[Rev. 2/11/2014 12:55:29 PM]

[NAC-634 Revised Date: 1-14]

CHAPTER 634 - CHIROPRACTIC

GENERAL PROVISIONS

634.110            Definitions.

634.111            “Advertisement” defined.

634.112            “Ancillary services” defined.

634.113            “Applicant” defined.

634.114            “Board” defined.

634.116            “Certificate” defined.

634.117            “Chiropractor’s assistant” defined.

634.119            “Direct supervision” defined.

634.1195          “Good standing” defined.

634.121            “Licensee” defined.

634.124            “Referral bureau” defined.

634.125            Severability of provisions.

CHIROPRACTIC PHYSICIANS’ BOARD OF NEVADA

634.130            Regular meetings.

634.140            Election of officers.

FEES

634.200            Amount; refunds.

634.210            Methods of payment.

634.215            Fee for issuance of license: Time for payment; failure to pay.

LICENSING AND CERTIFICATION

Examinations

634.220            Fingerprinting and investigation of applicants.

634.290            Examinations required for licensure; passing score.

634.300            Examinations for licensure: Period for taking; failure to pass; failure to appear.

634.305            Examination for certification as chiropractor’s assistant.

634.311            Retention and destruction of records.

634.320            Authorized persons in waiting area; conduct of applicant.

634.330            Cheating by applicants.

Preceptor Program

634.331            Definitions.

634.333            “Preceptor” defined.

634.334            “Student” defined.

634.335            Establishment.

634.336            Application procedure for student; eligibility requirements.

634.337            Application procedure for licensee; requirements to act as preceptor.

634.338            Preceptor agreement: Form; contents; required provisions.

634.339            Duties of preceptor; scope of authorized activities of student.

634.341            Student providing chiropractic services: Notice to patient; duties of preceptor.

634.342            Identification as student.

634.343            Continued professional relationship between student and preceptor.

634.347            Disciplinary action.

Chiropractor’s Assistants

634.348            Performance of ancillary services.

634.350            Application for certification: Filing; requirements; expiration; waiver of requirements.

634.355            Certification: Additional requirements; waiver of requirements.

634.360            Employment and training as chiropractor’s assistant trainee.

Miscellaneous Provisions

634.366            Requirements to practice chiropractic or provide services relating to chiropractic; report to Board of any other license, certificate or registration as provider of health care.

634.3665          Requirements to perform manipulation on patient under anesthesia.

634.367            Temporary license: Authorized acts.

634.368            Practice by applicant waiting to take examination.

634.370            Replacement of lost, stolen or mangled license or certificate.

634.373            Registration and change of name of practice.

634.375            Notification of Board of change of name.

634.380            Notification of Board regarding address of legal residence and mailing address.

634.383            Notification of Board of practice in mobile chiropractic office.

634.385            Continuing education of licensees.

634.390            Voluntary surrender of license; complaint.

STANDARDS OF PRACTICE

634.410            Conduct on premises.

634.412            Competence.

634.415            Supervision of others by licensee.

634.419            Authorization of person to provide other services for patients in office of licensee.

634.425            Reports to Board of certain judgments, settlements and convictions.

634.430            Unprofessional conduct: Interpretation of statutory definition.

634.435            Health care records.

634.445            Practice without maintaining professional liability insurance: Written disclosures.

634.455            Chiropractor’s assistant: Display of certificate.

634.460            Chiropractor’s assistant and chiropractor’s assistant trainee: Prohibited acts.

ADVERTISING AND OTHER COMMUNICATIONS

634.515            Permissible information.

634.521            False or misleading communications.

634.525            Advertisements for electronic media.

634.530            Advertisement of affiliation with provider of health care.

634.536            Designation as licensee.

634.541            Inclusion of name of licensee or referral bureau responsible for content.

634.545            Advertisement of affiliation with research project.

634.550            Advertisement as expert or specialist.

634.556            Advertisement of fees.

634.565            Advertisement of 24-hour service.

634.570            Inclusion of information in list or directory of licensees or chiropractic offices.

PRACTICE BEFORE THE CHIROPRACTIC PHYSICIANS’ BOARD OF NEVADA

General Provisions

634.610            Scope and construction of provisions; deviations.

Rules of Practice

634.615            Communications with Board.

634.620            Appearance and practice at hearings.

634.625            Participation by staff of Board.

634.630            Pleadings: Generally.

634.635            Pleadings: Complaints.

634.645            Filing and service of documents.

634.650            Pleadings: Answer to notice of charges; motions.

634.653            Declaratory orders and advisory opinions.

634.660            Subpoenas.

634.665            Filing of briefs.

634.670            Computation of time; obtaining information about proceedings.

Hearings

634.710            Persons presiding; resetting after continuance; location.

634.715            Failure to appear.

634.720            Preliminary procedure.

634.725            Standards of conduct.

634.730            Testimony: Oath or affirmation required.

634.735            Order of presentation.

634.740            Consolidation of proceedings.

634.745            Stipulations.

634.750            Rules of evidence.

634.755            Offer of proof.

634.760            Continuances.

634.765            Matters of official notice.

634.770            Transcripts.

634.775            Submission of matters for decision; dissemination of orders.

ENFORCEMENT

634.810            Authority of Board.

 

GENERAL PROVISIONS

      NAC 634.110  Definitions. (NRS 634.030)  As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 634.111 to 634.124, inclusive, have the meanings ascribed to them in those sections.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 3, §§ 3.1 through 3.6, eff. 12-8-74]—(NAC A 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008)

      NAC 634.111  “Advertisement” defined. (NRS 634.030)  “Advertisement” includes, without limitation, calling cards, inside and outside signs, stationery, listings in telephone and other directories, and advertisements in newspapers, magazines and by electronic means, including, without limitation, advertisements placed on the Internet.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.112  “Ancillary services” defined. (NRS 634.030)  “Ancillary services” means services related to the practice of chiropractic that a chiropractor’s assistant is authorized to perform under the terms of the certificate issued to him or her by the Board. The term does not include acts that a chiropractor’s assistant is prohibited from performing pursuant to NAC 634.460.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98; A by R101-08, 12-17-2008)

      NAC 634.113  “Applicant” defined. (NRS 634.030)  “Applicant” means a person who applies or petitions for any right or authority from the Board.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.114  “Board” defined. (NRS 634.030)  “Board” means the Chiropractic Physicians’ Board of Nevada.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.116  “Certificate” defined. (NRS 634.030)  “Certificate” means a current certificate as a chiropractor’s assistant.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98; A by R101-08, 12-17-2008)

      NAC 634.117  “Chiropractor’s assistant” defined. (NRS 634.030)  “Chiropractor’s assistant” means a person who holds a certificate as a chiropractor’s assistant pursuant to NRS 634.123 and the provisions of this chapter.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.119  “Direct supervision” defined. (NRS 634.030)  “Direct supervision” means that the supervising licensee or licensed provider of health care, as appropriate, is actually present in the chiropractic facility during the period of supervision.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.1195  “Good standing” defined. (NRS 634.030)  “Good standing” with respect to a license to practice chiropractic means that the license is not restricted by revocation, suspension or probation or otherwise encumbered as specified by an order of the Board.

     (Added to NAC by Chiropractic Physicians’ Bd. by R101-08, eff. 12-17-2008)

      NAC 634.121  “Licensee” defined. (NRS 634.030)  “Licensee” means a chiropractic physician who is licensed by the Board pursuant to chapter 634 of NRS.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.124  “Referral bureau” defined. (NRS 634.030)  “Referral bureau” means a group of two or more licensees who practice in separate locations, have a telephone number specifically designated for the referral bureau and advertise or market themselves as a referral bureau.

     (Added to NAC by Chiropractic Physicians’ Bd. by R101-08, eff. 12-17-2008)

      NAC 634.125  Severability of provisions. (NRS 634.030)  The provisions of this chapter are hereby declared to be severable and the invalidity of any rule, clause, sentence, paragraph or section of this chapter does not affect the validity of the remainder.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 10, § 10.3, eff. 12-8-74]—(NAC A 7-29-88)—(Substituted in revision for NAC 634.115)

CHIROPRACTIC PHYSICIANS’ BOARD OF NEVADA

      NAC 634.130  Regular meetings. (NRS 634.030, 634.040)  Regular meetings of the Board will be held at its principal office or at any other place and time as the Board may specify.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 2, § 2.2, eff. 12-8-74]

      NAC 634.140  Election of officers. (NRS 634.030)  The Board will elect officers as required pursuant to NRS 634.030 at the first regular meeting of the Board during each even-numbered year.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

FEES

      NAC 634.200  Amount; refunds. (NRS 634.030, 634.115, 634.135)

     1.  The Board will charge and collect the following fees:

 

For an application for a license to practice chiropractic.............................................. $200.00

For an examination for a license to practice chiropractic.............................................. 125.00

For an application for, and the issuance of, a certificate as a chiropractor’s assistant.. 100.00

For an application for a temporary license to practice chiropractic pursuant to NRS 634.115.................................................................................................................................... 50.00

For an examination for a certificate as a chiropractor’s assistant.................................... 60.00

For the issuance of a license to practice chiropractic.................................................... 225.00

For the issuance of a temporary license to practice chiropractic pursuant to NRS 634.115 50.00

For the biennial renewal of an active license to practice chiropractic........................... 700.00

For the biennial renewal of an inactive license to practice chiropractic........................ 250.00

For the biennial renewal of a certificate as a chiropractor’s assistant........................... 120.00

For the restoration to active status of an inactive license to practice chiropractic........ 300.00

For reinstating a license to practice chiropractic which has been suspended or revoked 500.00

For reinstating a certificate as a chiropractor’s assistant which has been suspended or revoked .................................................................................................................................... 70.00

For reinstating an inactive license to practice chiropractic which has been suspended or revoked .................................................................................................................... 200.00

For a review of any subject on the examination.............................................................. 25.00

For the issuance of a duplicate license or certificate or for changing the name on a license or certificate.................................................................................................................... 35.00

For written verification of licensure or issuance of a certificate of good standing......... 25.00

For providing a list of persons who are licensed to practice chiropractic to a person who is not licensed to practice chiropractic................................................................................. 25.00

For providing a list of persons who were licensed to practice chiropractic following the most recent examination of the Board to a person who is not licensed to practice chiropractic.................................................................................................................................... 10.00

For a set of mailing labels containing the names and addresses of the persons who are licensed to practice chiropractic in this State........................................................................... 35.00

For a check which is made payable to the Board that is dishonored upon presentation for payment...................................................................................................................... 25.00

For providing a copy of the statutes, regulations and other rules governing the practice of chiropractic in this State............................................................................................. 25.00

For each page of a list of continuing education courses which have been approved by the Board............................................................................................................................ 0.50

For a review by the Board of a course offered by a chiropractic school or college or a course of continuing education in chiropractic...................................................................... 25.00

 

     2.  The fees set forth in this section are not refundable.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R140-05, 11-17-2005; R101-08, 12-17-2008)

      NAC 634.210  Methods of payment. (NRS 634.030)  Payment of fees and remittances made to the Board by money order, bank draft or check must be made payable to the Chiropractic Physicians’ Board of Nevada. Remittances in currency or coin are made wholly at the risk of the sender, and the Board assumes no responsibility for their loss. Postage stamps will not be accepted as payment.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 2, § 2.4, eff. 12-8-74]—(NAC A 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.215  Fee for issuance of license: Time for payment; failure to pay. (NRS 634.030)

     1.  An applicant for a license to practice chiropractic in this State must pay the fee for the issuance of a license to practice chiropractic required pursuant to NAC 634.200 within 1 year after he or she has satisfied all the requirements for licensure set forth in this chapter and chapter 634 of NRS, other than the payment of the fee for the issuance of the license.

     2.  If such an applicant does not pay the fee for the issuance of a license to practice chiropractic in the period set forth in subsection 1, he or she:

     (a) Shall be deemed to have withdrawn the application; and

     (b) Must reinitiate the application process if he or she wishes to apply for a license at a later date.

     (Added to NAC by Chiropractic Physicians’ Bd. by R095-03, eff. 10-22-2003)

LICENSING AND CERTIFICATION

Examinations

      NAC 634.220  Fingerprinting and investigation of applicants. (NRS 634.030)  Each applicant for examination must:

     1.  Submit two sets of his or her fingerprints on separate standard fingerprint cards with his or her application and pay any associated costs; and

     2.  Agree to a background investigation.

     [Bd. of Chiropractic Exam’rs, Art. XV § 4, eff. 8-27-76; A 11-28-79]—(NAC A 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.290  Examinations required for licensure; passing score. (NRS 634.030, 634.070)

     1.  Except as otherwise provided in this section and in addition to the subjects of examination set forth in NRS 634.070, an applicant for a license to practice chiropractic in Nevada must pass:

     (a) Part IV of the examination administered by the National Board of Chiropractic Examiners;

     (b) An examination on the statutes and regulations of this State which are related to the practice of chiropractic, other than those set forth in this chapter and chapter 634 of NRS; and

     (c) Any other subject or examination that the Board determines to be necessary. An examination required by the Board pursuant to this paragraph may include, without limitation, an examination on clinical rationale.

     2.  An applicant who has actively practiced chiropractic in another state in accordance with subparagraph (2) of paragraph (c) of subsection 1 of NRS 634.090 may, in lieu of passing Part IV of the examination administered by the National Board of Chiropractic Examiners, pass the Special Purposes Examination for Chiropractic prepared by the National Board of Chiropractic Examiners.

     3.  To pass a subject or examination required pursuant to NRS 634.070 or this section, an applicant for a license to practice chiropractic in Nevada must receive a score of at least 75 percent.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.300  Examinations for licensure: Period for taking; failure to pass; failure to appear. (NRS 634.030)

     1.  Except as otherwise provided in subsection 2 and NAC 634.215:

     (a) If a person applies for a license to practice chiropractic in Nevada, the application remains open for 1 year after the date of the first examination that the person is eligible to take.

     (b) During the period in which an application is open, an applicant may take any required examination twice.

     (c) If an applicant does not, on the first attempt, pass an examination that is administered by the Board, the applicant may retake the examination one time without paying an additional fee.

     2.  If an applicant provides evidence satisfactory to the Board that the applicant failed to appear for an examination because of exceptional circumstances, the Board may:

     (a) Allow the applicant to take the next scheduled examination without the payment of an additional fee; and

     (b) If necessary, extend the period during which the application is open.

     3.  If an applicant for a license to practice chiropractic fails on two occasions to pass any portion of the examinations administered pursuant to NRS 634.070, the applicant shall:

     (a) Refrain from supervised practice; or

     (b) Submit a new application for examination in accordance with NRS 634.080.

     4.  An applicant for a license to practice chiropractic who fails to appear for examination within 1 year after being first qualified therefor:

     (a) Shall be deemed to have withdrawn his or her application; and

     (b) Forfeits the application fee.

Ê If the applicant applies thereafter for a license, he or she must establish eligibility for that license in accordance with the provisions of this chapter and chapter 634 of NRS.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003)

      NAC 634.305  Examination for certification as chiropractor’s assistant. (NRS 634.030)

     1.  At least once each year, the Board will administer an examination to applicants for a certificate as a chiropractor’s assistant.

     2.  The examination will consist of the following subjects, including, without limitation:

     (a) Radiographic technology, protection, quality control and positioning of the patient;

     (b) Ancillary procedures and applications relating to chiropractic; and

     (c) The provisions of NRS and NAC that are related to the practice of chiropractic.

     3.  An applicant who receives a score of at least 75 percent on the examination is entitled to a certificate as a chiropractor’s assistant.

     4.  If an applicant fails to receive a score of at least 75 percent on the examination the first time he or she takes the examination, the applicant may retake the examination within 1 year without payment of an additional fee.

     5.  If an applicant who receives training and employment as a chiropractor’s assistant trainee pursuant to subparagraph (2) of paragraph (a) of subsection 2 of NAC 634.355 fails to receive a score of at least 75 percent on the examination after two attempts and wishes to continue working as a chiropractor’s assistant trainee, the supervising licensee must, within 30 days after the date of the notice from the Board of the results of the examination, submit a plan for additional training to the Board. The chair of the test committee will:

     (a) Approve or deny the plan; and

     (b) Determine whether the chiropractor’s assistant trainee may continue working as a chiropractor’s assistant trainee.

     6.  If, pursuant to paragraph (b) of subsection 5, the chair of the test committee determines that a chiropractor’s assistant trainee may continue working as a chiropractor’s assistant trainee, the chiropractor’s assistant trainee may continue working as a chiropractor’s assistant trainee if he or she:

     (a) Pursuant to NAC 634.350, submits a new application for a certificate as a chiropractor’s assistant and pays the required fee; and

     (b) Provides the chair of the test committee with proof that the chiropractor’s assistant trainee is enrolled in an educational course in a subject described in subsection 2.

     7.  If a chiropractor’s assistant trainee who has submitted an application pursuant to paragraph (a) of subsection 6 fails to pass any portion of the examination after two attempts, the chiropractor’s assistant trainee shall not work as a chiropractor’s assistant trainee until the chiropractor’s assistant trainee has passed all the portions of the examination.

     8.  An applicant for a certificate as a chiropractor’s assistant who fails on two occasions to appear for an examination that he or she has been scheduled to take:

     (a) Shall be deemed to have withdrawn his or her application;

     (b) Forfeits any application fees paid to the Board; and

     (c) Must, if he or she has been receiving training and employment as a chiropractor’s assistant trainee pursuant to subparagraph (2) of paragraph (a) of subsection 2 of NAC 634.355, cease working as a chiropractor’s assistant trainee.

Ê If the applicant applies thereafter for a certificate, the applicant must establish eligibility for the certificate in accordance with the provisions of this chapter and chapter 634 of NRS.

     9.  As used in this section, “chair of the test committee” means the member of the Board who is assigned by the Board to serve as the chair of the committee that is created by the Board to administer an examination to applicants for a certificate as a chiropractor’s assistant.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 5-13-82; A 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R014-10, 5-5-2011)

      NAC 634.311  Retention and destruction of records. (NRS 634.030)

     1.  Except as otherwise provided in this section, the Board:

     (a) May destroy the records of examination for a successful applicant not earlier than 90 days after granting a license to the applicant.

     (b) Will retain the records of examination for an unsuccessful applicant until the examination has been given two additional times.

     2.  The Board may extend the period of retention for records of examination for good cause shown.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93)

      NAC 634.320  Authorized persons in waiting area; conduct of applicant. (NRS 634.030)  During the examination of applicants for licensing as chiropractic physicians or for certification as chiropractor’s assistants, only members of the Board, testing consultants, examination proctors, applicants and persons requested by the Board will be allowed in the waiting area for applicants or in the room in which the examination is given. An applicant may not:

     1.  Communicate with any person while he or she is in the waiting area, halls or restrooms;

     2.  Leave the waiting area without the permission of a member of the Board, a testing consultant or an examination proctor; or

     3.  Bring any written or recorded material relating to the practice of chiropractic into the examination facility.

     [Bd. of Chiropractic Exam’rs, Art. XV § 1, eff. 8-27-76; A 11-28-79]—(NAC A 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008)

      NAC 634.330  Cheating by applicants. (NRS 634.030)  Any applicant who is found to be cheating during an examination will be required to leave immediately and will not be permitted to take an examination for 2 years after the date of the examination from which he or she was dismissed.

     [Bd. of Chiropractic Exam’rs, Art. XV § 2, eff. 8-27-76; A 11-28-79]—(NAC A 7-29-88)

Preceptor Program

      NAC 634.331  Definitions. (NRS 634.030, 634.137)  As used in NAC 634.331 to 634.347, inclusive, unless the context otherwise requires, the words and terms defined in NAC 634.333 and 634.334 have the meanings ascribed to them in those sections.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.333  “Preceptor” defined. (NRS 634.030, 634.137)  “Preceptor” means a licensee who has been approved by the Board to participate in the preceptor program.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.334  “Student” defined. (NRS 634.030, 634.137)  “Student” means a person who is enrolled in a college of chiropractic.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.335  Establishment. (NRS 634.030, 634.137)  The Board hereby establishes the preceptor program required by NRS 634.137 as set forth in NAC 634.331 to 634.347, inclusive.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.336  Application procedure for student; eligibility requirements. (NRS 634.030, 634.137, 634.1375)  A student who wishes to participate in the preceptor program must submit to the Board an application for approval to participate in the preceptor program. The application must include, without limitation:

     1.  Written proof, which may include a preliminary transcript, from the college of chiropractic at which the student is enrolled that the student:

     (a) Has successfully completed all the didactic course work required by the college of chiropractic to consider the student enrolled in his or her final academic year;

     (b) Is in good standing with the college of chiropractic; and

     (c) Has completed the hours of clinical work required by the college of chiropractic to qualify the student to participate in the preceptor program.

     2.  A copy of a written agreement entered into pursuant to NAC 634.338 evidencing that the student has been accepted to practice chiropractic under the supervision of a preceptor.

     3.  The date on which the student will commence his or her practice of chiropractic as a participant in the preceptor program.

     4.  The date by which the student will end his or her practice of chiropractic as a participant in the preceptor program, which must be not later than 1 year after the date of commencement of the practice.

     5.  Each address at which the student may perform chiropractic services.

     6.  A written acknowledgment that the student has read and understands the laws of this State relating to the practice of chiropractic.

     7.  A waiver of confidentiality which authorizes the Board to obtain information from the college of chiropractic at which the student is enrolled to verify that the student is qualified to practice chiropractic as a participant in the preceptor program.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.337  Application procedure for licensee; requirements to act as preceptor. (NRS 634.030, 634.137, 634.1379)

     1.  A licensee who wishes to act as a preceptor must submit to the Board an application for approval to participate in the preceptor program. The application must include, without limitation:

     (a) Proof satisfactory to the Board that the licensee maintains malpractice insurance in an amount not less than $1,000,000 per occurrence and not less than $3,000,000 in the aggregate;

     (b) Written evidence that the licensee has been accepted to serve as a preceptor by the college of chiropractic at which the student who will be supervised by the licensee is enrolled; and

     (c) Proof satisfactory to the Board that the licensee meets the requirements set forth in subsection 2.

     2.  A licensee who applies to participate in the preceptor program must have not less than 5 years of experience as a licensed chiropractor, at least 2 years of which must have been as a chiropractor licensed to practice chiropractic in Nevada.

     3.  In determining whether to approve an application to participate in the preceptor program submitted by a licensee, the Board will review the disciplinary history of the licensee.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.338  Preceptor agreement: Form; contents; required provisions. (NRS 634.030, 634.137)

     1.  A student and the preceptor who will supervise the student during his or her participation in the preceptor program must enter into an agreement before the student may commence the practice of chiropractic as a participant in the preceptor program.

     2.  The written agreement must include, without limitation:

     (a) A statement acknowledging that all work performed by the student must be done only at the direction of and under the direct supervision of the preceptor;

     (b) A statement by the preceptor in which he or she agrees to take full liability and responsibility for any work performed by the student;

     (c) A statement by the preceptor that he or she will not authorize the student to perform any act which is prohibited by NAC 634.339;

     (d) A statement by the student that he or she will not perform any act which is prohibited by NAC 634.339;

     (e) A statement setting forth the commencement date and end date of the period during which the student may perform chiropractic under the supervision of the preceptor; and

     (f) An acknowledgment that the student will not practice chiropractic for more than 40 hours during any week in which the student participates in the preceptor program.

     3.  If a student will be supervised by more than one preceptor, each preceptor who intends to supervise the student must be approved by the Board and enter into an agreement with the student pursuant to this section.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.339  Duties of preceptor; scope of authorized activities of student. (NRS 634.030, 634.137)

     1.  In supervising a student who is participating in the preceptor program, a preceptor:

     (a) Shall ensure that the student is exposed to and, within the discretion of the preceptor and except as otherwise provided in subsection 2, is allowed to perform all aspects of chiropractic as practiced by the preceptor;

     (b) Shall assume all responsibility and liability for all acts performed by the student;

     (c) Shall notify the Board within 15 business days after the termination of the student’s participation in the preceptor program; and

     (d) Shall not supervise more than one student.

     2.  A student who participates in the preceptor program shall not:

     (a) Diagnose the condition of a patient without the written concurrence of the preceptor, which must be documented in the health care record of the patient;

     (b) Establish a plan of treatment or prognosis for a patient without the written concurrence of the preceptor, which must be documented in the health care record of the patient;

     (c) Perform any service except at the direction of and under the direct supervision of the preceptor;

     (d) Practice chiropractic more than 40 hours during any week in which the student participates in the preceptor program; or

     (e) Bill independently of the preceptor for any service rendered.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.341  Student providing chiropractic services: Notice to patient; duties of preceptor. (NRS 634.030, 634.137)

     1.  Before a student who participates in the preceptor program provides chiropractic services to a patient:

     (a) The preceptor shall inform the patient that the patient will be receiving chiropractic services from a student pursuant to the preceptor program. The preceptor shall obtain from the patient written consent for the receipt of chiropractic services from a student.

     (b) The student or preceptor shall perform the initial evaluation and assessment of the patient and develop the plan of treatment for the patient. If the student:

          (1) Performs the initial evaluation or assessment or develops the plan of treatment, the student may execute the plan of treatment only after the preceptor has reviewed and initialed in the health care record of the patient the evaluation, assessment or plan of treatment developed by the student.

          (2) Observes or learns of a condition or issue that was not contained in the original evaluation, assessment or plan of treatment, the student shall immediately notify the preceptor of the condition or issue.

          (3) Wishes to make a change or addition to the plan of treatment of a patient, the student must obtain the concurrence of the preceptor before making the change or addition.

     2.  The final assessment of the condition of a patient must be conducted by a licensee.

     3.  The preceptor who supervises a student shall review the health care records of a patient not less than once every third visit of the patient to ensure that the student is performing the chiropractic services as directed by the preceptor and is maintaining the health care record of the patient in accordance with applicable law.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.342  Identification as student. (NRS 634.030, 634.137)  A student who is providing chiropractic services pursuant to the preceptor program shall wear a badge or other type of visible identification which clearly identifies the student as a “student” or “student chiropractor.”

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.343  Continued professional relationship between student and preceptor. (NRS 634.030, 634.105, 634.137)  If a student who participates in the preceptor program graduates from a college of chiropractic and his or her participation in the preceptor program is terminated, the student and a chiropractor may continue the professional relationship pursuant to the provisions of NRS 634.105 if the student and the chiropractor:

     1.  Submit a declaration to the Board of their intent to continue the relationship after the termination of the student’s participation in the preceptor program; and

     2.  Comply with all requirements for authorization to perform chiropractic services pursuant to NRS 634.105 while the student is waiting to take the Board’s examination, including, without limitation, compliance with NAC 634.368.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

      NAC 634.347  Disciplinary action. (NRS 634.030, 634.137, 634.140, 634.190)

     1.  The Board may place conditions upon the issuance of a license to an applicant who participated in the preceptor program if the Board determines that the applicant violated any provision of this chapter or chapter 634 of NRS during the applicant’s participation in the preceptor program.

     2.  The Board may take appropriate disciplinary action against a licensee who participates in the preceptor program, including, without limitation, disallowing the person from serving as a preceptor, if the licensee or a student supervised by the licensee violates any provision of this chapter or chapter 634 of NRS during the student’s participation in the preceptor program.

     (Added to NAC by Chiropractic Physicians’ Bd. by R004-12, eff. 11-1-2012)

Chiropractor’s Assistants

      NAC 634.348  Performance of ancillary services. (NRS 634.030, 634.125)

     1.  A person who desires to perform ancillary services must obtain a certificate as a chiropractor’s assistant.

     2.  A person who holds a certificate as a chiropractor’s assistant may perform ancillary services, including, without limitation:

     (a) Administering to patients by means of physiotherapeutic equipment;

     (b) Taking and developing X-rays;

     (c) Assisting with the education of a patient concerning his or her health;

     (d) Assisting a patient with exercise or rehabilitation activities;

     (e) Taking the history of the health of a patient; and

     (f) Assisting the supervising licensee with an examination of a patient.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98; A by R095-03, 10-22-2003; R101-08, 12-17-2008)

      NAC 634.350  Application for certification: Filing; requirements; expiration; waiver of requirements. (NRS 634.030, 634.123)

     1.  An applicant for a certificate as a chiropractor’s assistant must file an application with the Board on a form furnished by the Board and pay the required fee within 15 days after the date on which the applicant has begun performing duties as a chiropractor’s assistant. An applicant who has not begun performing duties as a chiropractor’s assistant may file an application at any time after completing his or her formal training required pursuant to NRS 634.123.

     2.  The application must set forth:

     (a) The date of the application.

     (b) The applicant’s date and place of birth and two personal references based upon 5 years’ acquaintance.

     (c) The applicant’s name, age, social security number, sex and current residence.

     (d) The name and mailing address of the applicant’s current employer, if any.

     (e) If applicable, the date on which he or she was hired to perform the duties of a chiropractor’s assistant.

     (f) Whether or not the applicant has ever applied for certification as a chiropractor’s assistant in another state. If the applicant has so applied, he or she must state when and where he or she applied and the result of that application.

     (g) If the applicant has been certified in another state, whether any proceeding to discharge, dismiss or discipline him or her or other similar proceeding has ever been instituted against him or her and the disposition of each such proceeding.

     3.  An application expires after 1 year.

     4.  For good cause shown, the Board may, at its discretion, waive one or more of the requirements of this section.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 5-13-82; A 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R101-08, 12-17-2008)

      NAC 634.355  Certification: Additional requirements; waiver of requirements. (NRS 634.030, 634.123)

     1.  An applicant for a certificate as a chiropractor’s assistant must, in addition to fulfilling the requirements of NAC 634.350, furnish evidence satisfactory to the Board that he or she:

     (a) Is 18 years of age or older; and

     (b) Has received a score of at least 75 percent on an examination administered by the Board on the provisions of NRS and NAC that are related to the practice of chiropractic.

     2.  In addition to the requirements set forth in subsection 1 and NAC 634.350, an applicant for a certificate as a chiropractor’s assistant must furnish evidence satisfactory to the Board that he or she:

     (a) Satisfies one of the following:

          (1) Is certified as a chiropractor’s assistant by a program for chiropractor’s assistants that is approved by the Board; or

          (2) Has had 6 months of full-time training and employment as a chiropractor’s assistant trainee from a licensee.

     (b) Has received a score of at least 75 percent on the examination for certification required pursuant to NAC 634.305.

     3.  Evidence of an applicant’s completion of approved training pursuant to subparagraph (2) of paragraph (a) of subsection 2 must consist of a certification by the licensed provider of health care, and the certification must be notarized.

     4.  The Board may, at its discretion:

     (a) Waive one or more of the requirements of this section for good cause shown.

     (b) Upon receipt from an applicant of documentation demonstrating that the applicant has received additional formal training, education or experience, grant the applicant credit toward fulfilling the requirements of subparagraph (2) of paragraph (a) of subsection 2.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 5-13-82; A 7-29-88; 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R101-08, 12-17-2008)

      NAC 634.360  Employment and training as chiropractor’s assistant trainee. (NRS 634.030, 634.123)

     1.  A person may not be employed and trained for more than 15 days as a chiropractor’s assistant trainee for the purposes of satisfying subparagraph (2) of paragraph (a) of subsection 2 of NAC 634.355 unless the person, within the first 15 days during which he or she performs any duties as a chiropractor’s assistant trainee, applies to the Board by submitting a form provided by the Board.

     2.  Except as otherwise provided in subsection 3, an applicant for a certificate as a chiropractor’s assistant who completes training pursuant to subparagraph (2) of paragraph (a) of subsection 2 of NAC 634.355 shall, upon the completion of the training:

     (a) Apply to the Board to sit for the next scheduled examination; and

     (b) Submit the fees required by the Board pursuant to NAC 634.200.

     3.  For good cause shown, the Board may, at its discretion, extend the training period of a chiropractor’s assistant trainee and authorize the trainee to take a later scheduled examination.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R101-08, 12-17-2008)

Miscellaneous Provisions

      NAC 634.366  Requirements to practice chiropractic or provide services relating to chiropractic; report to Board of any other license, certificate or registration as provider of health care. (NRS 634.030, 634.137)

     1.  Except as otherwise provided in NAC 634.360, a person may not practice chiropractic or provide services relating to chiropractic to patients unless the person:

     (a) Is a licensee;

     (b) Holds a valid certificate as a chiropractor’s assistant pursuant to NRS 634.123 and the provisions of this chapter;

     (c) Is authorized to perform chiropractic pursuant to NRS 634.105 while waiting to take the Board’s examination;

     (d) Holds a valid temporary license to practice chiropractic pursuant to NRS 634.115;

     (e) Holds a valid license or certificate as a provider of health care that is issued by an agency of this State pursuant to one or more of the chapters of title 54 of NRS; or

     (f) Is a student who is authorized to perform chiropractic pursuant to the preceptor program.

     2.  A licensee shall report to the Board any other license, certificate or registration as a provider of health care he or she obtains pursuant to a chapter of title 54 of NRS other than chapter 634 of NRS within 15 days after the effective date of the license, certificate or registration.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98; A by R095-03, 10-22-2003; R101-08, 12-17-2008; R004-12, 11-1-2012)

      NAC 634.3665  Requirements to perform manipulation on patient under anesthesia. (NRS 634.030)

     1.  A licensee shall not perform manipulation on a patient under anesthesia unless the licensee performs the manipulation at a medical facility or office described in subsection 2 and:

     (a) Has obtained certification to perform such manipulation from:

          (1) A college of chiropractic that is accredited by the Council on Chiropractic Education; or

          (2) Another program approved by the Board; or

     (b) Is enrolled in a program to obtain the certification described in paragraph (a) at the time the manipulation is performed and the licensee performs the manipulation under the direct supervision of a qualified instructor approved by the Board.

     2.  The manipulation described in subsection 1 may be performed:

     (a) On a patient who is under general anesthesia or deep sedation, only in a hospital or surgical center for ambulatory patients that is licensed by the Health Division of the Department of Health and Human Services and accredited by:

          (1) The Joint Commission on Accreditation of Healthcare Organizations; or

          (2) The National Committee for Quality Assurance; or

     (b) On a patient who is under conscious sedation:

          (1) In a medical facility described in paragraph (a); or

          (2) In the office of a physician licensed pursuant to chapter 630 of NRS or osteopathic physician licensed pursuant to chapter 633 of NRS who is currently certified by a specialty board of the American Board of Medical Specialties in the specialty of anesthesiology, emergency medicine or the management of pain, if the office is approved by the Board for the administration, monitoring and control of conscious sedation by a licensee.

     3.  As used in this section:

     (a) “Conscious sedation” means a minimally depressed level of consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, in which the patient retains the ability independently and continuously to maintain an airway and to respond appropriately to physical stimulation and verbal commands.

     (b) “Deep sedation” means a controlled state of depressed consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by a partial loss of protective reflexes and the inability to respond purposefully to verbal commands.

     (c) “General anesthesia” means a controlled state of unconsciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by partial or complete loss of protective reflexes and the inability independently to maintain an airway and respond purposefully to physical stimulation or verbal commands.

     (d) “Hospital” has the meaning ascribed to it in NRS 449.012.

     (e) “Surgical center for ambulatory patients” has the meaning ascribed to it in NRS 449.019.

     (Added to NAC by Chiropractic Physicians’ Bd. by R095-03, eff. 10-22-2003; A by R034-05, 10-31-2005)

      NAC 634.367  Temporary license: Authorized acts. (NRS 634.030, 634.115)  A person who is issued a temporary license pursuant to NRS 634.115 is authorized to:

     1.  Substitute for a licensee during a period in which the licensee is:

     (a) On vacation; or

     (b) Unable to perform chiropractic services because of illness or injury.

     2.  Perform chiropractic services for a traveling sports or professional group.

     3.  Demonstrate and perform chiropractic services as a visiting teacher of an educational seminar.

     4.  Perform chiropractic services in other circumstances as the Board may approve.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.368  Practice by applicant waiting to take examination. (NRS 634.030, 634.105)

     1.  Except as otherwise provided in this section, an applicant for a license to practice chiropractic may perform chiropractic as specified in NRS 634.105 if:

     (a) His or her completed application is on file in the office of the Board and he or she meets the requirements of NRS 634.090;

     (b) The fee for the application has been paid; and

     (c) The Board has approved a licensee to supervise the applicant after receiving from that licensee a completed form that is provided by the Board and which sets forth:

          (1) The fact of the applicant’s employment;

          (2) The date that the applicant is to begin working for the supervising licensee;

          (3) A statement in which the supervising licensee agrees to take responsibility for the applicant’s work;

          (4) The assurance of the supervising licensee that any act prohibited by subsection 5 will not be performed by the applicant; and

          (5) The statement required pursuant to subsection 2.

     2.  The supervising licensee shall inform the applicant of the provisions of this section, and the applicant must sign a statement indicating that he or she has been so informed and understands the provisions and agrees to comply with them. The statement must be in substantially the following form:

 

     I, ..........................., (name of applicant) am an applicant for a license to practice chiropractic who is waiting to take the Board’s examination. I have been informed by my supervising chiropractor .......................... (name of supervising chiropractor) of the content of the provisions of NAC 634.368. I understand those provisions, and I agree that I will not perform any act prohibited by subsection 5 of NAC 634.368 during this supervisory period.

 

......................................                                                       .....................................................

              (date)                                                                               (signature of applicant)

 

     3.  An applicant who works for a supervising licensee under the provisions of this section and NRS 634.105 is not required to apply for or obtain a certificate as a chiropractor’s assistant.

     4.  The supervising licensee shall notify the Board within 5 business days after the applicant leaves his or her employ and the date on which the applicant left such employ.

     5.  In addition to the prohibitions set forth in NRS 634.105, an applicant shall not:

     (a) Perform any service, except at the direction and direct supervision of a licensee; or

     (b) Bill independently of the supervising licensee for any service rendered.

     6.  Any violation of chapter 634 of NRS or this chapter by the applicant constitutes grounds for the Board to:

     (a) Prohibit the applicant from taking the examination for licensure or place conditions upon the issuance of a license to the applicant; and

     (b) Take appropriate disciplinary action against the supervising licensee.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 5-13-82; A 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R014-10, 5-5-2011; R004-12, 11-1-2012)—(Substituted in revision for NAC 634.340)

      NAC 634.370  Replacement of lost, stolen or mangled license or certificate. (NRS 634.030)  A licensee or holder of a certificate is entitled to a duplicate license or certificate if the original license or certificate is lost, stolen or mangled. Each request for a duplicate license or certificate must be accompanied by the required fee and a signed written statement which sets forth the circumstances concerning the need for the duplicate license or certificate. If the duplicate license or certificate is requested to replace a mangled license or certificate, the licensee or holder of the certificate shall submit the mangled license or certificate with the request.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.373  Registration and change of name of practice. (NRS 634.030)  A licensee who operates or organizes a business, corporation, office, partnership or practice for the purpose of providing chiropractic services shall:

     1.  Ensure that the name of the business, corporation, office, partnership or practice is registered with the Board; and

     2.  If the name of the business, corporation, office, partnership or practice changes, provide the new name to the Board within 15 days after the change.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

      NAC 634.375  Notification of Board of change of name. (NRS 634.030)  A licensee or holder of a certificate who legally changes his or her name from that which is currently registered with the Board or which appears on his or her license or certificate:

     1.  Shall, within 15 days after the change, provide the Board with the new name by submitting a written statement and legal documentation of the change to the office of the Board; and

     2.  May obtain a replacement license or certificate if he or she:

     (a) Complies with the provisions of subsection 1;

     (b) Remits the required fee; and

     (c) Returns his or her current license or certificate to the Board.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.380  Notification of Board regarding address of legal residence and mailing address. (NRS 634.030)

     1.  A chiropractic physician or chiropractor’s assistant who is licensed or certified by the Board shall:

     (a) Provide the Board with the address of his or her current legal residence; and

     (b) Notify the Board, in writing, of any change in his or her legal residence within 15 days after the change.

     2.  In addition to providing the Board with the address of each office where he or she practices pursuant to NRS 634.129, and the address of his or her legal residence, a chiropractic physician or chiropractor’s assistant may provide the number of a post office box which is to be used as his or her mailing address.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008)

      NAC 634.383  Notification of Board of practice in mobile chiropractic office. (NRS 634.030)

     1.  A chiropractic physician or chiropractor’s assistant who practices in a mobile chiropractic office shall notify the Board of that fact within 15 days after beginning to practice in the mobile chiropractic office.

     2.  As used in this section, “mobile chiropractic office” means a self-contained, self-supporting, enclosed mobile unit where one or more persons engage in the practice of chiropractic at multiple locations, including, without limitation, within the mobile unit or at a patient’s home, business or hotel room.

     (Added to NAC by Chiropractic Physicians’ Bd. by R101-08, eff. 12-17-2008)

      NAC 634.385  Continuing education of licensees. (NRS 634.030, 634.130)

     1.  Except as otherwise provided in subsection 7, the Board may approve or endorse an educational class or a seminar if it is designed to advance the professional skills and knowledge of the chiropractic physicians licensed in this State for the purpose of ensuring an optimum quality of chiropractic health care.

     2.  The Board may approve or endorse the attendance by licensees, in person or on-line, of an educational seminar or seminars if:

     (a) The syllabus and curriculum of the instructors of the seminar or seminars and the required fee are submitted to the Board;

     (b) The seminar or seminars provide instruction in conformity with subsection 3 of NRS 634.130;

     (c) The seminar or seminars concern the clinical aspects of a practice or another topic that the Board determines to be in the best interest of the public;

     (d) The sponsor of the seminar or seminars ensures that each licensee who requests credit for continuing education to satisfy the requirement set forth in subsection 3 of NRS 634.130 attends at least 50 minutes of each hour of instruction;

     (e) The seminar or seminars are sponsored by:

          (1) A chiropractic college which has been accredited by:

               (I) The Council on Chiropractic Education; or

               (II) Another educational entity that has been approved by the Board;

          (2) A state chiropractic board or association; or

          (3) The American Chiropractic Association, the International Chiropractors Association or the successor of either; and

     (f) An original or a copy of a certificate of attendance at the seminar or seminars is provided directly to the Board by the sponsor or licensee on or before January 1 of each odd-numbered year before the issuance of a renewal certificate.

     3.  As an alternative to the method of approval and endorsement provided in subsection 2, the Board will approve and endorse the attendance by licensees, in person or on-line, of an educational seminar or seminars if the seminar or seminars have been granted recognition status by the Providers of Approved Continuing Education of the Federation of Chiropractic Licensing Boards.

     4.  The sponsor of the seminar or seminars shall ensure that each licensee attending that seminar is in attendance in a timely manner at the start of each lecture. If the sponsor fails to maintain the proper monitoring procedure, such failure may constitute grounds for the Board to withdraw its approval of a current or future seminar or seminars hosted or arranged by that sponsor.

     5.  The sponsor of a seminar shall allow any representative of the Board to attend all or part of the seminar in order to monitor the content of the course or lecture and the procedures for taking attendance. A representative who is taking the seminar to satisfy the requirements of subsection 3 of NRS 634.130 shall pay the full registration fee.

     6.  The sponsor of a seminar which has received the approval of the Board shall report to the Board all changes in the seminar as soon as possible.

     7.  Except as otherwise provided in this subsection, the Board will not award credit for continuing education to a licensee for an educational class or seminar that is of a nonclinical nature, including, without limitation, an educational class or seminar regarding the building or management of a chiropractic practice. For the purposes of this subsection, an educational class or seminar regarding proper billing procedures shall not be deemed to be an educational class or seminar regarding the building or management of a chiropractic practice.

     8.  The Board will not award credit for continuing education to an instructor of an educational class or seminar unless the instructor obtained from the Board approval for such credit before teaching the educational class or seminar.

     9.  Continuing education hours earned through the completion of a specific educational class or seminar may be counted only once during a calendar year toward the hours of continuing education required by subsection 3 of NRS 634.130, even if the licensee completes that class or seminar more than once during that calendar year.

     [Bd. of Chiropractic Exam’rs, eff. 4-15-63; A 3-19-65; 3-12-71]—(NAC A 7-29-88; 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R034-05, 10-31-2005; R101-08, 12-17-2008; R014-10, 5-5-2011)

      NAC 634.390  Voluntary surrender of license; complaint. (NRS 634.030)

     1.  If a licensee desires to surrender his or her license to practice chiropractic, the licensee shall submit to the Board a sworn written statement of surrender of the license accompanied by delivery to the Board of the actual license issued to him or her. The Board will accept or reject the surrender of the license. If the Board accepts the surrender of the license, the surrender is absolute and irrevocable and the Board will notify any agency or person of the surrender and the conditions under which the surrender occurred, as the Board considers advisable.

     2.  The voluntary surrender of a license or the failure to renew a license does not preclude the Board from hearing a complaint for disciplinary action made against the licensee.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98)

STANDARDS OF PRACTICE

      NAC 634.410  Conduct on premises. (NRS 634.030)

     1.  A licensee is responsible for the conduct of his or her employees and other persons subject to his or her supervision in his or her place of practice and shall ensure that the conduct conforms to the law and to the provisions of this chapter.

     2.  Sexual acts involving patients, patrons or customers must not be permitted on the premises of any facility used by a licensee for the practice of chiropractic.

     [Bd. of Chiropractic Exam’rs, Art. XII, eff. 3-14-73]—(NAC A 7-29-88)

      NAC 634.412  Competence. (NRS 634.030)

     1.  A licensee shall maintain competence in:

     (a) The application of chiropractic; and

     (b) The production and interpretation of X-rays.

     2.  In determining whether a licensee has maintained competence in the production and interpretation of X-rays, the Board will consider whether the licensee:

     (a) Produces X-rays that are of diagnostic quality;

     (b) Uses appropriate techniques to protect a patient in the taking of X-rays;

     (c) Ensures that the exposure of a patient to radiation is based upon clinical necessity as documented by the record of that patient;

     (d) Documents the interpretation of X-rays in writing and maintains those written interpretations as a part of the record of the patient to whom the X-rays pertain; and

     (e) Ensures that the radiographic equipment with which X-rays are taken and produced:

          (1) Meets the specifications established by the manufacturer for the safety and use of that equipment;

          (2) Is maintained properly; and

          (3) Is registered with and made available for inspection by the Division of Public and Behavioral Health of the Department of Health and Human Services pursuant to chapter 459 of NAC.

     (Added to NAC by Chiropractic Physicians’ Bd. by R030-98, eff. 9-10-98; A by R095-03, 10-22-2003)

      NAC 634.415  Supervision of others by licensee. (NRS 634.030, 634.137)  A licensee who supervises:

     1.  A chiropractor’s assistant;

     2.  An applicant for a license to practice chiropractic who is authorized to perform chiropractic pursuant to NRS 634.105;

     3.  A student who is authorized to perform chiropractic pursuant to the preceptor program; or

     4.  Any other person who is subject to the supervision of the licensee,

Ê shall ensure that the person who is supervised complies with the provisions of this chapter and chapter 634 of NRS, and shall make all decisions relating to the diagnosis, treatment, management and future disposition of a patient.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008; R004-12, 11-1-2012)

      NAC 634.419  Authorization of person to provide other services for patients in office of licensee. (NRS 634.030)

     1.  A licensee may authorize a person to provide services for his or her patients in the office of the licensee, other than chiropractic or clerical services, only if the licensee submits the information required by subsection 2 to the Board, on a form prescribed by the Board, at least 15 days before the person commences providing the services.

     2.  The form prescribed by the Board pursuant to subsection 1 must include:

     (a) The name, business telephone number and license number of the licensee;

     (b) The name of the person who will be providing the services for the patients of the licensee;

     (c) The type of services that the person will be providing for the patients of the licensee;

     (d) The address of the location at which the person will be providing the services for the patients of the licensee;

     (e) The date on which the person will begin providing the services for the patients of the licensee;

     (f) A statement indicating that the person will not be providing chiropractic services, including, without limitation, taking X-rays, services that involve the use of physiotherapeutic equipment and massage therapy;

     (g) A statement indicating whether the person who will be providing the services is an employee of the licensee or is retained by the licensee as an independent contractor;

     (h) A copy of any license or certificate that authorizes the person to provide the services that he or she will be providing for the patients of the licensee;

     (i) A statement indicating that the licensee will ensure that a copy of any license or certificate that is provided to the Board pursuant to paragraph (h) is available to each patient of the licensee for whom the person provides services; and

     (j) The signature of the licensee.

     3.  A licensee shall ensure that each employee of the licensee who provides services for the patients of the licensee in the office of the licensee, other than chiropractic or clerical services, provides those services only under the direct supervision of the licensee.

     4.  A licensee who authorizes an independent contractor to provide services in the office of the licensee pursuant to the provisions of this section shall establish procedures which ensure that each patient of the licensee to whom the independent contractor provides services is notified that:

     (a) The independent contractor is not an employee of the licensee;

     (b) The services provided by the independent contractor in the office of the licensee are not provided under the supervision or control of the licensee; and

     (c) The licensee will not bill the patient or the insurance company of the patient for any services provided by the independent contractor.

     5.  A licensee shall notify the Board within 15 days after an employee or independent contractor who is authorized pursuant to this section to provide services to the patients of the licensee leaves the employ of or is no longer retained by the licensee.

     (Added to NAC by Chiropractic Physicians’ Bd. by R140-05, eff. 11-17-2005)

      NAC 634.425  Reports to Board of certain judgments, settlements and convictions. (NRS 634.030)

     1.  If a judgment is entered against him or her in any court, or a settlement is reached, on a claim involving malpractice, a licensee shall report that fact to the Board within 15 days. The licensee may satisfy the provisions of this subsection if he or she provides the Board with a copy of the judgment or settlement.

     2.  If a licensee or holder of a certificate is convicted of any crime, other than a traffic violation, he or she shall report that fact to the Board within 15 days after the conviction.

     3.  If a licensee or holder of a certificate fails to report a judgment, settlement or conviction pursuant to this section, he or she may be subject to disciplinary action pursuant to NRS 634.140 to 634.216, inclusive.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.430  Unprofessional conduct: Interpretation of statutory definition. (NRS 634.018, 634.030)

     1.  As used in subsection 10 of NRS 634.018, the Board will interpret the phrase “conduct unbecoming a person licensed to practice chiropractic or detrimental to the best interests of the public” to include, without limitation:

     (a) Engaging in or soliciting sexual misconduct as defined in subsection 2.

     (b) Performing any chiropractic service on a patient who is under the age of 18 years without first obtaining the consent of the parent or legal guardian of that patient if the consent is required pursuant to NRS 129.030.

     (c) Performing manipulation on a patient under anesthesia without complying with the requirements set forth in NAC 634.3665.

     (d) Entering into a financial agreement or making a financial arrangement with a potential or existing patient as an inducement to enter into or continue care. This paragraph does not prohibit a licensee from providing complimentary chiropractic services to an existing patient.

     (e) Participating in any verbal or written arrangement that involves capping or fee splitting.

     (f) Engaging in practices regarding the billing of patients or the making of claims under a contract of insurance that are abusive or fraudulent, or both, including, without limitation:

          (1) Billing patients or making claims under a contract of insurance for chiropractic services that have not been performed.

          (2) Billing patients or making claims under a contract of insurance in a manner which misrepresents the nature of the chiropractic services that have been performed.

          (3) Submitting to patients or carriers of insurance bills or claims which fail to disclose pertinent information or which contain false information, including, without limitation:

               (I) Failing to disclose to a patient that a bill has already been paid, in full or in part, by a carrier of insurance.

               (II) Failing to disclose to a carrier of insurance that a claim has already been paid, in full or in part, by a different carrier of insurance.

               (III) Stating falsely that the injury of a patient is the result of an accident or work-related incident.

     (g) Engaging in a practice of waiving, abrogating or rebating the deductible or copayment required to be paid by a policy of insurance or a third party if the practice is used as a device for advertising or marketing, or both.

     (h) Failing to make any report or record available to the Board upon lawful request, failing to cooperate with any investigation by the Board or knowingly giving false information to the Board.

     (i) Failing to make any report or record available to another licensee, practitioner, patient or institution upon a lawful request to do so in compliance with the provisions of chapter 629 of NRS.

     (j) Being delinquent in the payment of a judgment for the payment of child support pursuant to chapter 425 of NRS or being subject to a court order for the support of one or more children and not complying with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

     (k) Being in default on the payment of a student loan.

     (l) Violating the rules or regulations of a federal program that relates to the practice of chiropractic.

     (m) Engaging in fraud, misrepresentation or deception in any business affairs that relate to the practice of chiropractic.

     (n) Allowing a person to:

          (1) Perform chiropractic services; or

          (2) Engage in any aspect of the provision of chiropractic care to patients,

Ê if that person is not authorized to perform such services or provide such care pursuant to this chapter and chapter 634 of NRS. The prohibition set forth in this paragraph does not apply to a person who is licensed or certified as a provider of health care pursuant to one or more of the chapters of title 54 of NRS.

     (o) Engaging with a patient in a romantic or dating relationship unless the patient is the spouse of the licensee.

     (p) Examining or treating the anus, breast or genitalia of a patient without first:

          (1) Obtaining from the patient an informed consent that refers to the specific procedures that will be performed on those parts of the body of the patient; and

          (2) Making a note of such consent in the record of the patient.

     (q) Violating a provision of a chapter of title 54 of NRS other than chapter 634 of NRS pursuant to which the licensee holds a license or certificate as a provider of health care.

     (r) Knowingly giving a false or factually unsupported opinion in a peer review, records review, independent medical examination or chiropractic examination for the purpose of reducing a payment or reimbursement to a licensee for the care or treatment of a patient.

     (s) Failing to either post a written disclosure or give a written disclosure to a patient and maintain the written disclosure concerning a lack of maintaining professional liability insurance in accordance with the requirements of NRS 634.1295 and NAC 634.445.

     2.  As used in this section:

     (a) “Capping” means the use by a licensee of the services of a person who is remunerated for referring to the licensee a new patient who has been involved in a motor vehicle accident or who has been injured as a result of the actions of another person.

     (b) “Fee splitting” means the acceptance of remuneration by a licensee for referring a patient to another provider of health care or a health care facility or the provision of remuneration by a licensee for a referral to the business of the licensee.

     (c) “Sexual misconduct” means:

          (1) Sexual relations between a licensee and a patient of that licensee, regardless of whether the patient initiated or consented to those sexual relations.

          (2) Conduct by a licensee, in regard to a patient, that is sexual in nature, sexually suggestive or sexually demeaning to the patient.

          (3) The commission by a licensee of one or more of the offenses defined in NRS 200.368, 200.730, 201.210 and 201.220.

          (4) The use by a licensee of deception, misrepresentation or force for the purpose of engaging in sexual conduct with a patient in:

               (I) A clinical setting; or

               (II) A setting that is used ordinarily for the provision of chiropractic services.

Ê The term does not include sexual conduct or sexual relations that take place between a licensee and his or her spouse or between a licensee and a person who was a patient after the chiropractor-patient relationship has been terminated for a reasonable time.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R140-05, 11-17-2005)

      NAC 634.435  Health care records. (NRS 634.030)

     1.  In addition to the requirements set forth in chapter 629 of NRS, a licensee shall ensure that the health care records of his or her patients:

     (a) Include documentation of treatment of a patient, as specified in subparagraph (3) of paragraph (e), within 72 hours after that treatment;

     (b) Include documentation of information exchanged with a patient within 72 hours after that exchange;

     (c) Are clear, legible, complete and accurate;

     (d) Remain confidential, where such confidentiality is required by law; and

     (e) Contain the following information:

          (1) A description of the chief complaint for which the patient sought treatment from the licensee;

          (2) Documentation of any significant event that affects the chief complaint of the patient or the general history of the health of the patient; and

          (3) An accurate record of the diagnostic and therapeutic procedures that the licensee has employed in providing chiropractic services to the patient, including, without limitation:

               (I) Examinations and the results of those examinations;

               (II) Diagnoses;

               (III) Plans for treatment of the patient, including, without limitation, any changes in those plans and the reasons for those changes;

               (IV) Areas of the body of the patient on which the licensee has performed chiropractic adjustments;

               (V) Dates on which the licensee provided chiropractic services to the patient; and

               (VI) A record of the response of the patient to treatment.

     2.  A licensee who obtains the records of a patient of another licensee because of a change in the ownership of a practice shall:

     (a) Report to the Board the transfer of the records; and

     (b) Inform the Board, in writing, of the physical location of those records within 15 days after the change in ownership of the practice.

     3.  A licensee who retires, moves to another state or changes the status of his or her license from active to inactive shall inform the Board of the location at which the records of his or her patients may be obtained.

     4.  The administrator of the estate of a licensee who is deceased shall inform the Board of the location at which the records of the patients of the deceased licensee will be retained.

     5.  As used in this section, “patient” includes:

     (a) A member of the licensee’s family;

     (b) A relative of the licensee; and

     (c) A member of the licensee’s staff,

Ê to whom the licensee provides chiropractic services.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R014-10, 5-5-2011)

      NAC 634.445  Practice without maintaining professional liability insurance: Written disclosures. (NRS 634.030, 634.1295)

     1.  Each written disclosure that is posted by a licensee pursuant to paragraph (a) of subsection 1 of NRS 634.1295 must:

     (a) Be printed in boldface capital letters on paper that is at least 8 1/2 inches by 11 inches in size;

     (b) Not contain text that is smaller than a 42-point font or less than 1/2 inch in height; and

     (c) Be in substantially the following form:

 

IMPORTANT NOTICE TO MY PATIENTS

     I, ........................... (NAME OF CHIROPRACTOR), DO NOT MAINTAIN PROFESSIONAL LIABILITY INSURANCE.

 

     2.  Each written disclosure that is given to a patient by a licensee pursuant to paragraph (b) of subsection 1 of NRS 634.1295 must:

     (a) Be printed in boldface letters on paper that is at least 8 1/2 inches by 11 inches in size;

     (b) Be captioned in capital letters in text that is not smaller than a 28-point font or less than 1/4 inch in height;

     (c) Not contain text that is smaller than an 18-point font or less than 1/4 inch in height; and

     (d) Be in substantially the following form:

 

ACKNOWLEDGMENT OF LACK OF PROFESSIONAL LIABILITY INSURANCE

     I, ........................... (name of patient), acknowledge that I am aware that .......................... (name of chiropractor) does not maintain professional liability insurance coverage.

 

                                                                                          .................................................................

                                     (date)                                                            (signature of patient)

 

     3.  A written disclosure described in subsection 2 must be signed by the patient before the licensee provides any chiropractic treatment or care to the patient.

     4.  After a written disclosure described in subsection 2 is signed by a patient, the licensee shall maintain the written disclosure as a part of the record of the patient.

     (Added to NAC by Chiropractic Physicians’ Bd. by R140-05, eff. 11-17-2005; A by R101-08, 12-17-2008)

      NAC 634.455  Chiropractor’s assistant: Display of certificate. (NRS 634.030)

     1.  A chiropractor’s assistant shall display his or her certificate at the place of practice of the supervising licensee.

     2.  If the supervising licensee practices at more than one location and the chiropractor’s assistant works at more than one of those locations, the chiropractor’s assistant shall:

     (a) Display his or her certificate at the office where he or she performs the majority of his or her work; and

     (b) Display a duplicate certificate, which the chiropractor’s assistant shall obtain from the Board, at each of the other locations where he or she works.

     3.  A chiropractor’s assistant shall not display his or her certificate except as otherwise provided in this section.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008)

      NAC 634.460  Chiropractor’s assistant and chiropractor’s assistant trainee: Prohibited acts. (NRS 634.030)  A chiropractor’s assistant or chiropractor’s assistant trainee may not:

     1.  Diagnose a patient or establish a prognosis.

     2.  Prescribe a program of treatment for any patient.

     3.  Perform any service that is not specifically authorized by the provisions of chapter 634 of NRS.

     4.  Perform any service that is not specifically authorized by the terms of his or her certificate.

     5.  Perform a chiropractic adjustment.

     6.  Perform any service, except at the direction and under the direct supervision of a licensee.

     7.  Bill independently of the supervising licensee for any services rendered.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R034-05, 10-31-2005; R101-08, 12-17-2008)

ADVERTISING AND OTHER COMMUNICATIONS

      NAC 634.515  Permissible information. (NRS 634.030)  The following information included in an advertisement or written communication shall be deemed to be in compliance with NAC 634.515 to 634.570, inclusive:

     1.  Information relating to the licensee or chiropractic office, including, but not limited to:

     (a) The name of the licensee or chiropractic office;

     (b) A list of licensees associated with a chiropractic office and their designations, such as doctor of chiropractic, chiropractor or chiropractic physician;

     (c) The address and telephone number of the office; and

     (d) The hours during which the office will be open or the licensee will be available.

     2.  The date on which a license was issued to the licensee by the Board or by the licensing agency of another state.

     3.  Technical and professional licenses granted by this or any other state.

     4.  The ability of the licensee or persons employed by the licensee or in the chiropractic office to speak a language other than English.

     5.  The fields of chiropractic in which the licensee is certified or is a specialist, subject to the restrictions of NAC 634.550.

     6.  Information regarding prepaid or group plans for health care services in which the licensee participates.

     7.  The types of credit cards, if any, which are accepted.

     8.  The fee for an initial consultation or a schedule of fees provided in accordance with NAC 634.556.

     9.  The use of the name and address of a licensee or chiropractic office in a public service announcement or in connection with a charitable, civic or community program or event.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003)

      NAC 634.521  False or misleading communications. (NRS 634.030)  A licensee shall not make any false or misleading communications about himself or herself or his or her services. A communication shall be deemed to be misleading if it contains a material misrepresentation of fact or law, or omits a fact necessary to make the statement, considered as a whole, not misleading.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003)

      NAC 634.525  Advertisements for electronic media. (NRS 634.030)

     1.  An advertisement for any electronic media may contain the same factual information and illustrations which are allowed in advertisements for any printed media.

     2.  A person who appears in an advertisement for any electronic media as a licensee or appears in such a manner as to imply that he or she is a licensee must be:

     (a) A licensee who holds a license in good standing to practice chiropractic in this State; and

     (b) The licensee who will provide the services advertised or who is associated with the practice which is advertising the service.

     3.  A person who appears in an advertisement on electronic media as an employee of a licensee or chiropractic practice must be an actual employee of the licensee or chiropractic practice whose services are being advertised, unless the advertisement discloses that such a person is an actor.

     4.  If an actor appears in an advertisement in accordance with this section, the advertisement must disclose that the person is an actor.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.530  Advertisement of affiliation with provider of health care. (NRS 634.030)  A licensee shall not represent that he or she is affiliated within the same office with a provider of health care who is not licensed pursuant to chapter 634 of NRS unless that provider of health care spends at least 20 percent of his or her time in the licensee’s office.

     [Bd. of Chiropractic Exam’rs, Art. V §§ 2 & 4, eff. 3-15-61; A 5-15-64; 3-14-73; 4-26-76; 11-28-79]—(NAC A 12-3-80; 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003)

      NAC 634.536  Designation as licensee. (NRS 634.018, 634.030)  The failure of a licensee in any advertising to clearly designate himself or herself as a licensee shall be deemed to be false and misleading for the purposes of subsection 4 of NRS 634.018.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.541  Inclusion of name of licensee or referral bureau responsible for content. (NRS 634.030)  All advertisements and written communication must include the name of at least one licensee or a referral bureau for licensees that is responsible for the content of the advertisement or communication.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 7-29-88; A 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.545  Advertisement of affiliation with research project. (NRS 634.018, 634.030)  If a licensee advertises any affiliation with a research project, he or she must make a written statement of the objectives, cost and budget of the project and the persons conducting the research available on request to the Board, to scientific organizations and to the general public. Any willful failure to comply with the requirements of this section shall be deemed to be false and deceptive advertising for the purposes of subsection 4 of NRS 634.018.

     [Bd. of Chiropractic Exam’rs, Art. V § 6, eff. 3-15-61; A 5-15-64; 3-14-73; 4-26-76; 11-28-79]—(NAC A 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.550  Advertisement as expert or specialist. (NRS 634.030)  Except as otherwise provided in NAC 634.515 to 634.570, inclusive, a licensee shall not hold himself or herself out in any advertisement as being:

     1.  Certified; or

     2.  An expert or specialist other than an expert witness,

Ê in a field of chiropractic unless he or she is registered with and approved by the Board as holding the applicable professional credentials in that field.

     [Bd. of Chiropractic Exam’rs, Art. V § 7, eff. 3-15-61; A 5-15-64; 3-14-73; 4-26-76; 11-28-79]—(NAC A 7-29-88; 1-31-94; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003)

      NAC 634.556  Advertisement of fees. (NRS 634.030)

     1.  Except as otherwise provided in this section, a licensee who advertises a specific fee or range of fees shall honor the advertised fee or range of fees for at least 90 days after the last date that the advertisement is broadcast or disseminated, unless the advertisement specifies a shorter period. If a specific fee or range of fees is advertised in a telephone directory or other type of media which is not published more frequently than annually, the licensee shall honor that fee or range of fees for at least 1 year after the publication of the telephone directory or other type of media.

     2.  If an advertisement states that a chiropractic service is being offered free of charge or at a discounted rate:

     (a) The service must be provided at the advertised rate regardless of whether the service is to be paid for by the patient or a third party, such as an insurer.

     (b) The licensee who advertises the service shall ensure that:

          (1) A patient to whom the service is provided receives and signs a statement of disclosure which sets forth:

               (I) A detailed description of the service that will be provided free of charge or at a discounted rate.

               (II) The amount that will be charged for any additional services that will be provided.

               (III) If the offer to provide a service free of charge or at a discounted rate is valid for a limited time, the date on which that offer will end.

          (2) A statement of disclosure that is required pursuant to subparagraph (1) is placed and maintained in the record of a patient to whom a service is provided free of charge or at a discounted rate.

     3.  If a licensee provides diagnostic services, including, without limitation, examinations and X-rays, free of charge or at a discounted rate pursuant to an advertisement, the licensee shall provide those services in a sufficiently complete and thorough manner so as to allow the licensee to make a proper diagnosis.

     4.  No separate charge may be made for the professional evaluation of diagnostic tests or procedures which are provided free of charge or at a discount, regardless of whether the professional evaluation is made at the time of the initial office visit or at a later time.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R095-03, 10-22-2003; R014-10, 5-5-2011)

      NAC 634.565  Advertisement of 24-hour service. (NRS 634.030)  No licensee or referral bureau for licensees may advertise 24-hour service unless a licensee is available at all times to perform any chiropractic service which may be needed.

     [Bd. of Chiropractic Exam’rs, Art. XI §§ 1-3, eff. 3-14-73; A 11-28-79]—(NAC A 6-12-80; 12-3-80; 7-29-88; 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.570  Inclusion of information in list or directory of licensees or chiropractic offices. (NRS 634.030)  The provisions of NAC 634.515 to 634.570, inclusive, do not prohibit the inclusion of information relating to a licensee or chiropractic office in a list or directory of licensees or chiropractic offices which is intended primarily for use by persons in the chiropractic profession, if the information has been traditionally included in such a list or directory.

     (Added to NAC by Bd. of Chiropractic Exam’rs, eff. 11-23-93; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

PRACTICE BEFORE THE CHIROPRACTIC PHYSICIANS’ BOARD OF NEVADA

General Provisions

      NAC 634.610  Scope and construction of provisions; deviations. (NRS 634.030)

     1.  NAC 634.610 to 634.775, inclusive, govern all practice and procedure before the Chiropractic Physicians’ Board of Nevada, except as otherwise directed by the Board.

     2.  Each provision of NAC 634.610 to 634.775, inclusive, must be liberally construed to secure a just, speedy and economical determination of all issues presented to the Board.

     3.  In special cases, for good cause shown and when not contrary to statute, the Board may permit deviation from a provision of NAC 634.610 to 634.775, inclusive, if it finds that compliance is impractical or unnecessary.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 1, §§ 1.1 through 1.3, eff. 12-8-74]—(NAC A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

Rules of Practice

      NAC 634.615  Communications with Board. (NRS 634.030)  All formal written communications and documents must be addressed to the Board and not to its individual members or staff. All communications and documents are deemed to be officially received by the Board when delivered at its principal office.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 2, § 2.3, eff. 12-8-74]

      NAC 634.620  Appearance and practice at hearings. (NRS 634.030)

     1.  An interested party who is or may be directly and substantially affected by a hearing may appear, introduce evidence and, at the discretion of the Board, otherwise participate in the proceeding.

     2.  A party shall appear at the beginning of a hearing, or at a time designated by the presiding officer, by giving his or her name and address and stating his or her position or interest in the hearing to the presiding officer. This information must be recorded in the transcript of the hearing.

     3.  A party who is entitled to appear may appear in person or by an attorney.

     4.  An attorney who appears as counsel in any proceeding must be an attorney at law who is admitted to practice and is in good standing before the highest court of any state. If the attorney is not admitted to practice in the State of Nevada, he or she must be associated with a Nevada attorney.

     5.  Any attorney of record who wishes to withdraw from a proceeding before the Board must immediately notify the Board or the presiding officer in writing of that fact and name the party whom he or she represents.

     6.  As used in this section, “interested party” means a person who believes that he or she may be affected by a proceeding but who does not seek to participate in the proceeding.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 4, §§ 4.1 through 4.5, eff. 12-8-74]—(NAC A 7-29-88; 11-23-93)

      NAC 634.625  Participation by staff of Board. (NRS 634.030)  The staff of the Board may appear at any hearing and has all of the rights of participation of a party to the proceeding.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 3, § 3.7, eff. 12-8-74]

      NAC 634.630  Pleadings: Generally. (NRS 634.030)

     1.  Each pleading must be designated as an application, petition, notice of charges, answer or motion.

     2.  All pleadings, except motions and notices of charges brought by the Board on its own motion, must be verified.

     3.  The Board may allow any pleading to be amended or corrected or any omission therein to be supplied.

     4.  Pleadings will be liberally construed, and defects which do not affect substantial rights of the parties will be disregarded.

     5.  If, within a notice of charges, a member of the Board’s staff groups similar violations into one cause of action, that grouping is for administrative convenience only and does not affect the authority of the Board to take disciplinary action for each separate violation.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 5, §§ 5.1 through 5.3, eff. 12-8-74]—(NAC A by Chiropractic Physicians’ Bd. by R014-10, 5-5-2011)

      NAC 634.635  Pleadings: Complaints. (NRS 634.030, 634.160)

     1.  A complaint as described in NRS 634.160 may be made against a licensee charging him or her with one or more of the causes set forth in chapter 634 of NRS for which he or she is subject to disciplinary action.

     2.  The original complaint must be in writing, signed and verified by the person making it and filed with the Executive Director of the Board.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 5, § 5.4, eff. 12-8-74]—(NAC A 11-23-93; A by Chiropractic Physicians’ Bd. by R095-03, 10-22-2003)

      NAC 634.645  Filing and service of documents. (NRS 634.030)

     1.  An original of all pleadings must be filed with the Board. A copy of any pleading designated by the Board must be made available by the party filing it to any other person whom the Board determines may be affected by the proceeding and who desires a copy of the pleading.

     2.  All notices, findings of fact, opinions and orders required to be served by the Board and all documents filed by any party may be served by mail, and service thereof shall be deemed complete when a copy of the paper or document, properly addressed and stamped, is deposited in the United States mail.

     3.  An acknowledgment of service or certificate of mailing must appear on each document which is required to be served.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 6, §§ 6.1 through 6.3, eff. 12-8-74]—(NAC A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.650  Pleadings: Answer to notice of charges; motions. (NRS 634.030)

     1.  An answer to a notice of charges as described in NRS 634.170 must be filed with the Board and service thereof made on parties of record within 15 days after service of the notice of charges, unless the Board, for good cause shown, extends the time. Any matter which is alleged as an affirmative defense must be separately stated and numbered.

     2.  A party who fails to answer the notice of charges within 15 days shall be deemed to have admitted the allegations set forth in the notice of charges. Based on those admissions, the Board may impose discipline on the licensee in the same manner as if the allegations had been proven by substantial evidence at a hearing of the Board held on the complaint. The Board may proceed with the matter based solely upon the issues set forth in the notice of charges unless the matter is continued by the Board.

     3.  Any motion upon a notice of charges must be filed before the answer is due. If it is not so filed, the objection must be raised in the answer.

     4.  If a motion is directed toward an answer, it must be filed within 5 days of service after the answer.

     5.  All other motions must be timely filed.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 6, §§ 6.4 and 6.5, eff. 12-8-74]—(NAC A 11-23-93; A by Chiropractic Physicians’ Bd. by R095-03, 10-22-2003)

      NAC 634.653  Declaratory orders and advisory opinions. (NRS 233B.120, 634.030)

     1.  A petition to the Board for a declaratory order or advisory opinion may only be filed by the holder of or an applicant for a license issued by the Board.

     2.  The filing must include the original and 10 copies of the petition.

     3.  A petition that is filed with the Board not less than 10 days before its next regularly scheduled meeting will be reviewed by the Board at that meeting. The Board will issue a declaratory order or advisory opinion within 30 days after reviewing the petition.

     (Added to NAC by Chiropractic Physicians’ Bd. by R101-08, eff. 12-17-2008)

      NAC 634.660  Subpoenas. (NRS 634.030, 634.196)

     1.  A subpoena requiring the attendance of a witness from any place within the State at a hearing to receive his or her testimony may be issued by the Secretary of the Board upon application in writing.

     2.  Subpoenas for the production of documents, books or other records, unless issued by the Board on its own motion, will be issued only upon application in writing. The application must specify as clearly as possible the documents, books or other records desired.

     3.  The Board, upon a prompt motion not later than the time specified in the subpoena for compliance, may:

     (a) Quash the subpoena if it is unreasonable or oppressive; or

     (b) Condition denial of the motion upon the advancement of the reasonable cost of producing the documents, books or other records desired by the person in whose behalf the subpoena is issued.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.10, eff. 12-8-74]

      NAC 634.665  Filing of briefs. (NRS 634.030)

     1.  At a hearing, the Board may order briefs to be filed within a time which it prescribes. Any requested brief must be filed with the Board and must be accompanied by an acknowledgment of service on, or a certificate of mailing to, the other parties of record.

     2.  The Board may set the matter for oral argument after briefs are filed or when a motion is contested. Ten days’ notice of the time set for oral argument must be given to all parties of record, unless the Board specifies a shorter time.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.13, eff. 12-8-74]—(NAC A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.670  Computation of time; obtaining information about proceedings. (NRS 634.030)

     1.  The time within which any act ordered pursuant to this chapter must be accomplished is computed by excluding the first day and including the last day unless the last day is Saturday, Sunday or a legal holiday, in which case it is excluded.

     2.  Additional information about proceedings before the Board or the status of any matter relating to the Board may be secured by applying to the Secretary of the Board at the principal office of the Board.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 10, §§ 10.1 and 10.2, eff. 12-8-74]—(NAC A 7-29-88)

Hearings

      NAC 634.710  Persons presiding; resetting after continuance; location. (NRS 634.030)

     1.  Hearings will be held before one or more members of the Board.

     2.  A hearing which has been previously continued may be reset upon a notice of not less than 10 days.

     3.  Hearings will be held at a place in the State as designated by the Board in the notice of hearing.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.1, eff. 12-8-74]

      NAC 634.715  Failure to appear. (NRS 634.030, 634.190)

     1.  If the party who filed the complaint or the licensee fails to appear at the hearing scheduled by the Board and no continuance has been requested or granted, the Board may hear the evidence of those witnesses who have appeared and proceed to consider the matter and dispose of it on the basis of the evidence before it in the manner required by NAC 634.720 to 634.775, inclusive.

     2.  Where, because of accident, sickness or other reasonable cause, a person fails to appear for a hearing scheduled by the Board or fails to request a continuance thereof, he or she may, within a reasonable time, but not more than 15 days, apply to the Secretary of the Board at the office of the Board to reopen the proceedings. The Board, if it finds that the cause for failing to appear is sufficient and reasonable, will immediately fix a time and place for the hearing and give the person notice thereof. At the time and place fixed by the Board, the person may testify in his or her own behalf or present other evidence. Witnesses who have previously testified are not required to appear at the second hearing unless so directed by the Board.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.2, eff. 12-8-74]—(NAC A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98)

      NAC 634.720  Preliminary procedure. (NRS 634.030)  The presiding officer of the Board will call the proceeding or hearing to order, proceed with each party’s appearance and act upon any pending motions. The parties may then make opening statements.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.3, eff. 12-8-74]

      NAC 634.725  Standards of conduct. (NRS 634.030)  All parties to the hearing, their counsel and spectators shall conduct themselves in a respectful manner.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.4, eff. 12-8-74]

      NAC 634.730  Testimony: Oath or affirmation required. (NRS 634.030)  All testimony considered by the Board in formal hearings, except matters officially noticed or entered by stipulation, must be sworn. Before testifying, each person shall swear or affirm that he or she will testify truthfully.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.5, eff. 12-8-74]

      NAC 634.735  Order of presentation. (NRS 634.030)

     1.  Evidence at the hearing must be presented in the following order:

     (a) Opening statements by counsel for complainant and respondent. Respondent may defer his or her opening statement until the completion of the complainant’s case.

     (b) Presentation of complainant’s case, which may be followed by cross-examination.

     (c) Presentation of respondent’s case, which may be followed by cross-examination.

     (d) Rebuttal testimony, if any.

     (e) Argument by respective counsel, in the following order:

          (1) Opening argument for complainant.

          (2) Argument for respondent.

          (3) Closing argument for complainant.

     2.  As used in this section:

     (a) “Complainant” means a person who complains to the Board of any act. If the Board initiates a proceeding, it may be a complainant.

     (b) “Respondent” means a person against whom a complaint has been filed or of whom an investigation has been commenced.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.6, eff. 12-8-74]—(NAC A 7-29-88)

      NAC 634.740  Consolidation of proceedings. (NRS 634.030)

     1.  The Board may consolidate two or more proceedings in any one hearing when it appears that the issues are substantially the same and that the rights of the parties will not be prejudiced thereby.

     2.  At a consolidated hearing, the presiding officer will determine the order in which the parties must introduce their evidence and which party must open and close the proceeding.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.7, eff. 12-8-74]

      NAC 634.745  Stipulations. (NRS 634.030)

     1.  With the approval of the presiding officer, the parties may stipulate any fact at issue, either by written stipulation introduced in evidence as an exhibit or by oral statements shown upon the record.

     2.  A stipulation is binding upon all parties so stipulating and may be regarded by the Board as evidence at the hearing.

     3.  The Board may require proof by evidence of the facts stipulated in addition to the stipulation of the parties.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.8, eff. 12-8-74]

      NAC 634.750  Rules of evidence. (NRS 634.030)

     1.  In conducting any investigation, inquiry or hearing, the Board, its officers or employees are not bound by the technical rules of evidence and any informality in a proceeding or in the manner of taking testimony does not invalidate any order, decision, rule or regulation made, approved or confirmed by the Board.

     2.  Rules of evidence recognized by the courts of Nevada will be followed generally but may be relaxed by the Board when deviation from the technical rules of evidence will aid in ascertaining the facts.

     3.  When an objection is made to the admissibility of evidence, the evidence may be received subject to a later ruling by the Board.

     4.  The Board may exclude inadmissible, incompetent, cumulative or irrelevant evidence, or order that presentation of that evidence be discontinued.

     5.  A party objecting to the introduction of evidence shall state briefly the grounds of objection at the time the evidence is offered.

     6.  Evidence must be material and relevant to the issues involved to be admitted at the hearing.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.9, eff. 12-8-74]

      NAC 634.755  Offer of proof. (NRS 634.030)  An offer of proof for the record consists of a statement of the substance of the evidence to which an objection has been sustained.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.18, eff. 12-8-74]

      NAC 634.760  Continuances. (NRS 634.030)  The Board, before or during a hearing, on proper showing, may grant continuances for the submission of further proof of any subject matter.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.12, eff. 12-8-74]

      NAC 634.765  Matters of official notice. (NRS 634.030)  The Board may take official notice of:

     1.  Regulations, official reports, decisions and orders of the Board or any other regulatory agency of this State.

     2.  The contents of decisions, orders, certificates and permits issued by the Board.

     3.  Matters of common knowledge and established technical or scientific facts.

     4.  Pertinent official documents, when properly introduced into the record of formal proceedings by reference. Proper and definite reference to official documents must be made by the party offering them and they must be published and generally circulated so that an opportunity is given to all the parties of interest to the hearing to examine them and present rebuttal evidence.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.14, eff. 12-8-74]

      NAC 634.770  Transcripts. (NRS 634.030)  The Board will have a transcript made of all formal hearings. Parties desiring copies of the transcript may obtain them from the transcriber upon payment of the fees fixed therefor.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 7, § 7.16, eff. 12-8-74]

      NAC 634.775  Submission of matters for decision; dissemination of orders. (NRS 634.030)

     1.  A proceeding is submitted for decision to the Board after the taking of evidence, the filing of briefs or the presentation of oral argument as prescribed by the Board or the presiding officer unless otherwise specifically approved.

     2.  Orders of the Board will be served by the Secretary by mailing a copy to each party of record or their representatives or by personal service. Additional copies of orders issued by the Board may be obtained upon written request.

     [Bd. of Chiropractic Exam’rs, Rule of Practice No. 8, §§ 8.1 and 8.2, eff. 12-8-74]

ENFORCEMENT

      NAC 634.810  Authority of Board. (NRS 634.030, 634.137, 634.140, 634.190)  The Board may begin proceedings against:

     1.  A licensee;

     2.  A chiropractor’s assistant;

     3.  An applicant for a license to practice chiropractic who is authorized to perform chiropractic pursuant to NRS 634.105;

     4.  A student who is authorized to perform chiropractic pursuant to the preceptor program; or

     5.  A person who holds a temporary license to practice chiropractic pursuant to NRS 634.115,

Ê for a violation of any provision of this chapter or of chapter 634 of NRS even though no member of the public is actually harmed by the violation and there is no complaint from any other person.

     [Bd. of Chiropractic Exam’rs, Reg., Art. XVI, eff. 11-28-79]—(NAC A 7-29-88; A by Chiropractic Physicians’ Bd. by R030-98, 9-10-98; R101-08, 12-17-2008; R004-12, 11-1-2012)