the client or former client was shared with the massage therapist, reflexologist or structural integration practitioner;

(g) The nature of the health condition of the client or former client, if any, during the professional relationship between the massage therapist, reflexologist or structural integration practitioner and the client or former client and after that professional relationship ended;

(h) The extent of emotional dependence of the client or former client on the massage therapist, reflexologist or structural integration practitioner, if any, and the vulnerability of the client or former client; and

(i) The standard cycle for revisiting a massage therapist, reflexologist or structural integration practitioner as determined by the Board.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.420 Provisions regarding unprofessional or unethical conduct: Consent does not excuse or negate responsibility to comply; exceptions. (NRS 640C.320, 640C.700)

1. Except as otherwise provided in paragraph (c) of subsection 4 of NRS 640C.700, the consent of the client or former client does not excuse or negate the responsibility of the massage therapist, reflexologist or structural integration practitioner to comply with NAC 640C.400 and 640C.410 and the provisions of NRS 640C.700 with regard to sexual activity.

2. The provisions of NAC 640C.400 and 640C.410 do not prohibit:

(a) A massage therapist, reflexologist or structural integration practitioner from providing health care services during the course of practicing massage therapy, reflexology or structural integration on a person in the case of an emergency if the services cannot or will not be provided by a health care provider;

(b) Contact by a massage therapist, reflexologist or structural integration practitioner with a client that is necessary for a legitimate health care purpose and that meets the standard of appropriate care of a massage therapist, reflexologist or structural integration practitioner as determined by the Board; or

(c) Providing services related to the practice of massage therapy, reflexology or structural integration to a person who is in a preexisting established personal relationship with the massage therapist, reflexologist or structural integration practitioner if there is no evidence of, or potential for, exploiting the person.

(Added to NAC by Bd. of Massage Therapists by R009-07, eff. 6-17-2008; A by Bd. of Massage Therapy by R108-17, 2-27-2018)

NAC 640C.450 Schedule of administrative fines. (NRS 640C.320, 640C.755)

1. The Board adopts the following schedule of administrative fines for any administrative citation issued pursuant to NRS 640C.755:

Violation	First Violation	Second Violation	Third or Subsequent Violation
MASSAGE THERAPIST, REFLEXOLOGIST OR STRUCTURAL INTEGRATION PRACTITIONER
Practicing with an expired license.........................	$200	$500	$1,000
Failure to display license in a conspicuous manner as required by NRS 640C.450.......................	200	500	1,000
Using advertisements which contain knowingly false or deceptive statements...........................	500	1,500	2,500
Altering a license.................................................	1,000	3,000	5,000
Advertising without a license number on advertisement.................................................	100	250	500
Failing to comply with NAC 640C.200 to 640C.320, inclusive........................................	200	500	1,000
Failing to notify the Board of a change of his or her address as required by NAC 640C.085....	100	200	500
Failing to drape a client as required by NAC 640C.340......................................................	200	500	1,000
Performing reflexology on a client in violation of NAC 640C.345.............................................	200	500	1,000
Offering to perform sexual activities during the practice of massage therapy, reflexology or structural integration........................................	1,000	2,000	5,000
MASSAGE ESTABLISHMENTS, REFLEXOLOGY ESTABLISHMENTS OR STRUCTURAL INTEGRATION ESTABLISHMENTS
Failing to notify the Board of a change of the name or address of an establishment as required by NAC 640C.085.............................................	100	200	500
Failing to comply with NAC 640C.200 to 640C.320, inclusive........................................	200	500	1,000
Operating a massage establishment, a reflexology establishment or a structural integration establishment without the applicable certificate.	1,000	2,500	5,000
Failure to display certificate..................................	200	500	1,000
Offering to perform sexual activities......................	1,000	2,000	5,000
ANY PERSON
Practicing massage therapy, reflexology or structural integration without a license or certificate........................................................	1,000	2,500	5,000
Copying or altering a license or certificate for the purposes of fraud, deception, misrepresentation or other illegal purpose........	1,000	3,000	5,000
Using a copied or altered license or certificate for purposes of fraud, deception, misrepresentation or other illegal purpose........	1,000	2,000	5,000
Offering to perform massage therapy, reflexology or structural integration without a license..........	1,000	2,000	5,000
Offering to perform sexual activities during the course of practicing massage therapy, reflexology or structural integration..................	1,000	2,000	5,000
Advertising to perform massage therapy, reflexology or structural integration without the applicable license............................................	1,000	2,500	5,000

2. A person who violates a provision of this chapter or chapter 640C of NRS for which this section does not provide a specific fine, including, without limitation, a second or subsequent violation, may be:

(a) Ordered to appear at a disciplinary hearing before the Board; and

(b) Punished by the Board as set forth in NRS 640C.700.

(Added to NAC by Bd. of Massage Therapy by R108-17, eff. 2-27-2018; A by R040-18, 6-26-2018)

NAC 640C.455 Additional factors for consideration by Board in determining administrative fine imposed against licensee for engaging in or soliciting sexual activity or for conviction of prostitution or other sexual offense. (NRS 640C.320, 640C.712) In addition to the factors described in NRS 640C.712, in determining the amount of an administrative fine imposed pursuant to NRS 640C.712, the Board will consider:

1. The number of times the licensee has been arrested for prostitution or any other sexual offense;

2. The number of times the licensee has been convicted of prostitution or any other sexual offense;

3. Whether there were any aggravating factors involved in the sexual activity, including, without limitation, the use of firearms;

4. The good faith of the licensee; and

5. Any other aggravating or mitigating factor found by the Board.

(Added to NAC by Bd. of Massage Therapy by R040-18, eff. 6-26-2018)