Assembly Bill No. 350–Assemblymen Ohrenschall
and Claborn

 

March 17, 2003

____________

 

Referred to Committee on Judiciary

 

SUMMARY—Prohibits State Board of Health from requiring certain residential facilities for groups to purchase or maintain policy of liability insurance. (BDR 40‑971)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: No.

 

~

 

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

 

AN ACT relating to facilities for the dependent; prohibiting the State Board of Health from requiring a residential facility for groups which provides care only to older patients to purchase or maintain a policy of liability insurance; 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 the provisions set forth as sections 2 and 3 of this act.

1-3  Sec. 2.  “Older patient” means a patient who is 60 years of

1-4  age or older.

1-5  Sec. 3.  The Board shall not require a residential facility for

1-6  groups which provides care only to older patients to purchase or

1-7  maintain a policy of liability insurance for the facility.

1-8  Sec. 4.  NRS 449.001 is hereby amended to read as follows:

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

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

1-11  inclusive, and section 2 of this act have the meanings ascribed to

1-12  them in those sections.

1-13      Sec. 5.  NRS 449.030 is hereby amended to read as follows:

1-14      449.030  1.  No person, state or local government or agency

1-15  thereof may operate or maintain in this state any medical facility or

2-1  facility for the dependent without first obtaining a license therefor as

2-2  provided in NRS 449.001 to 449.240, inclusive[.] , and sections 2

2-3  and 3 of this act.

2-4  2.  Unless licensed as a facility for hospice care, a person, state

2-5  or local government or agency thereof shall not operate a program

2-6  of hospice care without first obtaining a license for the program

2-7  from the Board.

2-8  Sec. 6.  NRS 449.037 is hereby amended to read as follows:

2-9  449.037  1.  The Board shall adopt:

2-10      (a) Licensing standards for each class of medical facility or

2-11  facility for the dependent covered by NRS 449.001 to 449.240,

2-12  inclusive, and sections 2 and 3 of this act, and for programs of

2-13  hospice care.

2-14      (b) Regulations governing the licensing of such facilities and

2-15  programs.

2-16      (c) Regulations governing the procedure and standards for

2-17  granting an extension of the time for which a natural person may

2-18  provide certain care in his home without being considered a

2-19  residential facility for groups pursuant to NRS 449.017. The

2-20  regulations must require that such grants are effective only if made

2-21  in writing.

2-22      (d) Regulations establishing a procedure for the indemnification

2-23  by the Health Division, from the amount of any surety bond or other

2-24  obligation filed or deposited by a facility for refractive laser surgery

2-25  pursuant to NRS 449.068 or 449.069, of a patient of the facility who

2-26  has sustained any damages as a result of the bankruptcy of or any

2-27  breach of contract by the facility.

2-28      (e) Any other regulations as it deems necessary or convenient to

2-29  carry out the provisions of NRS 449.001 to 449.240, inclusive[.] ,

2-30  and sections 2 and 3 of this act.

2-31      2.  The Board shall adopt separate regulations governing the

2-32  licensing and operation of:

2-33      (a) Facilities for the care of adults during the day; and

2-34      (b) Residential facilities for groups,

2-35  which provide care to persons with Alzheimer’s disease.

2-36      3.  The Board shall adopt separate regulations for:

2-37      (a) The licensure of rural hospitals which take into consideration

2-38  the unique problems of operating such a facility in a rural area.

2-39      (b) The licensure of facilities for refractive laser surgery which

2-40  take into consideration the unique factors of operating such a

2-41  facility.

2-42      (c) The licensure of mobile units which take into consideration

2-43  the unique factors of operating a facility that is not in a fixed

2-44  location.

3-1  4.  The Board shall require that the practices and policies of

3-2  each medical facility or facility for the dependent provide

3-3  adequately for the protection of the health, safety and physical,

3-4  moral and mental well-being of each person accommodated in the

3-5  facility.

3-6  5.  The Board shall establish minimum qualifications for

3-7  administrators and employees of residential facilities for groups. In

3-8  establishing the qualifications, the Board shall consider the related

3-9  standards set by nationally recognized organizations which accredit

3-10  such facilities.

3-11      6.  The Board shall adopt separate regulations regarding the

3-12  assistance which may be given pursuant to NRS 453.375 and

3-13  454.213 to an ultimate user of controlled substances or dangerous

3-14  drugs by employees of residential facilities for groups. The

3-15  regulations must require at least the following conditions before

3-16  such assistance may be given:

3-17      (a) The ultimate user’s physical and mental condition is stable

3-18  and is following a predictable course.

3-19      (b) The amount of the medication prescribed is at a maintenance

3-20  level and does not require a daily assessment.

3-21      (c) A written plan of care by a physician or registered nurse has

3-22  been established that:

3-23          (1) Addresses possession and assistance in the administration

3-24  of the medication; and

3-25          (2) Includes a plan, which has been prepared under the

3-26  supervision of a registered nurse or licensed pharmacist, for

3-27  emergency intervention if an adverse condition results.

3-28      (d) The prescribed medication is not administered by injection

3-29  or intravenously.

3-30      (e) The employee has successfully completed training and

3-31  examination approved by the Health Division regarding the

3-32  authorized manner of assistance.

3-33      7.  The Board shall, if it determines necessary, adopt

3-34  regulations and requirements to ensure that each residential facility

3-35  for groups and its staff are prepared to respond to an emergency,

3-36  including, without limitation:

3-37      (a) The adoption of plans to respond to a natural disaster and

3-38  other types of emergency situations, including, without limitation,

3-39  an emergency involving fire;

3-40      (b) The adoption of plans to provide for the evacuation of a

3-41  residential facility for groups in an emergency, including, without

3-42  limitation, plans to ensure that nonambulatory patients may be

3-43  evacuated;

3-44      (c) Educating the residents of residential facilities for groups

3-45  concerning the plans adopted pursuant to paragraphs (a) and (b); and

4-1  (d) Posting the plans or a summary of the plans adopted

4-2  pursuant to paragraphs (a) and (b) in a conspicuous place in each

4-3  residential facility for groups.

4-4  Sec. 7.  NRS 449.070 is hereby amended to read as follows:

4-5  449.070  The provisions of NRS 449.001 to 449.240, inclusive,

4-6  and sections 2 and 3 of this act do not apply to:

4-7  1.  Any facility conducted by and for the adherents of any

4-8  church or religious denomination for the purpose of providing

4-9  facilities for the care and treatment of the sick who depend solely

4-10  upon spiritual means through prayer for healing in the practice of

4-11  the religion of the church or denomination, except that such a

4-12  facility must comply with all regulations relative to sanitation and

4-13  safety applicable to other facilities of a similar category.

4-14      2.  Foster homes as defined in NRS 424.014.

4-15      3.  Any medical facility or facility for the dependent operated

4-16  and maintained by the United States Government or an agency

4-17  thereof.

4-18      Sec. 8.  NRS 449.160 is hereby amended to read as follows:

4-19      449.160  1.  The Health Division may deny an application for

4-20  a license or may suspend or revoke any license issued under the

4-21  provisions of NRS 449.001 to 449.240, inclusive, and sections 2

4-22  and 3 of this act upon any of the following grounds:

4-23      (a) Violation by the applicant or the licensee of any of the

4-24  provisions of NRS 439B.410 or 449.001 to 449.245, inclusive, and

4-25  sections 2 and 3 of this act or of any other law of this state or of the

4-26  standards, rules and regulations adopted thereunder.

4-27      (b) Aiding, abetting or permitting the commission of any illegal

4-28  act.

4-29      (c) Conduct inimical to the public health, morals, welfare and

4-30  safety of the people of the State of Nevada in the maintenance and

4-31  operation of the premises for which a license is issued.

4-32      (d) Conduct or practice detrimental to the health or safety of the

4-33  occupants or employees of the facility.

4-34      (e) Failure of the applicant to obtain written approval from the

4-35  Director of the Department of Human Resources as required by

4-36  NRS 439A.100 or as provided in any regulation adopted pursuant to

4-37  this chapter, if such approval is required.

4-38      2.  In addition to the provisions of subsection 1, the Health

4-39  Division may revoke a license to operate a facility for the dependent

4-40  if, with respect to that facility, the licensee that operates the facility,

4-41  or an agent or employee of the licensee:

4-42      (a) Is convicted of violating any of the provisions of

4-43  NRS 202.470;

4-44      (b) Is ordered to but fails to abate a nuisance pursuant to NRS

4-45  244.360, 244.3603 or 268.4124; or

5-1  (c) Is ordered by the appropriate governmental agency to correct

5-2  a violation of a building, safety or health code or regulation but fails

5-3  to correct the violation.

5-4  3.  The Health Division shall maintain a log of any complaints

5-5  that it receives relating to activities for which the Health Division

5-6  may revoke the license to operate a facility for the dependent

5-7  pursuant to subsection 2.

5-8  4.  On or before February 1 of each odd-numbered year, the

5-9  Health Division shall submit to the Director of the Legislative

5-10  Counsel Bureau a written report setting forth, for the previous

5-11  biennium:

5-12      (a) Any complaints included in the log maintained by the Health

5-13  Division pursuant to subsection 3; and

5-14      (b) Any disciplinary actions taken by the Health Division

5-15  pursuant to subsection 2.

5-16      Sec. 9.  NRS 449.163 is hereby amended to read as follows:

5-17      449.163  1.  If a medical facility or facility for the dependent

5-18  violates any provision related to its licensure, including any

5-19  provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

5-20  sections 2 and 3 of this act, or any condition, standard or regulation

5-21  adopted by the Board, the Health Division in accordance with the

5-22  regulations adopted pursuant to NRS 449.165 may:

5-23      (a) Prohibit the facility from admitting any patient until it

5-24  determines that the facility has corrected the violation;

5-25      (b) Limit the occupancy of the facility to the number of beds

5-26  occupied when the violation occurred, until it determines that the

5-27  facility has corrected the violation;

5-28      (c) Impose an administrative penalty of not more than $1,000

5-29  per day for each violation, together with interest thereon at a rate not

5-30  to exceed 10 percent per annum; and

5-31      (d) Appoint temporary management to oversee the operation of

5-32  the facility and to ensure the health and safety of the patients of the

5-33  facility, until:

5-34          (1) It determines that the facility has corrected the violation

5-35  and has management which is capable of ensuring continued

5-36  compliance with the applicable statutes, conditions, standards and

5-37  regulations; or

5-38          (2) Improvements are made to correct the violation.

5-39      2.  If the facility fails to pay any administrative penalty imposed

5-40  pursuant to paragraph (c) of subsection 1, the Health Division may:

5-41      (a) Suspend the license of the facility until the administrative

5-42  penalty is paid; and

5-43      (b) Collect court costs, reasonable attorney’s fees and other

5-44  costs incurred to collect the administrative penalty.

6-1  3.  The Health Division may require any facility that violates

6-2  any provision of NRS 439B.410, 449.001 to 449.240, inclusive, and

6-3  sections 2 and 3 of this act, or any condition, standard or regulation

6-4  adopted by the Board, to make any improvements necessary to

6-5  correct the violation.

6-6  4.  Any money collected as administrative penalties pursuant to

6-7  this section must be accounted for separately and used to protect the

6-8  health or property of the residents of the facility in accordance with

6-9  applicable federal standards.

6-10      Sec. 10.  NRS 449.220 is hereby amended to read as follows:

6-11      449.220  1.  The Health Division may bring an action in the

6-12  name of the State to enjoin any person, state or local government

6-13  unit or agency thereof from operating or maintaining any facility

6-14  within the meaning of NRS 449.001 to 449.240, inclusive[:] , and

6-15  sections 2 and 3 of this act:

6-16      (a) Without first obtaining a license therefor; or

6-17      (b) After his license has been revoked or suspended by the

6-18  Health Division.

6-19      2.  It is sufficient in such action to allege that the defendant did,

6-20  on a certain date and in a certain place, operate and maintain such

6-21  facility without a license.

6-22      Sec. 11.  NRS 427A.175 is hereby amended to read as follows:

6-23      427A.175  1.  Within 1 year after an older patient sustains

6-24  damage to his property as a result of any act or failure to act by a

6-25  facility for intermediate care, a facility for skilled nursing, a

6-26  residential facility for groups or an agency to provide nursing in the

6-27  home in protecting the property, the older patient may file a verified

6-28  complaint with the Division setting forth the details of the damage.

6-29      2.  Upon receiving a verified complaint pursuant to subsection

6-30  1, the Administrator shall investigate the complaint and attempt to

6-31  settle the matter through arbitration, mediation or negotiation.

6-32      3.  If a settlement is not reached pursuant to subsection 2, the

6-33  facility, agency or older patient may request a hearing before

6-34  the Specialist for the Rights of Elderly Persons. If requested, the

6-35  Specialist for the Rights of Elderly Persons shall conduct a hearing

6-36  to determine whether the facility or agency is liable for damages to

6-37  the patient. If the Specialist for the Rights of Elderly Persons

6-38  determines that the facility or agency is liable for damages to the

6-39  patient, he shall order the amount of the surety bond pursuant to

6-40  NRS 449.065 or the substitute for the surety bond necessary to pay

6-41  for the damages pursuant to NRS 449.067 to be released to the

6-42  Division. The Division shall pay any such amount to the older

6-43  patient or the estate of the older patient.

6-44      4.  The Division shall create a separate account for money to be

6-45  collected and distributed pursuant to this section.

7-1  5.  As used in this section:

7-2  (a) “Agency to provide nursing in the home” has the meaning

7-3  ascribed to it in NRS 449.0015;

7-4  (b) “Facility for intermediate care” has the meaning ascribed to

7-5  it in NRS 449.0038;

7-6  (c) “Facility for skilled nursing” has the meaning ascribed to it

7-7  in NRS 449.0039;

7-8  (d) “Older patient” has the meaning ascribed to it in [NRS

7-9  449.063;] section 2 of this act; and

7-10      (e) “Residential facility for groups” has the meaning ascribed to

7-11  it in NRS 449.017.

7-12      Sec. 12.  NRS 449.063 is hereby repealed.

7-13      Sec. 13.  This act becomes effective on July 1, 2003.

 

7-14  TEXT OF REPEALED SECTION

 

7-15      449.063  “Older patient” defined. As used in this section

7-16   and NRS 449.065 and 449.067, “older patient” means a patient who

7-17   is 60 years of age or older.

 

 

7-18  H