[Rev. 8/22/2025 11:15:20 AM]
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Assembly Bill No. 315Assemblymember Edgeworth
Joint Sponsor: Senator Taylor
CHAPTER 245
[Approved: June 3, 2025]
AN ACT relating to Medicaid; requiring an application to participate in Medicaid as a provider to be accompanied with a verification of the identity and signature of the applicant; establishing the means by which the identity and signature of an applicant may be established; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law requires an application to participate in Medicaid as a provider to contain a statement that all matters stated within the application are true and accurate. Existing law requires a natural person who is the applicant, or is authorized to act on behalf of the applicant, to sign the statement under the pains and penalties of perjury. Existing law provides that a person who signs such a statement knowing that the application contains information which is false, whether in whole or in part, and whether by commission or omission, is guilty of a category D felony. (NRS 422.550) This bill additionally requires that an application submitted to participate in Medicaid as a provider be accompanied by verification of the identity and signature of the person who signed the statement. This bill specifies that a person may verify his or her identity and signature for this purpose by: (1) oath or affirmation before a notary public or other person authorized by law to administer oaths or affirmations; or (2) through the use of an electronic identity verification system.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 422.550 is hereby amended to read as follows:
422.550 1. Each application or report submitted to participate as a provider, each report stating income or expense upon which rates of payment are or may be based, and each invoice for payment for goods or services provided to a recipient must contain a statement that all matters stated therein are true and accurate, signed by a natural person who is the provider or is authorized to act for the provider, under the pains and penalties of perjury.
2. In addition to the requirements of subsection 1, each application submitted to participate as a provider must be accompanied by verification of the identity and signature of the natural person who signed the statement pursuant to subsection 1:
(a) By oath or affirmation of the person administered by a notary public or other person authorized by law to administer oaths or affirmations; or
(b) Through an electronic identity verification system that is used or approved by the Department for the purpose of verifying the identification or signature of a person.
3. A person is guilty of perjury which is a category D felony and shall be punished as provided in NRS 193.130 if the person signs or submits, or causes to be signed or submitted, [such] a statement [,] described in subsection 1, knowing that the application, report or invoice contains information which is false, in whole or in part, by commission or by omission.
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subsection 1, knowing that the application, report or invoice contains information which is false, in whole or in part, by commission or by omission.
[3.] 4. For the purposes of this section, a person who signs on behalf of a provider is presumed to have the authorization of the provider and to be acting at the direction of the provider.
5. As used in this section, electronic identity verification system means an electronic system that is capable of verifying the identity or signature of a person by:
(a) Using multifactor authentication;
(b) Verifying data contained within governmental databases or appearing on government-issued identification cards, including, without limitation, photographs and signatures;
(c) Utilizing biometric data or facial recognition technology;
(d) Utilizing a combination of any mechanism described in paragraphs (a), (b) and (c); or
(e) Utilizing other secure and accurate means or procedures.
Sec. 2. This act becomes effective on July 1, 2025.
________
Assembly Bill No. 319Assemblymember Orentlicher
CHAPTER 246
[Approved: June 3, 2025]
AN ACT relating to health care; making various revisions governing the qualifications and procedure for licensure as a physician, physician assistant, practitioner of respiratory care or perfusionist; requiring screening of youth for certain health conditions when certain physical examinations are conducted; revising the authority of a practitioner of respiratory care to perform certain laboratory tests; requiring certain sharing of information between the Board of Medical Examiners and the State Board of Osteopathic Medicine; authorizing the Board of Medical Examiners to require certain competency demonstrations; eliminating certain special licenses; revising provisions related to fees owed to the Board of Medical Examiners or the State Board of Osteopathic Medicine; eliminating certain fees; revising investigation procedures and grounds for discipline against a licensee of the Board of Medical Examiners; revising requirements governing certain medical procedures; authorizing a medical assistant to perform tasks under the supervision of a registered nurse; authorizing a certified registered nurse anesthetist to perform certain tasks in certain hospitals; authorizing discipline against a registered nurse who fails to adequately supervise a medical assistant; and providing other matters properly relating thereto.
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Legislative Counsels Digest:
Existing law provides for the licensure and regulation of physicians, physician assistants, anesthesiologist assistants, practitioners of respiratory care and perfusionists by the Board of Medical Examiners. (Chapter 630 of NRS) Sections 11 and 14 of this bill revise provisions governing examinations that are necessary for licensure as a physician. Section 14 also increases the amount of the fine that the Board may impose on an applicant for a license as a physician who submits false information in connection with the application.
Section 21 of this bill requires each licensee of the Board to maintain a permanent electronic mail address for communication with the Board.
Existing law prescribes separate qualifications for licensure for: (1) persons who received their medical education in the United States or Canada; and (2) persons who received their medical education in other foreign countries. (NRS 630.160, 630.170, 630.195, 630.263, 630.264, 630.265) Existing law also requires a physician to have completed certain residencies in ophthalmology in the United States or Canada in order to perform laser surgery or intense pulsed light therapy on the globe of the eye. (NRS 630.371) Sections 4, 5, 8, 14, 19, 26-28 and 64 of this bill make various changes so that persons who received their medical education in the United Kingdom, Australia or New Zealand, and other foreign countries whose standards for medical education are determined to be equivalent by the Board, are treated identically to persons who received their medical education in the United States or Canada for those purposes.
Existing law requires: (1) an applicant for a license to practice medicine to hold certain certifications or have completed or be enrolled in certain progressive postgraduate education; and (2) a physician who performs certain procedures on the eye to have completed certain progressive postgraduate education in ophthalmology. (NRS 630.160, 630.371) Section 6 of this bill prescribes the manner in which the Board must determine whether postgraduate education is progressive for those purposes. Section 14 revises the amount of progressive postgraduate education that a resident physician must have completed in order to be eligible for a license.
Existing law authorizes a practitioner of respiratory care to perform certain laboratory tests without obtaining certification as an assistant in a medical laboratory. (NRS 652.210) Sections 9 and 82 of this bill authorize a practitioner of respiratory care to perform certain moderate complexity tests without obtaining such certification if: (1) the practitioner of respiratory care has been trained to perform the test; and (2) the test is within the scope of practice of a practitioner of respiratory care.
Sections 15, 16 and 84 of this bill revise and simplify provisions governing licensure by endorsement as a physician by: (1) eliminating expedited licensure by endorsement, except for certain persons affiliated with the Armed Forces of the United States; and (2) making certain revisions relating to the qualifications for licensure by endorsement. Sections 17, 18, 20, 23 and 30 of this bill eliminate references to a section repealed by section 84.
Existing law authorizes the Board to require a licensee who has not practiced in more than 24 consecutive months to take the same examination to test competency as that given to applicants for a license. (NRS 630.257) Section 22 of this bill revises this provision to apply to inactive licensees and applicants for a license who have not actively practiced in more than 24 consecutive months. Section 22 also authorizes the Board to require such a person to demonstrate his or her competency in a manner other than by taking an examination. Sections 16, 28, 36, 40 and 41 of this bill make conforming changes to add references to those requirements where appropriate.
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Existing law provides for the issuance of various special licenses to practice medicine. (NRS 630.258-630.266) Section 23 removes the requirement that the Board automatically issue a special volunteer license, which authorizes certain retired physicians to continue practicing on a volunteer basis, to a person who possesses the required qualifications for such a license. Section 24 of this bill eliminates the specific statutory requirements for licensure from which a person applying for licensure as an administrative physician is exempt and instead requires the Board to adopt regulations prescribing the requirements from which such an applicant is exempt. Sections 25 and 30 of this bill eliminate a special license that allows a licensed physician of another state to come into this State to care for a specific patient in association with a physician licensed in this State. Section 25 also eliminates a restricted license for a specified period if the Board determines the applicant needs supervision or restriction. Sections 1, 25 and 30 of this bill revise the name of a special purpose license, which allows an out-of-state physician to provide certain medical services to patients in this State electronically, telephonically or by fiber optics, to instead be called a telemedicine license.
Existing law establishes fees for the issuance and renewal of a license as a physician assistant or anesthesiologist assistant who is simultaneously licensed by the Board of Medical Examiners and the State Board of Osteopathic Medicine that are one-half of the amount of the standard fees for the issuance and renewal of such a license, meaning that such a person is required to pay one-half of the standard licensure fees to each of those boards. (NRS 630.268, 633.501) If a person who pays such a reduced fee to one of those boards fails to also pay the required fee to the other board within 12 months, sections 29, 31-33, 38, 42 and 76-81 of this bill require the person to pay to the board to whom the person has paid a fee the difference between the reduced fee and the standard fee. Sections 12, 13 and 73-75 of this bill require the Board of Medical Examiners and the State Board of Osteopathic Medicine to share information as necessary to enforce that requirement. Section 30 eliminates certain fees charged by the Board of Medical Examiners.
Section 10 of this bill exempts certain students who engage in the supervised practice of perfusion from the requirement to be licensed by the Board of Medical Examiners. Sections 34-37 and 84 of this bill remove a requirement that an applicant for a license as a perfusionist pass an examination given by the American Board of Cardiovascular Perfusion, or its successor organization, and instead require such an applicant to be certified by that organization. Section 39 of this bill eliminates a provision prohibiting the Board from requiring a physician assistant to be certified by a nationally recognized organization for the accreditation of physician assistants to satisfy applicable continuing education requirements. Sections 40 and 41 revise the conditions under which the Board may deny an application for licensure by endorsement as a physician assistant. Section 43 of this bill eliminates certain educational qualifications for licensure as a practitioner of respiratory care.
Sections 44 and 45 of this bill clarify certain grounds for discipline against a licensee of the Board. Section 45 also authorizes the Board to discipline a licensee who fails to cooperate with an investigation of the Board. Sections 46-49, 52 and 62 of this bill revise certain provisions regarding the provision to the Board of information relating to certain licensees, the examination to determine the fitness of certain licensees and the removal of limitations or suspensions of licenses to be applicable to all licensees of the Board. Section 46 provides that certain reports filed by an insurer relating to malpractice actions are public records. Section 51 of this bill provides that the Board is not required to review a complaint that is not within the jurisdiction of the Board.
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Existing law refers to the document that the Board files to initiate a formal disciplinary proceeding as a formal complaint. (NRS 630.311) However, existing law regarding the procedure of licensing boards generally refers to such a document as a charging document. (NRS 622A.300) Sections 3, 50, 51, 54, 56, 57 and 59 of this bill standardize terminology so that such a document is referred to as a charging document. Section 50 also requires that a charging document for charges against a physician assistant, anesthesiologist assistant, perfusionist or practitioner of respiratory care be filed by the Board.
Section 57 removes a requirement that the Board hold a hearing on a report from the Attorney General that a licensee has violated certain laws prohibiting industrial insurance fraud. Section 49 instead requires the Board to treat such a report like a complaint, meaning that the Board would conduct an initial investigation before deciding whether to proceed with disciplinary proceedings. (NRS 630.311)
In certain circumstances that create doubt about the fitness of a physician, physician assistant, practitioner of respiratory care or perfusionist to practice, existing law authorizes the Board to require such a licensee to undergo certain examinations to determine his or her fitness to practice. (NRS 630.318) Section 52: (1) makes this provision additionally applicable to anesthesiologist assistants; and (2) provides that the failure to submit to such an examination is grounds for the summary suspension of a license pending further disciplinary proceedings.
Existing law authorizes the Board to summarily suspend a license pending further disciplinary proceedings if the Board determines that the health, safety or welfare of the public or any patient is at risk of imminent or continued harm. (NRS 630.326) Section 54: (1) additionally authorizes the Board to restrict the practice of a licensee without suspending his or her license under such circumstances; and (2) removes a requirement that the Board hold a hearing on the summary suspension of a license within 60 days after the summary suspension. Sections 55 and 61 of this bill authorize a court to stay an order of the Board suspending a license if the suspension is not a summary suspension. Section 55 also prohibits a court from staying an order of the Board summarily restricting the practice of a licensee. Section 84 eliminates a duplicative provision authorizing the summary suspension of a licensees authority to prescribe and dispense controlled substances for certain violations related to such prescribing and dispensing, and section 53 of this bill eliminates a reference to that provision.
Section 56: (1) makes revisions relating to collaboration between the Board and other governmental entities investigating a person; and (2) authorizes the Board, with authorization from a licensee, to cooperate with the employer of a licensee or any other person or entity responsible for credentialing a licensee. Section 57 removes certain procedural requirements governing hearings conducted by the Board. Section 58 of this bill revises requirements governing service of process in proceedings before the Board. Section 59 removes a requirement that the Board allow a complainant to participate in disciplinary proceedings. Section 60 of this bill removes the ability for any person other than the respondent or a witness to be held in contempt for certain conduct in a disciplinary proceeding. Section 62 removes authorization for a person whose license has been revoked by the Board to reinstate his or her license without applying for a new license.
Existing law prohibits the Board from investigating or disciplining a physician for: (1) disclosing to a governmental entity a violation of any law, rule or regulation by an applicant for a license to practice medicine or a physician; or (2) cooperating with a governmental entity that is conducting an investigation, hearing or inquiry into such a violation. (NRS 630.364) Section 63 of this bill: (1) makes this provision applicable to all licensees of the Board; and (2) requires the disclosure or cooperation to be in good faith for the immunity from investigation or discipline to apply.
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Existing law prohibits a physician from administering or supervising the administration of general anesthesia, moderate sedation or deep sedation: (1) in an office or facility that does not hold certain permits; or (2) outside of this State. (NRS 630.373) Section 65 of this bill makes this prohibition also applicable to: (1) physician assistants and anesthesiologist assistants; and (2) administering or supervising the administration of tumescent anesthesia, except where authorized by regulation of the Board. Sections 7, 68 and 72 of this bill require a physician, physician assistant, advanced practice registered nurse or osteopathic physician who performs a physical examination of a person who is at least 12 years of age but not more than 18 years of age to screen the person for certain health conditions.
Existing law provides for the registration and regulation of certified registered nurse anesthetists. (NRS 632.2395) Existing law authorizes a certified registered nurse anesthetist working under the supervision of a physician licensed to practice medicine or osteopathic medicine in this State to order, prescribe, possess and administer controlled substances, poisons, dangerous drugs and devices to treat a patient under the care of a licensed physician before, during and after surgery or childbirth only in a critical access hospital. (NRS 632.2397) Section 70.5 of this bill further authorizes a certified registered nurse anesthetist to perform such tasks in a hospital located in a city whose population is less than 25,000 (currently all cities except Carson City, Henderson, Las Vegas, North Las Vegas, Reno and Sparks).
Existing law authorizes: (1) an unlicensed medical assistant to perform clinical tasks under the supervision of a physician, osteopathic physician or physician assistant in accordance with regulations adopted by the Board of Medical Examiners or the State Board of Osteopathic Medicine, as appropriate; and (2) those boards to discipline a physician, osteopathic physician or physician assistant who fails to adequately supervise a medical assistant. (NRS 630.0129, 630.138, 630.306, 633.075, 633.293, 633.511) Sections 67, 70 and 71 of this bill similarly authorize: (1) an unlicensed medical assistant to perform clinical tasks under the supervision of a registered nurse in accordance with regulations of the State Board of Nursing; and (2) the State Board of Nursing to discipline a registered nurse who fails to adequately supervise a medical assistant. Section 69 of this bill establishes the applicability of the definition of medical assistant set forth in section 67.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 629.515 is hereby amended to read as follows:
629.515 1. Except as otherwise provided in this subsection, before a provider of health care who is located at a distant site may use telehealth to direct or manage the care or render a diagnosis of a patient who is located at an originating site in this State or write a treatment order or prescription for such a patient, the provider must hold a valid license or certificate to practice his or her profession in this State, including, without limitation, a [special purpose] telemedicine license issued pursuant to NRS 630.261. The requirements of this subsection do not apply to a provider of health care who is providing services within the scope of his or her employment by or pursuant to a contract entered into with an urban Indian organization, as defined in 25 U.S.C. § 1603.
2. The provisions of this section must not be interpreted or construed to:
(a) Modify, expand or alter the scope of practice of a provider of health care; or
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(b) Authorize a provider of health care to provide services in a setting that is not authorized by law or in a manner that violates the standard of care required of the provider of health care.
3. A provider of health care who is located at a distant site and uses telehealth to direct or manage the care or render a diagnosis of a patient who is located at an originating site in this State or write a treatment order or prescription for such a patient:
(a) Is subject to the laws and jurisdiction of the State of Nevada, including, without limitation, any regulations adopted by an occupational licensing board in this State, regardless of the location from which the provider of health care provides services through telehealth.
(b) Shall comply with all federal and state laws that would apply if the provider were located at a distant site in this State.
4. A provider of health care may establish a relationship with a patient using telehealth when it is clinically appropriate to establish a relationship with a patient in that manner. The State Board of Health may adopt regulations governing the process by which a provider of health care may establish a relationship with a patient using telehealth.
5. A provider of health care who is located at an originating site and is conducting a forensic medical examination of an apparent victim of sexual assault or strangulation may use telehealth to connect to an appropriately trained physician, physician assistant or registered nurse who is located at a distant site for the purpose of obtaining instructions and guidance on conducting the examination. The provisions of this subsection must not be construed to prohibit the use of telehealth for communication between providers of health care in other circumstances authorized by law.
6. As used in this section:
(a) Distant site means the location of the site where a telehealth provider of health care is providing telehealth services to a patient located at an originating site.
(b) Originating site means the location of the site where a patient is receiving telehealth services from a provider of health care located at a distant site.
(c) Sexual assault means a violation of NRS 200.366 or 200.368.
(d) Strangulation has the meaning ascribed to it in NRS 200.481.
(e) Telehealth means the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including facsimile or electronic mail. The term includes, without limitation, communication between a provider of health care who is providing in-person services to a patient and a provider of health care at a different location and the delivery of services from a provider of health care to a patient at a different location through the use of:
(1) Synchronous interaction or an asynchronous system of storing and forwarding information; and
(2) Audio-only interaction, whether synchronous or asynchronous.
Sec. 2. Chapter 630 of NRS is hereby amended by adding thereto the provisions set forth as sections 3 to 7, inclusive, of this act.
Sec. 3. Charging document means a charging document filed with the Board in accordance with NRS 622A.300.
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Sec. 4. Equivalent foreign country means:
1. Canada, the United Kingdom, Australia and New Zealand; and
2. Any other country designated by regulation of the Board based upon a determination that the standards for medical education and licensing in that country are substantially similar to the standards for medical education and licensing in the United States.
Sec. 5. Foreign medical school means a medical school that is not located in the United States or an equivalent foreign country.
Sec. 6. 1. For the purposes of this chapter:
(a) Except as otherwise provided in this section, a program of postgraduate education or training is progressive if each year of the program progresses in a continuous manner and the person who completes the program does so in sequence without any breaks of 12 weeks or longer.
(b) The Board shall deem a program of postgraduate education or training approved by the Accreditation Council for Graduate Medical Education, including, without limitation, such a program that includes 1 year or more of scientific or clinical research, to be progressive if the person who completes the program does so in the format that was approved by the Accreditation Council for Graduate Medical Education.
2. Notwithstanding the provisions of subsection 1, the Executive Director of the Board or a designee thereof may, in his or her discretion upon review of the program, determine that a person has completed a progressive program of postgraduate education or training if the person:
(a) Completed 1 or more years in a program that meets the requirements of subsection 1; and
(b) Enrolled in a program that is closely related to the program described in paragraph (a) and completed that program without any breaks of 12 weeks or longer.
Sec. 7. Each time a physician or physician assistant performs a routine physical examination of a person who is at least 12 years of age but not more than 18 years of age, the physician or physician assistant shall ask the person the questions prescribed in the Medical History Form and the Physical Examination Form of the Preparticipation Physical Evaluation Form developed jointly by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Sports Medicine, the American Medical Society for Sports Medicine, the American Orthopaedic Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine, or any successor form.
Sec. 8. NRS 630.005 is hereby amended to read as follows:
630.005 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 630.007 to 630.026, inclusive, and sections 3, 4 and 5 of this act have the meanings ascribed to them in those sections.
Sec. 9. NRS 630.021 is hereby amended to read as follows:
630.021 Practice of respiratory care includes:
1. Therapeutic and diagnostic use of medical gases, humidity and aerosols and the maintenance of associated apparatus;
2. The administration of drugs and medications to the cardiopulmonary system;
3. The provision of ventilatory assistance and control;
4. Postural drainage and percussion, breathing exercises and other respiratory rehabilitation procedures;
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5. Cardiopulmonary resuscitation and maintenance of natural airways and the insertion and maintenance of artificial airways;
6. Carrying out the written orders of a physician, physician assistant, anesthesiologist assistant, certified registered nurse anesthetist or an advanced practice registered nurse relating to respiratory care;
7. Techniques for testing to assist in diagnosis, monitoring, treatment and research related to respiratory care, including the measurement of ventilatory volumes, pressures and flows, collection of blood and other specimens, testing of pulmonary functions , performance of laboratory testing authorized by NRS 652.210 and hemodynamic and other related physiological monitoring of the cardiopulmonary system; and
8. Training relating to the practice of respiratory care.
Sec. 10. NRS 630.047 is hereby amended to read as follows:
630.047 1. This chapter does not apply to:
(a) A medical officer or perfusionist or practitioner of respiratory care of the Armed Forces or a medical officer or perfusionist or practitioner of respiratory care of any division or department of the United States in the discharge of his or her official duties, including, without limitation, providing medical care in a hospital in accordance with an agreement entered into pursuant to NRS 449.2455;
(b) Physicians who are called into this State, other than on a regular basis, for consultation with or assistance to a physician licensed in this State, and who are legally qualified to practice in the state where they reside;
(c) Physicians who are legally qualified to practice in the state where they reside and come into this State on an irregular basis to:
(1) Obtain medical training approved by the Board from a physician who is licensed in this State; or
(2) Provide medical instruction or training approved by the Board to physicians licensed in this State;
(d) Physicians who are temporarily exempt from licensure pursuant to NRS 630.2665 and are practicing medicine within the scope of the exemption;
(e) Any person permitted to practice any other healing art under this title who does so within the scope of that authority, or healing by faith or Christian Science;
(f) The practice of respiratory care or perfusion by a student as part of a program of study in respiratory care or perfusion, as applicable, that is approved by the Board, or is recognized by a national organization which is approved by the Board to review such programs, if the student is enrolled in the program and provides respiratory care or perfusion, as applicable, only under the supervision of a practitioner of respiratory care [;] or a perfusionist, as applicable;
(g) The practice of respiratory care by a student who:
(1) Is enrolled in a clinical program of study in respiratory care which has been approved by the Board;
(2) Is employed by a medical facility, as defined in NRS 449.0151; and
(3) Provides respiratory care to patients who are not in a critical medical condition or, in an emergency, to patients who are in a critical medical condition and a practitioner of respiratory care is not immediately available to provide that care and the student is directed by a physician to provide respiratory care under the supervision of the physician until a practitioner of respiratory care is available;
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available to provide that care and the student is directed by a physician to provide respiratory care under the supervision of the physician until a practitioner of respiratory care is available;
(h) The practice of respiratory care by a person on himself or herself or gratuitous respiratory care provided to a friend or a member of a persons family if the provider of the care does not represent himself or herself as a practitioner of respiratory care;
(i) A person who is employed by a physician and provides respiratory care or services as a perfusionist under the supervision of that physician;
(j) The maintenance of medical equipment for perfusion or respiratory care that is not attached to a patient;
(k) A person who installs medical equipment for respiratory care that is used in the home and gives instructions regarding the use of that equipment if the person is trained to provide such services and is supervised by a provider of health care who is acting within the authorized scope of his or her practice;
(l) The performance of medical services by a student enrolled in an educational program for a physician assistant which is accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or its successor organization, as part of such a program; and
(m) A physician assistant of any division or department of the United States in the discharge of his or her official duties unless licensure by a state is required by the division or department of the United States.
2. This chapter does not repeal or affect any statute of Nevada regulating or affecting any other healing art.
3. This chapter does not prohibit:
(a) Gratuitous services outside of a medical school or medical facility by a person who is not a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care in cases of emergency.
(b) The domestic administration of family remedies.
Sec. 11. NRS 630.130 is hereby amended to read as follows:
630.130 1. In addition to the other powers and duties provided in this chapter, the Board shall, in the interest of the public, judiciously:
(a) Enforce the provisions of this chapter;
(b) Establish by regulation standards for licensure under this chapter;
(c) [Conduct examinations for licensure and establish a system of scoring for those examinations;
(d)] Investigate the character of each applicant for a license and issue licenses to those applicants who meet the qualifications set by this chapter and the Board; and
[(e)] (d) Institute a proceeding in any court to enforce its orders or the provisions of this chapter.
2. On or before February 15 of each odd-numbered year, the Board shall submit to the Governor and to the Director of the Legislative Counsel Bureau for transmittal to the next regular session of the Legislature a written report compiling:
(a) Disciplinary action taken by the Board during the previous biennium against any licensee for malpractice or negligence;
(b) Information reported to the Board during the previous biennium pursuant to NRS 630.3067, 630.3068, subsections 3 and 6 of NRS 630.307 and NRS 690B.250; and
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(c) Information reported to the Board during the previous biennium pursuant to NRS 630.30665, including, without limitation, the number and types of surgeries performed by each holder of a license to practice medicine and the occurrence of sentinel events arising from such surgeries, if any.
Κ The report must include only aggregate information for statistical purposes and exclude any identifying information related to a particular person.
3. The Board may adopt such regulations as are necessary or desirable to enable it to carry out the provisions of this chapter. Such regulations may include, without limitation, regulations requiring, as a condition for licensure, that an applicant pass one or more examinations in addition to those required by this chapter and regulations concerning the scoring of any such examination.
Sec. 12. NRS 630.131 is hereby amended to read as follows:
630.131 1. On or before the last day of each quarter, the Board shall provide the State Board of Osteopathic Medicine a list of all anesthesiologist assistants licensed by the Board.
2. The Board and the State Board of Osteopathic Medicine shall share information as necessary to enforce the provisions of NRS 630.26835, 630.2684, 630.26845, 633.4256, 633.4258 and 633.426.
Sec. 13. NRS 630.132 is hereby amended to read as follows:
630.132 1. On or before the last day of each quarter, the Board shall provide to the State Board of Osteopathic Medicine a list of all physician assistants licensed by the Board.
2. The Board and the State Board of Osteopathic Medicine shall share information as necessary to enforce the provisions of NRS 630.2677, 630.2735, 630.2755, 633.4332, 633.438 and 633.4718.
Sec. 14. NRS 630.160 is hereby amended to read as follows:
630.160 1. Every person desiring to practice medicine must, before beginning to practice, procure from the Board a license authorizing the person to practice.
2. Except as otherwise provided in NRS 630.1605 to 630.161, inclusive, and 630.258 to 630.2665, inclusive, a license may be issued to any person who:
(a) Has received the degree of doctor of medicine from a medical school:
(1) Approved by the Liaison Committee on Medical Education of the American Medical Association and Association of American Medical Colleges; or
(2) Which provides a course of professional instruction equivalent to that provided in medical schools in the United States approved by the Liaison Committee on Medical Education;
(b) [Is currently certified by a specialty board of the American Board of Medical Specialties and who agrees to maintain the certification for the duration of the licensure, or has] Has passed:
(1) All parts of the examination given by the National Board of Medical Examiners;
(2) All parts of the Federation Licensing Examination;
(3) All parts of the United States Medical Licensing Examination;
(4) All parts of a licensing examination given by any state or territory of the United States, if the applicant is certified by a specialty board of the American Board of Medical Specialties;
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(5) All parts of the most commonly administered examination [to become a licentiate of the Medical Council of Canada;] for medical licensure in an equivalent foreign country; or
(6) Any combination of the examinations specified in subparagraphs (1), (2) and (3) that the Board determines to be sufficient; and
(c) Is currently certified by a specialty board of the American Board of Medical Specialties in the specialty of emergency medicine, preventive medicine or family medicine and who agrees to maintain certification in at least one of these specialties for the duration of the licensure, or:
(1) Has completed 36 months of progressive postgraduate:
(I) Education as a resident in the United States or [Canada] an equivalent foreign country in a program approved by the Board, a governmental entity that regulates medical education in an equivalent foreign country, the Accreditation Council for Graduate Medical Education, [the Royal College of Physicians and Surgeons of Canada, the Collθge des mιdecins du Quιbec or the College of Family Physicians of Canada, or, as applicable, their] or its successor [organizations;] organization, or an organization that accredits graduate medical education in an equivalent foreign country and is nationally recognized in that country; or
(II) Fellowship training in the United States or [Canada] an equivalent foreign country approved by the Board or the Accreditation Council for Graduate Medical Education;
(2) Has completed at least 36 months of postgraduate education, not less than 24 months of which must have been completed as a resident after receiving a medical degree from a combined dental and medical degree program approved by the Board; or
(3) Is a resident who is enrolled in a progressive postgraduate training program in the United States or [Canada] an equivalent foreign country approved by the Board, the Accreditation Council for Graduate Medical Education, [the Royal College of Physicians and Surgeons of Canada, the Collθge des mιdecins du Quιbec or the College of Family Physicians of Canada, or, as applicable, their] its successor [organizations,] organization, or an organization that accredits graduate medical education in an equivalent foreign country and is nationally recognized in that country, has [completed at least 24] less than 12 months [of] remaining before he or she completes the program and has committed, in writing, to the Board that he or she will complete the program . [; and
(d) Passes a written or oral examination, or both, as to his or her qualifications to practice medicine and provides the Board with a description of the clinical program completed demonstrating that the applicants clinical training met the requirements of paragraph (a).]
3. The Board may issue a license to practice medicine after the Board verifies, through any readily available source, that the applicant has complied with the provisions of subsection 2. The verification may include, but is not limited to, using the Federation Credentials Verification Service. If any information is verified by a source other than the primary source of the information, the Board may require subsequent verification of the information by the primary source of the information.
4. If the Board requires an applicant for a license to practice medicine to pass an examination required pursuant to paragraph (b) of subsection 2 within a prescribed number of attempts, the Board may, by regulation, allow an applicant who is currently certified by a specialty board of the American Board of Medical Specialties more attempts to pass such an examination than the Board allows to an applicant who does not hold such a certification, if the applicant agrees to maintain his or her certification for the duration of the licensure.
κ2025 Statutes of Nevada, Page 1599 (CHAPTER 246, AB 319)κ
board of the American Board of Medical Specialties more attempts to pass such an examination than the Board allows to an applicant who does not hold such a certification, if the applicant agrees to maintain his or her certification for the duration of the licensure.
5. Notwithstanding any provision of this chapter to the contrary, if, after issuing a license to practice medicine, the Board obtains information from a primary or other source of information and that information differs from the information provided by the applicant or otherwise received by the Board, the Board may:
(a) Temporarily suspend the license;
(b) Promptly review the differing information with the Board as a whole or in a committee appointed by the Board;
(c) Declare the license void if the Board or a committee appointed by the Board determines that the information submitted by the applicant was false, fraudulent or intended to deceive the Board;
(d) Refer the applicant to the Attorney General for possible criminal prosecution pursuant to NRS 630.400; or
(e) If the Board temporarily suspends the license, allow the license to return to active status subject to any terms and conditions specified by the Board, including:
(1) Placing the licensee on probation for a specified period with specified conditions;
(2) Administering a public reprimand;
(3) Limiting the practice of the licensee;
(4) Suspending the license for a specified period or until further order of the Board;
(5) Requiring the licensee to participate in a program to correct an alcohol or other substance use disorder;
(6) Requiring supervision of the practice of the licensee;
(7) Imposing an administrative fine not to exceed [$5,000;] $10,000;
(8) Requiring the licensee to perform community service without compensation;
(9) Requiring the licensee to take a physical or mental examination or an examination testing his or her competence to practice medicine;
(10) Requiring the licensee to complete any training or educational requirements specified by the Board; and
(11) Requiring the licensee to submit a corrected application, including the payment of all appropriate fees and costs incident to submitting an application.
[5.] 6. If the Board determines after reviewing the differing information to allow the license to remain in active status, the action of the Board is not a disciplinary action and must not be reported to any national database. If the Board determines after reviewing the differing information to declare the license void, its action shall be deemed a disciplinary action and shall be reportable to national databases.
Sec. 15. NRS 630.1605 is hereby amended to read as follows:
630.1605 1. Except as otherwise provided in NRS 630.161, the Board may issue a license by endorsement to practice medicine to an applicant who has been issued a license to practice medicine by the District of Columbia or any state or territory of the United States if:
(a) At the time the applicant files an application with the Board, the license is active and in [effect;] good standing;
κ2025 Statutes of Nevada, Page 1600 (CHAPTER 246, AB 319)κ
(b) The applicant:
(1) Submits to the Board proof of passage of an examination listed in paragraph (b) of subsection 2 of NRS 630.160 or another examination approved by regulation of the Board;
(2) Submits to the Board any documentation and other proof of qualifications required by the Board;
(3) Meets all of the statutory requirements for licensure to practice medicine in effect at the time of application except for [the] :
(I) The requirements set forth in paragraph (c) of subsection 2 of NRS 630.160; or
(II) Any other requirements specified by regulation of the Board; and
(4) Completes any additional requirements relating to the fitness of the applicant to practice required by the Board; and
(c) Any documentation and other proof of qualifications required by the Board is authenticated in a manner approved by the Board.
2. A license by endorsement to practice medicine may be issued at a meeting of the Board or between its meetings by the President and Executive Director of the Board. Such an action shall be deemed to be an action of the Board.
Sec. 16. NRS 630.1607 is hereby amended to read as follows:
630.1607 1. Except as otherwise provided in NRS 630.161, the Board may issue a license by endorsement to practice medicine to an applicant who is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran and who meets the requirements set forth in this section. An applicant may submit to the Board an application for such a license if the applicant:
(a) Holds a corresponding valid and unrestricted license to practice medicine in the District of Columbia or any state or territory of the United States; and
(b) Is certified in a specialty recognized by the American Board of Medical Specialties . [or the American Osteopathic Association.]
2. An applicant for a license by endorsement pursuant to this section must submit to the Board with his or her application:
(a) Proof satisfactory to the Board that the applicant:
(1) Satisfies the requirements of subsection 1;
(2) Has not been disciplined and is not currently under investigation by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant holds a license to practice medicine; and
(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;
(b) A complete set of fingerprints and written permission authorizing the Board to forward the fingerprints in the manner provided in NRS 630.167;
(c) An affidavit stating that the information contained in the application and any accompanying material is true and correct; and
(d) Any other information required by the Board.
3. Not later than 15 business days after receiving an application for a license by endorsement to practice medicine pursuant to this section, the Board shall provide written notice to the applicant of any additional information required by the Board to consider the application. Unless the Board denies the application for good cause, including, without limitation, failure to comply with any requirement imposed by the Board pursuant to NRS 630.257, the Board shall approve the application and issue a license by endorsement to practice medicine to the applicant not later than:
κ2025 Statutes of Nevada, Page 1601 (CHAPTER 246, AB 319)κ
failure to comply with any requirement imposed by the Board pursuant to NRS 630.257, the Board shall approve the application and issue a license by endorsement to practice medicine to the applicant not later than:
(a) Forty-five days after receiving all the additional information required by the Board to complete the application; [or]
(b) Ten days after receiving a report on the applicants background based on the submission of the applicants fingerprints [,] ; or
(c) Ten days after receiving proof that the applicant has complied with any requirement imposed by the Board pursuant to NRS 630.257, if applicable,
Κ whichever occurs later.
4. A license by endorsement to practice medicine may be issued at a meeting of the Board or between its meetings by the President and Executive Director of the Board. Such an action shall be deemed to be an action of the Board.
5. At any time before making a final decision on an application for a license by endorsement pursuant to this section, the Board may grant a provisional license authorizing an applicant to practice medicine in accordance with regulations adopted by the Board.
6. As used in this section, veteran has the meaning ascribed to it in NRS 417.005.
Sec. 17. NRS 630.165 is hereby amended to read as follows:
630.165 1. Except as otherwise provided in subsection 2, an applicant for a license to practice medicine must submit to the Board, on a form provided by the Board, an application in writing, accompanied by an affidavit stating that:
(a) The applicant is the person named in the proof of graduation and that it was obtained without fraud or misrepresentation or any mistake of which the applicant is aware; and
(b) The information contained in the application and any accompanying material is complete and correct.
2. An applicant for a license by endorsement to practice medicine pursuant to NRS 630.1605 [, 630.1606] or 630.1607 must submit to the Board, on a form provided by the Board, an application in writing, accompanied by an affidavit stating that:
(a) The applicant is the person named in the license to practice medicine issued by the District of Columbia or any state or territory of the United States and that the license was obtained without fraud or misrepresentation or any mistake of which the applicant is aware; and
(b) The information contained in the application and any accompanying material is complete and correct.
3. An application submitted pursuant to subsection 1 or 2 must include all information required to complete the application.
4. In addition to the other requirements for licensure, the Board may require such further evidence of the mental, physical, medical or other qualifications of the applicant as it considers necessary.
5. The applicant bears the burden of proving and documenting his or her qualifications for licensure.
Sec. 18. NRS 630.167 is hereby amended to read as follows:
630.167 1. In addition to any other requirements set forth in this chapter, each applicant for a license to practice medicine, including, without limitation, an expedited license pursuant to NRS [630.1606 or] 630.1607 or chapter 629A of NRS, and each applicant for a license to practice as a perfusionist, to practice as a physician assistant, to practice as an anesthesiologist assistant or to practice respiratory care shall submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report.
κ2025 Statutes of Nevada, Page 1602 (CHAPTER 246, AB 319)κ
chapter 629A of NRS, and each applicant for a license to practice as a perfusionist, to practice as a physician assistant, to practice as an anesthesiologist assistant or to practice respiratory care shall submit to the Board a complete set of fingerprints and written permission authorizing the Board to forward the fingerprints to the Central Repository for Nevada Records of Criminal History for submission to the Federal Bureau of Investigation for its report. Any fees or costs charged by the Board for this service pursuant to NRS 630.268 are not refundable.
2. Any communication between the Board and the Interstate Medical Licensure Compact Commission created by NRS 629A.100 relating to verification of a physicians eligibility for expedited licensure pursuant to that section must not include any information received in a report from the Federal Bureau of Investigation relating to a state and federal criminal records check performed for the purposes of an application for an expedited license issued pursuant to NRS 629A.100.
Sec. 19. NRS 630.170 is hereby amended to read as follows:
630.170 In addition to the other requirements for licensure, an applicant for a license to practice medicine who is a graduate of a medical school located in the United States or [Canada] an equivalent foreign country shall submit to the Board proof that the applicant has received the degree of doctor of medicine from a medical school which, at the time of graduation, was accredited by the Liaison Committee on Medical Education or [the Committee for the Accreditation of Canadian Medical Schools.] an organization that accredits medical schools in an equivalent foreign country and is nationally recognized in that country. The proof of the degree of doctor of medicine must be submitted directly to the Board by the medical school that granted the degree. If proof of the degree is unavailable from the medical school, the Board may accept proof from any other source specified by the Board.
Sec. 20. NRS 630.195 is hereby amended to read as follows:
630.195 1. Except as otherwise provided in NRS [630.1606 and] 630.1607, in addition to the other requirements for licensure, an applicant for a license to practice medicine who is a graduate of a foreign medical school shall submit to the Board proof that the applicant has received:
(a) The degree of doctor of medicine or its equivalent, as determined by the Board; and
(b) The standard certificate of the Educational Commission for Foreign Medical Graduates or a written statement from that Commission that the applicant passed the examination given by the Commission.
2. The proof of the degree of doctor of medicine or its equivalent must be submitted directly to the Board by the medical school that granted the degree. If proof of the degree is unavailable from the medical school that granted the degree, the Board may accept proof from any other source specified by the Board.
Sec. 21. NRS 630.254 is hereby amended to read as follows:
630.254 1. Each licensee shall maintain a permanent mailing address and electronic mail address with the Board to which all communications from the Board to the licensee must be sent. A licensee who changes his or her permanent mailing address or electronic mail address shall notify the Board in writing of the new permanent mailing address within 30 days after the change. If a licensee fails to notify the Board in writing of a change in his or her permanent mailing address within 30 days after the change, the Board:
κ2025 Statutes of Nevada, Page 1603 (CHAPTER 246, AB 319)κ
(a) May impose upon the licensee a fine not to exceed $250; and
(b) May initiate disciplinary action against the licensee as provided pursuant to paragraph (j) of subsection 1 of NRS 630.306.
2. Any licensee who changes the location of his or her office in this State shall notify the Board in writing of the change before practicing at the new location.
3. Any licensee who closes his or her office in this State shall:
(a) Notify the Board in writing of this occurrence within 14 days after the closure; and
(b) For a period of 5 years thereafter, unless a longer period of retention is provided by federal law, keep the Board apprised in writing of the location of the medical records of the licensees patients.
[4. In addition to the requirements of subsection 1, any licensee who performs any of the acts described in subsection 3 of NRS 630.020 from outside this State or the United States shall maintain an electronic mail address with the Board to which all communications from the Board to the licensee may be sent.]
Sec. 22. NRS 630.257 is hereby amended to read as follows:
630.257 If [a] an inactive licensee does not engage in the practice of medicine or practice as a physician assistant, as applicable, for a period of more than 24 consecutive months, or if an applicant for a license has not engaged in the practice of medicine, perfusion or respiratory therapy, practiced as a physician assistant or assisted in the practice of medicine, as applicable, for more than 24 consecutive months before the date of the application, the Board may require the licensee or applicant, as applicable, to [take] :
1. Take the same examination to test [medical] competency as that given to applicants for a license [.] , or a comparable examination; or
2. Otherwise demonstrate his or her competency to practice medicine, perfusion or respiratory therapy, practice as a physician assistant or assist in the practice of medicine, as applicable.
Sec. 23. NRS 630.258 is hereby amended to read as follows:
630.258 1. A physician who is retired from active practice and who:
(a) Wishes to donate his or her expertise for the medical care and treatment of persons in this State who are indigent, uninsured or unable to afford health care; or
(b) Wishes to provide services for any disaster relief operations conducted by a governmental entity or nonprofit organization,
Κ may obtain a special volunteer medical license by submitting an application to the Board pursuant to this section.
2. An application for a special volunteer medical license must be on a form provided by the Board and must include:
(a) Documentation of the history of medical practice of the physician;
(b) Proof that the physician previously has been issued an unrestricted license to practice medicine in any state of the United States and that the physician has never been the subject of disciplinary action by a medical board in any jurisdiction;
(c) Proof that the physician satisfies the requirements for licensure set forth in NRS 630.160 or the requirements for licensure by endorsement set forth in NRS 630.1605 [, 630.1606] or 630.1607;
κ2025 Statutes of Nevada, Page 1604 (CHAPTER 246, AB 319)κ
(d) Acknowledgment that the practice of the physician under the special volunteer medical license will be exclusively devoted to providing medical care:
(1) To persons in this State who are indigent, uninsured or unable to afford health care; or
(2) As part of any disaster relief operations conducted by a governmental entity or nonprofit organization; and
(e) Acknowledgment that the physician will not receive any payment or compensation, either direct or indirect, or have the expectation of any payment or compensation, for providing medical care under the special volunteer medical license, except for payment by a medical facility at which the physician provides volunteer medical services of the expenses of the physician for necessary travel, continuing education, malpractice insurance or fees of the State Board of Pharmacy.
3. If the Board finds that the application of a physician satisfies the requirements of subsection 2 and that the retired physician is competent to practice medicine, the Board [must] may issue a special volunteer medical license to the physician.
4. The initial special volunteer medical license issued pursuant to this section expires 1 year after the date of issuance. The license may be renewed pursuant to this section, and any license that is renewed expires 2 years after the date of issuance of the renewed license.
5. The Board shall not charge a fee for:
(a) The review of an application for a special volunteer medical license; or
(b) The issuance or renewal of a special volunteer medical license pursuant to this section.
6. A physician who is issued a special volunteer medical license pursuant to this section and who accepts the privilege of practicing medicine in this State pursuant to the provisions of the special volunteer medical license is subject to all the provisions governing disciplinary action set forth in this chapter.
7. A physician who is issued a special volunteer medical license pursuant to this section shall comply with the requirements for continuing education adopted by the Board.
Sec. 24. NRS 630.259 is hereby amended to read as follows:
630.259 1. A person may apply to the Board to be licensed as an administrative physician if the person meets all of the statutory requirements for licensure in effect at the time of application except [the] for such requirements [of paragraph (c) of subsection 2 of NRS 630.160.] as are specified by regulation of the Board.
2. A person who is licensed as an administrative physician pursuant to this section:
(a) May not engage in the practice of clinical medicine;
(b) Shall comply with all of the statutory requirements for continued licensure pursuant to this chapter; and
(c) Shall be deemed to hold a license to practice medicine in an administrative capacity only.
Sec. 25. NRS 630.261 is hereby amended to read as follows:
630.261 1. Except as otherwise provided in NRS 630.161, the Board may issue:
κ2025 Statutes of Nevada, Page 1605 (CHAPTER 246, AB 319)κ
(a) A locum tenens license, to be effective not more than 3 months after issuance, to any physician who is licensed and in good standing in another state, who meets the requirements for licensure in this State and who is of good moral character and reputation. The purpose of this license is to enable an eligible physician to serve as a substitute for another physician who is licensed to practice medicine in this State and who is absent from his or her practice for reasons deemed sufficient by the Board. A license issued pursuant to the provisions of this paragraph is not renewable.
(b) [A special license to a licensed physician of another state to come into this State to care for or assist in the treatment of his or her own patient in association with a physician licensed in this State. A special license issued pursuant to the provisions of this paragraph is limited to the care of a specific patient. The physician licensed in this State has the primary responsibility for the care of that patient.
(c) A restricted license for a specified period if the Board determines the applicant needs supervision or restriction.
(d)] A temporary license for a specified period if the physician is licensed and in good standing in another state and meets the requirements for licensure in this State, and if the Board determines that it is necessary in order to provide medical services for a community without adequate medical care. A temporary license issued pursuant to the provisions of this paragraph is not renewable.
[(e)] (c) A [special purpose] telemedicine license to a physician who is licensed in another state to perform any of the acts described in subsections 1 and 2 of NRS 630.020 by using equipment that transfers information concerning the medical condition of a patient in this State electronically, telephonically or by fiber optics, including, without limitation, through telehealth, from within or outside this State or the United States. A physician who holds a [special purpose] telemedicine license issued pursuant to this paragraph:
(1) Except as otherwise provided by specific statute or regulation, shall comply with the provisions of this chapter and the regulations of the Board; and
(2) To the extent not inconsistent with the Nevada Constitution or the United States Constitution, is subject to the jurisdiction of the courts of this State.
2. For the purpose of paragraph [(e)] (c) of subsection 1, the physician must:
(a) Hold a full and unrestricted license to practice medicine in another state;
(b) Not have had any disciplinary or other action taken against him or her by any state or other jurisdiction; and
(c) Be certified by a specialty board of the American Board of Medical Specialties or its successor.
3. Except as otherwise provided in this section, the Board may renew or modify any license issued pursuant to subsection 1.
Sec. 26. NRS 630.263 is hereby amended to read as follows:
630.263 1. If the Governor determines that there are critically unmet needs with regard to the number of physicians who are practicing a medical specialty within this State, the Governor may declare that a state of critical medical need exists for that medical specialty.
κ2025 Statutes of Nevada, Page 1606 (CHAPTER 246, AB 319)κ
medical need exists for that medical specialty. The Governor may, but is not required to, limit such a declaration to one or more geographic areas within this State.
2. In determining whether there are critically unmet needs with regard to the number of physicians who are practicing a medical specialty, the Governor may consider, without limitation:
(a) Any statistical data analyzing the number of physicians who are practicing the medical specialty in relation to the total population of this State or any geographic area within this State;
(b) The demand within this State or any geographic area within this State for the types of services provided by the medical specialty; and
(c) Any other factors relating to the medical specialty that may adversely affect the delivery of health care within this State or any geographic area within this State.
3. If the Governor makes a declaration pursuant to this section, the Board may waive the requirements of paragraph (c) of subsection 2 of NRS 630.160 for an applicant if the applicant:
(a) Intends to practice medicine in one or more of the medical specialties designated by the Governor in the declaration and, if the Governor has limited the declaration to one or more geographic areas within this State, in one or more of those geographic areas;
(b) Has completed at least 1 year of training as a resident in the United States or [Canada] an equivalent foreign country in a program approved by the Board, the Accreditation Council for Graduate Medical Education, [the Royal College of Physicians and Surgeons of Canada, the Collθge des mιdecins du Quιbec or the College of Family Physicians of Canada,] or [their] its successor [organizations, respectively;] organization, or an organization that accredits graduate medical education in an equivalent foreign country and is nationally recognized in that country;
(c) Has a minimum of 5 years of practical medical experience as a licensed allopathic physician or such other equivalent training as the Board deems appropriate; and
(d) Meets all other conditions and requirements for a license to practice medicine.
4. Any license issued pursuant to this section is a restricted license, and the person who holds the restricted license may practice medicine in this State only in the medical specialties and geographic areas for which the restricted license is issued.
5. Any person who holds a restricted license issued pursuant to this section and who completes 3 years of full-time practice under the restricted license may apply to the Board for an unrestricted license. In considering an application for an unrestricted license pursuant to this subsection, the Board shall require the applicant to meet all statutory requirements for licensure in effect at the time of application except the requirements of paragraph (c) of subsection 2 of NRS 630.160.
Sec. 27. NRS 630.264 is hereby amended to read as follows:
630.264 1. A board of county commissioners may petition the Board of Medical Examiners to waive the requirements of paragraph (c) of subsection 2 of NRS 630.160 for any applicant intending to practice medicine in a medically underserved area of that county as that term is defined by regulation by the Board of Medical Examiners.
κ2025 Statutes of Nevada, Page 1607 (CHAPTER 246, AB 319)κ
defined by regulation by the Board of Medical Examiners. The Board of Medical Examiners may waive that requirement and issue a license if the applicant:
(a) Has completed at least 1 year of training as a resident in the United States or Canada in a program approved by the Board, the Accreditation Council for Graduate Medical Education, [the Royal College of Physicians and Surgeons of Canada, the Collθge des mιdecins du Quιbec or the College of Family Physicians of Canada,] or [their] its successor [organizations, respectively;] organization, or an organization that accredits graduate medical education in an equivalent foreign country and is nationally recognized in that country;
(b) Has a minimum of 5 years of practical medical experience as a licensed allopathic physician or such other equivalent training as the Board deems appropriate; and
(c) Meets all other conditions and requirements for a license to practice medicine.
2. Any person licensed pursuant to subsection 1 must be issued a license to practice medicine in this State restricted to practice in the medically underserved area of the county which petitioned for the waiver only. A person may apply to the Board of Medical Examiners for renewal of that restricted license every 2 years after being licensed.
3. Any person holding a restricted license pursuant to subsection 1 who completes 3 years of full-time practice under the restricted license may apply to the Board for an unrestricted license. In considering an application for an unrestricted license pursuant to this subsection, the Board shall require the applicant to meet all statutory requirements for licensure in effect at the time of application except the requirements of paragraph (c) of subsection 2 of NRS 630.160.
Sec. 28. NRS 630.265 is hereby amended to read as follows:
630.265 1. Unless the Board denies such licensure pursuant to NRS 630.161 for failure to comply with any requirement imposed pursuant to NRS 630.257 or for other good cause, the Board shall issue to a qualified applicant a limited license to practice medicine as a resident physician in a graduate program approved by the Accreditation Council for Graduate Medical Education if the applicant is:
(a) A graduate of an accredited medical school in the United States or [Canada;] an equivalent foreign country; or
(b) A graduate of a foreign medical school and has received the standard certificate of the Educational Commission for Foreign Medical Graduates or a written statement from that Commission that the applicant passed the examination given by it.
2. The medical school or other institution sponsoring the program shall provide the Board with written confirmation that the applicant has been appointed to a position in the program. A limited license remains valid only while the licensee is actively practicing medicine in the residency program . [and is legally entitled to work and remain in the United States.]
3. The Board may issue a limited license for not more than 1 year but may renew the license if the applicant for the limited license meets the requirements set forth by the Board by regulation.
4. The holder of a limited license may practice medicine only in connection with his or her duties as a resident physician or under such conditions as are approved by the director of the program.
κ2025 Statutes of Nevada, Page 1608 (CHAPTER 246, AB 319)κ
5. The holder of a limited license granted pursuant to this section may be disciplined by the Board at any time for any of the grounds provided in NRS 630.161 or 630.301 to 630.3065, inclusive.
Sec. 29. NRS 630.2677 is hereby amended to read as follows:
630.2677 1. A person applying to renew a license to practice as a physician assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS;
[2.] (b) Apply:
[(a)] (1) To renew a license to practice as a physician assistant to the Board pursuant to this chapter; and
[(b)] (2) For a license to practice as a physician assistant to the State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501.
2. If an applicant to renew a license to practice as a physician assistant pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS and pays the fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268 but does not pay the application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501 within 1 year after the renewal of his or her license pursuant to this chapter:
(a) The Board of Medical Examiners shall notify the physician assistant that he or she is required to pay to the Board the difference between:
(1) The fee for biennial registration of a physician assistant established pursuant to NRS 630.268; and
(2) The fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268; and
(b) The physician assistant shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 30. NRS 630.268 is hereby amended to read as follows:
630.268 1. The Board shall charge and collect not more than the following fees:
For application for and issuance of a license to practice as a physician, including a license by endorsement............................................................................................................ $600
For application for and issuance of a temporary, locum tenens, limited, restricted, authorized facility, [special, special purpose] telemedicine or special event license............... 400
κ2025 Statutes of Nevada, Page 1609 (CHAPTER 246, AB 319)κ
For renewal of a limited, restricted [,] or authorized facility [or special] license $400
For application for and issuance of a license as a physician assistant, including a license by endorsement............................................................................................................... 400
For application for and issuance of a simultaneous license as a physician assistant 200
For biennial registration of a physician assistant................................ 800
For biennial simultaneous registration of a physician assistant....... 400
For biennial registration of a physician................................................ 800
For application for and issuance of a license as a perfusionist or practitioner of respiratory care 400
For biennial renewal of a license as a perfusionist............................. 600
For application for and issuance of a license or temporary license to practice as an anesthesiologist assistant............................................................................................................... 400
For application for and initial issuance of a simultaneous license as an anesthesiologist assistant 200
For biennial registration of an anesthesiologist assistant.................. 800
For biennial simultaneous registration of an anesthesiologist assistant 400
For biennial registration of a practitioner of respiratory care........... 600
For biennial registration for a physician who is on inactive status.. 400
For written verification of licensure........................................................ 50
[For a duplicate identification card........................................................ 25]
For a duplicate license............................................................................... 50
[For computer printouts or labels.......................................................... 500
For verification of a listing of physicians, per hour............................ 20]
For furnishing a list of new physicians................................................. 100
2. Except as otherwise provided in subsections 4 and 5, in addition to the fees [prescribed in] established pursuant to subsection 1, the Board shall charge and collect necessary and reasonable fees for the expedited processing of a request or for any other incidental service the Board provides.
3. The cost of any special meeting called at the request of a licensee, an institution, an organization, a state agency or an applicant for licensure must be paid for by the person or entity requesting the special meeting. Such a special meeting must not be called until the person or entity requesting it has paid a cash deposit with the Board sufficient to defray all expenses of the meeting.
4. If an applicant submits an application for a license by endorsement pursuant to [:
(a)] NRS 630.1607 [, and the applicant is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran, the Board shall collect not more than one-half of the fee set forth in subsection 1 for the initial issuance of the license.
κ2025 Statutes of Nevada, Page 1610 (CHAPTER 246, AB 319)κ
than one-half of the fee set forth in subsection 1 for the initial issuance of the license. As used in this paragraph, veteran has the meaning ascribed to it in NRS 417.005.
(b) NRS] or 630.2752, the Board shall collect not more than one-half of the fee set forth in subsection 1 for the initial issuance of the license.
5. If an applicant submits an application for a license by endorsement pursuant to NRS [630.1606 or] 630.2751, [as applicable,] the Board shall charge and collect not more than the fee specified in subsection 1 for the application for and initial issuance of a license.
Sec. 31. NRS 630.26835 is hereby amended to read as follows:
630.26835 1. A person applying for an anesthesiologist assistant license pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS;
[2.] (b) Apply for a license to practice as an anesthesiologist assistant to:
[(a)] (1) The Board pursuant to this chapter; and
[(b)] (2) The State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for application for and issuance of a simultaneous license as an anesthesiologist assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501.
2. If a person who applies for an anesthesiologist assistant license pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS and pays the fee for application for and issuance of a simultaneous license as an anesthesiologist assistant established pursuant to NRS 630.268 and the person does not pay the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501 within 1 year after the issuance of his or her license pursuant to this chapter:
(a) The Board of Medical Examiners shall notify the person that he or she is required to pay to the Board the difference between:
(1) The fee for application for and issuance of a license to practice as an anesthesiologist assistant established pursuant to NRS 630.268; and
(2) The fee for application for and initial issuance of a simultaneous license as an anesthesiologist assistant established pursuant to NRS 630.268; and
(b) The person shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 32. NRS 630.2684 is hereby amended to read as follows:
630.2684 1. A person applying to renew an anesthesiologist assistant license pursuant to the provisions of this chapter who wishes to hold a simultaneous anesthesiologist assistant license pursuant to the provisions of chapter 633 of NRS must:
κ2025 Statutes of Nevada, Page 1611 (CHAPTER 246, AB 319)κ
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS;
[2.] (b) Apply:
[(a)] (1) To renew an anesthesiologist assistant license to the Board pursuant to this chapter; and
[(b)] (2) For an anesthesiologist assistant license to the State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501.
2. If an applicant to renew an anesthesiologist assistant license pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS and pays the fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268 but does not pay the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501 within 1 year after the renewal of his or her license pursuant to this chapter:
(a) The Board of Medical Examiners shall notify the anesthesiologist assistant that he or she is required to pay to the Board the difference between:
(1) The fee for biennial registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
(2) The fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
(b) The anesthesiologist assistant shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 33. NRS 630.26845 is hereby amended to read as follows:
630.26845 1. If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 633 of NRS, the person must:
[1.] (a) Apply for an anesthesiologist assistant license to the State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[2.] (b) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501.
2. If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter pays the fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268 in accordance with subparagraph (1) of paragraph (b) of subsection 1 but does not pay the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501 within 1 year after the next time the person renews his or her license pursuant to this chapter:
κ2025 Statutes of Nevada, Page 1612 (CHAPTER 246, AB 319)κ
(a) The Board of Medical Examiners shall notify the anesthesiologist assistant that he or she is required to pay to the Board the difference between:
(1) The fee for biennial registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
(2) The fee for biennial simultaneous registration of an anesthesiologist assistant established pursuant to NRS 630.268; and
(b) The anesthesiologist assistant shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 34. NRS 630.269 is hereby amended to read as follows:
630.269 The Board shall adopt regulations regarding the licensure of perfusionists, including, without limitation:
1. The criteria for licensure as a perfusionist and the standards of professional conduct for holders of such a license;
2. The qualifications and fitness of applicants for licenses, renewal of licenses and reciprocal licenses;
3. [The requirements for any practical, oral or written examination for a license that the Board may require pursuant to NRS 630.2692, including, without limitation, the passing grade for such an examination;
4.] The [fees] fee for [examination and for] the reinstatement of expired licenses;
[5.] 4. The requirements for continuing education for the renewal of a license;
[6.] 5. A code of ethics for perfusionists; and
[7.] 6. The procedures for the revocation, suspension or denial of a license for a violation of this chapter or the regulations of the Board.
Sec. 35. NRS 630.2691 is hereby amended to read as follows:
630.2691 To be eligible for licensing by the Board as a perfusionist, an applicant must:
1. Be a natural person of good moral character;
2. Submit a completed application as required by the Board ; [by the date established by the Board;]
3. Submit any required fees ; [by the date established by the Board;]
4. Have successfully completed a perfusion education program approved by the Board, which must:
(a) Have been approved by the Committee on Allied Health Education and Accreditation of the American Medical Association before June 1, 1994; or
(b) Be a program that has educational standards that are at least as stringent as those established by the Accreditation Committee-Perfusion Education and approved by the Commission on Accreditation of Allied Health Education Programs of the American Medical Association, or its successor;
5. [Pass an examination required pursuant to NRS 630.2692;] Hold a current, valid certification issued by the American Board of Cardiovascular Perfusion, or its successor organization; and
6. Comply with any other requirements set by the Board.
Sec. 36. NRS 630.2695 is hereby amended to read as follows:
630.2695 1. Each license issued pursuant to NRS 630.2694 expires on June 30, or if June 30 is a Saturday, Sunday or legal holiday, on the next business day after June 30, of every odd-numbered year and may be renewed if, before the license expires, the holder of the license submits to the Board:
κ2025 Statutes of Nevada, Page 1613 (CHAPTER 246, AB 319)κ
business day after June 30, of every odd-numbered year and may be renewed if, before the license expires, the holder of the license submits to the Board:
(a) A completed application for renewal on a form prescribed by the Board;
(b) Proof of completion of the requirements for continuing education prescribed by regulations adopted by the Board pursuant to NRS 630.269; and
(c) The applicable fee for renewal of the license prescribed by the Board pursuant to NRS 630.2691.
2. A license that expires pursuant to this section not more than 2 years before an application for renewal is made may be reinstated only if the applicant:
(a) Complies with the provisions of subsection 1; and
(b) Submits to the Board the fees:
(1) For the reinstatement of an expired license, prescribed by regulations adopted by the Board pursuant to NRS 630.269; and
(2) For each biennium that the license was expired, for the renewal of the license.
3. If a license has been expired for more than 2 years, a person may not renew or reinstate the license but must apply for a new license and [submit to the examination required] comply with any requirement imposed by the Board pursuant to NRS [630.2692.] 630.257.
4. The Board shall send a notice of renewal to each licensee not later than 60 days before his or her license expires. The notice must include the amount of the fee for renewal of the license.
Sec. 37. NRS 630.2696 is hereby amended to read as follows:
630.2696 1. The Board may issue a temporary license to practice perfusion in this State to a person who has not yet [completed the examination] obtained the certification required pursuant to NRS [630.2692] 630.2691 but who:
(a) Has completed an approved perfusion education program;
(b) Files an application; and
(c) Pays the required fee.
2. A perfusionist shall supervise and direct a temporarily licensed perfusionist at all times during which the temporarily licensed perfusionist performs perfusion.
3. A temporary license is valid for 1 year after the date it is issued and may be [extended subject to regulation by the Board.] renewed once. The application for renewal must be signed by a supervising licensed perfusionist.
[4. If a temporarily licensed perfusionist fails any portion of the examination required pursuant to NRS 630.2692, he or she shall immediately surrender the temporary license to the Board.]
Sec. 38. NRS 630.2735 is hereby amended to read as follows:
630.2735 1. A person applying for a license to practice as a physician assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS;
κ2025 Statutes of Nevada, Page 1614 (CHAPTER 246, AB 319)κ
[2.] (b) Apply for a license to practice as a physician assistant to:
[(a)] (1) The Board pursuant to this chapter; and
[(b)] (2) The State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501.
2. If a person who applies for a license to practice as a physician assistant pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS and pays the fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268 but does not pay the application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501 within 1 year after the issuance of his or her license pursuant to this chapter:
(a) The Board of Medical Examiners shall notify the person that he or she is required to pay to the Board the difference between:
(1) The fee for application for and issuance of a license as a physician assistant established pursuant to NRS 630.268; and
(2) The fee for application for and initial issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268; and
(b) The person shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 39. NRS 630.275 is hereby amended to read as follows:
630.275 The Board shall adopt regulations regarding the licensure of a physician assistant, including, but not limited to:
1. The educational and other qualifications of applicants.
2. The required academic program for applicants.
3. The procedures for applications for and the issuance of licenses.
4. The procedures deemed necessary by the Board for applications for and the initial issuance of licenses by endorsement pursuant to NRS 630.2751 or 630.2752.
5. The tests or examinations of applicants required by the Board.
6. The medical services which a physician assistant may perform, except that a physician assistant may not perform those specific functions and duties delegated or restricted by law to persons licensed as dentists, chiropractic physicians, naprapaths, podiatric physicians and optometrists under chapters 631, 634, 634B, 635 and 636, respectively, of NRS, or as hearing aid specialists.
7. The duration, renewal and termination of licenses, including licenses by endorsement. [The Board shall not require a physician assistant to receive or maintain certification by the National Commission on Certification of Physician Assistants, or its successor organization, or by any other nationally recognized organization for the accreditation of physician assistants to satisfy any continuing education requirements for the renewal of licenses.]
8. The grounds and procedures respecting disciplinary actions against physician assistants.
κ2025 Statutes of Nevada, Page 1615 (CHAPTER 246, AB 319)κ
9. The supervision of medical services of a physician assistant by a supervising physician.
10. A physician assistants use of equipment that transfers information concerning the medical condition of a patient in this State electronically, telephonically or by fiber optics, including, without limitation, through telehealth, from within or outside this State or the United States.
Sec. 40. NRS 630.2751 is hereby amended to read as follows:
630.2751 1. The Board may issue a license by endorsement to practice as a physician assistant to an applicant who meets the requirements set forth in this section. An applicant may submit to the Board an application for such a license if the applicant holds a corresponding valid and unrestricted license to practice as a physician assistant in the District of Columbia or any state or territory of the United States.
2. An applicant for a license by endorsement pursuant to this section must submit to the Board with his or her application:
(a) Proof satisfactory to the Board that the applicant:
(1) Satisfies the requirements of subsection 1; and
(2) Has not been disciplined [or] and is not currently being investigated by the corresponding regulatory authority of the District of Columbia or any state or territory in which the applicant currently holds or has held a license to practice as a physician assistant; [and
(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;]
(b) A complete set of fingerprints and written permission authorizing the Board to forward the fingerprints in the manner provided in NRS 630.167;
(c) An affidavit stating that the information contained in the application and any accompanying material is true and correct; and
(d) Any other information required by the Board.
3. Not later than 15 business days after receiving an application for a license by endorsement to practice as a physician assistant pursuant to this section, the Board shall provide written notice to the applicant of any additional information required by the Board to consider the application. Unless the Board denies the application for good cause, including, without limitation, failure to comply with any requirement imposed by the Board pursuant to NRS 630.257, the Board shall approve the application and issue a license by endorsement to practice as a physician assistant to the applicant not later than:
(a) Forty-five days after receiving the application; [or]
(b) Ten days after the Board receives a report on the applicants background based on the submission of the applicants fingerprints [,] ; or
(c) Ten days after the Board receives proof that the applicant has complied with any requirement imposed by the Board pursuant to NRS 630.257, if applicable,
Κ whichever occurs later.
4. A license by endorsement to practice as a physician assistant may be issued at a meeting of the Board or between its meetings by the President and Executive Director of the Board. Such an action shall be deemed to be an action of the Board.
κ2025 Statutes of Nevada, Page 1616 (CHAPTER 246, AB 319)κ
Sec. 41. NRS 630.2752 is hereby amended to read as follows:
630.2752 1. The Board may issue a license by endorsement to practice as a physician assistant to an applicant who meets the requirements set forth in this section. An applicant may submit to the Board an application for such a license if the applicant:
(a) Holds a corresponding valid and unrestricted license to practice as a physician assistant in the District of Columbia or any state or territory of the United States; and
(b) Is an active member of, or the spouse of an active member of, the Armed Forces of the United States, a veteran or the surviving spouse of a veteran.
2. An applicant for a license by endorsement pursuant to this section must submit to the Board with his or her application:
(a) Proof satisfactory to the Board that the applicant:
(1) Satisfies the requirements of subsection 1; and
(2) Has not been disciplined [or] and is not currently being investigated by the corresponding regulatory authority of the District of Columbia or the state or territory in which the applicant holds a license to practice as a physician assistant; [and
(3) Has not been held civilly or criminally liable for malpractice in the District of Columbia or any state or territory of the United States;]
(b) A complete set of fingerprints and written permission authorizing the Board to forward the fingerprints in the manner provided in NRS 630.167;
(c) An affidavit stating that the information contained in the application and any accompanying material is true and correct; and
(d) Any other information required by the Board.
3. Not later than 15 business days after receiving an application for a license by endorsement to practice as a physician assistant pursuant to this section, the Board shall provide written notice to the applicant of any additional information required by the Board to consider the application. Unless the Board denies the application for good cause, including, without limitation, failure to comply with any requirement imposed by the Board pursuant to NRS 630.257, the Board shall approve the application and issue a license by endorsement to practice as a physician assistant to the applicant not later than:
(a) Forty-five days after receiving all the additional information required by the Board to complete the application; [or]
(b) Ten days after the Board receives a report on the applicants background based on the submission of the applicants fingerprints [,] ; or
(c) Ten days after the Board receives proof that the applicant has complied with any requirement imposed by the Board pursuant to NRS 630.257, if applicable,
Κ whichever occurs later.
4. A license by endorsement to practice as a physician assistant may be issued at a meeting of the Board or between its meetings by the President and Executive Director of the Board. Such an action shall be deemed to be an action of the Board.
5. At any time before making a final decision on an application for a license by endorsement pursuant to this section, the Board may grant a provisional license authorizing an applicant to practice as a physician assistant in accordance with regulations adopted by the Board.
κ2025 Statutes of Nevada, Page 1617 (CHAPTER 246, AB 319)κ
6. As used in this section, veteran has the meaning ascribed to it in NRS 417.005.
Sec. 42. NRS 630.2755 is hereby amended to read as follows:
630.2755 1. If a person licensed to practice as a physician assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 633 of NRS, the person must:
[1.] (a) Apply for a license to practice as a physician assistant to the State Board of Osteopathic Medicine pursuant to chapter 633 of NRS; and
[2.] (b) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268; and
[(b)] (2) The application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501.
2. If a person licensed as a physician assistant pursuant to the provisions of this chapter pays the fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268 in accordance with subparagraph (1) of paragraph (b) of subsection 1 but does not pay the application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501 within 1 year after the next time the person renews his or her license pursuant to this chapter:
(a) The Board of Medical Examiners shall notify the person that he or she is required to pay to the Board the difference between:
(1) The fee for biennial registration of a physician assistant established pursuant to NRS 630.268; and
(2) The fee for biennial simultaneous registration of a physician assistant established pursuant to NRS 630.268; and
(b) The person shall pay to the Board of Medical Examiners the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 43. NRS 630.277 is hereby amended to read as follows:
630.277 1. Every person who wishes to practice respiratory care in this State must:
(a) [Have:
(1) A high school diploma; or
(2) A general equivalency diploma or an equivalent document;
(b)] Complete an educational program for respiratory care which has been approved by the Commission on Accreditation of Allied Health Education Programs or its successor organization or the Commission on Accreditation for Respiratory Care or its successor organization;
[(c)] (b) Pass the examination as an entry-level or advanced practitioner of respiratory care administered by the National Board for Respiratory Care or its successor organization;
[(d)] (c) Be certified by the National Board for Respiratory Care or its successor organization; and
[(e)] (d) Be licensed to practice respiratory care by the Board and have paid the required fee for licensure.
2. Except as otherwise provided in subsection 3, a person shall not:
(a) Practice respiratory care; or
(b) Hold himself or herself out as qualified to practice respiratory care,
Κ in this State without complying with the provisions of subsection 1.
κ2025 Statutes of Nevada, Page 1618 (CHAPTER 246, AB 319)κ
3. Any person who has completed the educational requirements set forth in [paragraphs] paragraph (a) [and (b)] of subsection 1 may practice respiratory care pursuant to a program of practical training as an intern in respiratory care for not more than 12 months after completing those educational requirements.
Sec. 44. NRS 630.301 is hereby amended to read as follows:
630.301 The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure:
1. Conviction of a felony relating to the practice of medicine or the ability to practice medicine. A plea of nolo contendere is a conviction for the purposes of this subsection.
2. Conviction of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240, 616D.300, 616D.310, or 616D.350 to 616D.440, inclusive.
3. Any disciplinary action, including, without limitation, the revocation, suspension, modification or limitation of a license to practice any type of medicine, taken by another agency of this State or another state, the Federal Government, a foreign country or any other jurisdiction or the surrender of the license or discontinuing the practice of medicine while under investigation by any licensing authority, a medical facility, a branch of the Armed Services of the United States, an insurance company, an agency of the Federal Government or an employer.
4. Malpractice, which may be evidenced by claims settled against a practitioner, but only if the malpractice is established by a preponderance of the evidence.
5. The engaging by a practitioner in any sexual activity with a patient who is currently being treated by the practitioner. For the purposes of this subsection, a practitioner shall be deemed to be currently treating a patient if the practitioner:
(a) Has treated the patient within the immediately preceding 3 years; and
(b) Has not discharged the patient in writing.
6. Disruptive behavior with physicians, hospital personnel, patients, members of the families of patients or any other persons if the behavior interferes with patient care or has an adverse impact on the quality of care rendered to a patient.
7. The engaging in conduct that violates the trust of a patient and exploits the relationship between the physician and the patient for financial or other personal gain.
8. The failure to offer appropriate procedures or studies, to protest inappropriate denials by organizations for managed care, to provide necessary services or to refer a patient to an appropriate provider, when the failure occurs with the intent of positively influencing the financial well-being of the practitioner or an insurer.
9. The engaging in conduct that brings the medical profession into disrepute, including, without limitation, conduct that violates any provision of a code of ethics adopted by the Board by regulation based on a national code of ethics.
10. The engaging in sexual contact with the surrogate of a patient or other key persons related to a patient, including, without limitation, a spouse, parent or legal guardian, which exploits the relationship between the physician and the patient in a sexual manner.
κ2025 Statutes of Nevada, Page 1619 (CHAPTER 246, AB 319)κ
11. Conviction of:
(a) Murder, voluntary manslaughter or mayhem;
(b) Any felony involving the use of a firearm or other deadly weapon;
(c) Assault with intent to kill or to commit sexual assault or mayhem;
(d) Sexual assault, statutory sexual seduction, incest, lewdness, indecent exposure or any other sexually related crime;
(e) Abuse or neglect of a child or contributory delinquency;
(f) A violation of any federal or state law regulating the possession, distribution or use of any controlled substance or any dangerous drug as defined in chapter 454 of NRS; or
(g) Any offense involving moral turpitude.
Sec. 45. NRS 630.306 is hereby amended to read as follows:
630.306 1. The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure:
(a) Inability to practice medicine with reasonable skill and safety because of illness, a mental or physical condition or the use of alcohol, drugs, narcotics or any other substance.
(b) Engaging in any conduct:
(1) Which is intended to deceive;
(2) Which the Board has determined is a violation of the standards of practice established by regulation of the Board; or
(3) Which is in violation of a provision of chapter 639 of NRS, or a regulation adopted by the State Board of Pharmacy pursuant thereto, that is applicable to a licensee who is a practitioner, as defined in NRS 639.0125.
(c) Administering, dispensing or prescribing any controlled substance, or any dangerous drug as defined in chapter 454 of NRS, to or for himself or herself or to others except as authorized by law.
(d) Performing, assisting or advising the injection of any substance containing liquid silicone into the human body, except for the use of silicone oil to repair a retinal detachment.
(e) Practicing or offering to practice beyond the scope permitted by law or performing services which the licensee knows or has reason to know that he or she is not competent to perform or which are beyond the scope of his or her training.
(f) Performing, without first obtaining the informed consent of the patient or the patients family, any procedure or prescribing any therapy which by the current standards of the practice of medicine is experimental.
(g) Continual failure to exercise the skill or diligence or use the methods ordinarily exercised under the same circumstances by physicians in good standing practicing in the same specialty or field.
(h) Having an alcohol or other substance use disorder.
(i) Making or filing a report which the licensee or applicant knows to be false or failing to file a record or report as required by law or regulation.
(j) Failing to comply with the requirements of NRS 630.254.
(k) Failure by a licensee or applicant to report in writing, within 30 days, any disciplinary action taken against the licensee or applicant by another state, the Federal Government or a foreign country, including, without limitation, the revocation, suspension or surrender of a license to practice medicine in another jurisdiction. The provisions of this paragraph do not apply to any disciplinary action taken by the Board or taken because of any disciplinary action taken by the Board.
κ2025 Statutes of Nevada, Page 1620 (CHAPTER 246, AB 319)κ
(l) Failure by a licensee or applicant to report in writing, within 30 days, any arrest or criminal [action taken or] conviction [obtained against] of the licensee or applicant, other than a minor traffic violation, in this State or any other state or by the Federal Government, a branch of the Armed Forces of the United States or any local or federal jurisdiction of a foreign country.
(m) Failure to be found competent to practice medicine as a result of an examination to determine medical competency pursuant to NRS 630.318.
(n) Operation of a medical facility at any time during which:
(1) The license of the facility is suspended or revoked; or
(2) An act or omission occurs which results in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This paragraph applies to an owner or other principal responsible for the operation of the facility.
(o) Failure to comply with the requirements of NRS 630.373.
(p) Engaging in any act that is unsafe or unprofessional conduct in accordance with regulations adopted by the Board.
(q) Knowingly or willfully procuring or administering a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(1) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(2) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328;
(3) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS; or
(4) Is an individualized investigational treatment or investigational drug or biological product prescribed to a patient pursuant to NRS 630.3735 or 633.6945.
(r) Failure to supervise adequately a medical assistant pursuant to the regulations of the Board.
(s) Failure to comply with the provisions of NRS 630.3745.
(t) Failure to obtain any training required by the Board pursuant to NRS 630.2535.
(u) Failure to comply with the provisions of NRS 454.217 or 629.086.
(v) Failure to comply with the provisions of NRS 441A.315 or any regulations adopted pursuant thereto.
(w) Performing or supervising the performance of a pelvic examination in violation of NRS 629.085.
(x) Failure to respond to the Board or an investigative committee of the Board during an investigation or otherwise cooperate with an investigation pursuant to this chapter.
2. As used in this section:
(a) Individualized investigational treatment has the meaning ascribed to it in NRS 454.690.
(b) Investigational drug or biological product has the meaning ascribed to it in NRS 454.351.
Sec. 46. NRS 630.3067 is hereby amended to read as follows:
630.3067 1. The insurer of a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist licensed under this chapter shall report to the Board:
κ2025 Statutes of Nevada, Page 1621 (CHAPTER 246, AB 319)κ
(a) Any action for malpractice against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist not later than 45 days after the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist receives service of a summons and complaint for the action;
(b) Any claim for malpractice against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist that is submitted to arbitration or mediation not later than 45 days after the claim is submitted to arbitration or mediation; and
(c) Any settlement, award, judgment or other disposition of any action or claim described in paragraph (a) or (b) not later than 45 days after the settlement, award, judgment or other disposition.
2. The Board shall report any failure to comply with subsection 1 by an insurer licensed in this State to the Division of Insurance of the Department of Business and Industry. If, after a hearing, the Division of Insurance determines that any such insurer failed to comply with the requirements of subsection 1, the Division may impose an administrative fine of not more than $10,000 against the insurer for each such failure to report. If the administrative fine is not paid when due, the fine must be recovered in a civil action brought by the Attorney General on behalf of the Division.
3. Except where otherwise required by law, a report made by an insurer pursuant to this section is a public record.
Sec. 47. NRS 630.3068 is hereby amended to read as follows:
630.3068 1. A physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist shall report to the Board:
(a) Any action for malpractice against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist not later than 45 days after the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist receives service of a summons and complaint for the action;
(b) Any claim for malpractice against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist that is submitted to arbitration or mediation not later than 45 days after the claim is submitted to arbitration or mediation;
(c) Any settlement, award, judgment or other disposition of any action or claim described in paragraph (a) or (b) not later than 45 days after the settlement, award, judgment or other disposition, including, without limitation, any amount paid to resolve the claim; and
(d) Any sanctions imposed against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist that are reportable to the National Practitioner Data Bank not later than 45 days after the sanctions are imposed.
2. If the Board finds that a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist has violated any provision of this section, the Board may impose a fine of not more than $5,000 against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist for each violation, in addition to any other fines or penalties permitted by law.
3. All reports made by a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist pursuant to this section are public records.
κ2025 Statutes of Nevada, Page 1622 (CHAPTER 246, AB 319)κ
Sec. 48. NRS 630.3069 is hereby amended to read as follows:
630.3069 If the Board receives a report pursuant to the provisions of NRS 630.3067, 630.3068 or 690B.250 indicating that a judgment has been rendered or an award has been made against a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist regarding an action or claim for malpractice or that such an action or claim against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist has been resolved by settlement, the Board shall conduct an investigation to determine whether to impose disciplinary action against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist regarding the action or claim, unless the Board has already commenced or completed such an investigation regarding the action or claim before it receives the report.
Sec. 49. NRS 630.307 is hereby amended to read as follows:
630.307 1. Except as otherwise provided in subsection 2, any person may file with the Board a complaint against a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care on a form provided by the Board. The form may be submitted in writing or electronically. If a complaint is submitted anonymously, the Board may accept the complaint but may refuse to consider the complaint if the lack of the identity of the complainant makes processing the complaint impossible or unfair to the person who is the subject of the complaint.
2. Any licensee, medical school or medical facility that becomes aware that a person practicing medicine, perfusion or respiratory care or assisting in the practice of medicine in this State has, is or is about to become engaged in conduct which constitutes grounds for initiating disciplinary action shall file a written complaint with the Board within 30 days after becoming aware of the conduct.
3. Except as otherwise provided in subsection 4, any hospital, clinic or other medical facility licensed in this State, or medical society, shall report to the Board any change in the privileges of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to practice while the physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care is under investigation and the outcome of any disciplinary action taken by that facility or society against the physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care concerning the care of a patient or the competency of the physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care within 30 days after the change in privileges is made or disciplinary action is taken.
4. A hospital, clinic or other medical facility licensed in this State, or medical society, shall report to the Board within 5 days after a change in the privileges of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to practice that is based on:
(a) An investigation of the mental, medical or psychological competency of the physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care; or
(b) Suspected or alleged substance abuse in any form by the physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care.
κ2025 Statutes of Nevada, Page 1623 (CHAPTER 246, AB 319)κ
5. The Board shall report any failure to comply with subsection 3 or 4 by a hospital, clinic or other medical facility licensed in this State to the Division of Public and Behavioral Health of the Department of Health and Human Services. If, after a hearing, the Division of Public and Behavioral Health determines that any such facility or society failed to comply with the requirements of subsection 3 or 4, the Division may impose an administrative fine of not more than $10,000 against the facility or society for each such failure to report. If the administrative fine is not paid when due, the fine must be recovered in a civil action brought by the Attorney General on behalf of the Division.
6. The clerk of every court shall report to the Board any finding, judgment or other determination of the court that a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care:
(a) Is mentally ill;
(b) Is mentally incompetent;
(c) Has been convicted of a felony or any law governing controlled substances or dangerous drugs;
(d) Is guilty of abuse or fraud under any state or federal program providing medical assistance; or
(e) Is liable for damages for malpractice or negligence,
Κ within 45 days after such a finding, judgment or determination is made.
7. If the Board receives a report pursuant to subsection 5 of NRS 228.420, the Board must proceed as if a complaint had been filed against the licensee who is the subject of the report.
8. The Board shall retain all complaints filed with the Board pursuant to this section for at least 10 years, including, without limitation, any complaints not acted upon.
Sec. 50. NRS 630.309 is hereby amended to read as follows:
630.309 To institute a disciplinary action against a perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care, a written [complaint,] charging document, specifying the charges, must be filed with the Board by [:
1. The] the Board or a committee designated by the Board to investigate a complaint . [;
2. Any member of the Board; or
3. Any other person who is aware of any act or circumstance constituting a ground for disciplinary action set forth in the regulations adopted by the Board.]
Sec. 51. NRS 630.311 is hereby amended to read as follows:
630.311 1. Except as otherwise provided in NRS 630.323, a committee designated by the Board and consisting of members of the Board shall review each complaint received by the Board that is within the jurisdiction of the Board and conduct an investigation to determine if there is a reasonable basis for the complaint. The committee must be composed of at least three members of the Board, at least one of whom is not a physician. The committee may issue orders to aid its investigation including, but not limited to, compelling a physician to appear before the committee.
2. If, after conducting an investigation, the committee determines that there is a reasonable basis for the complaint and that a violation of any provision of this chapter has occurred, the committee may file a formal [complaint] charging document with the Board.
κ2025 Statutes of Nevada, Page 1624 (CHAPTER 246, AB 319)κ
3. The proceedings of the committee are confidential and are not subject to the requirements of NRS 241.020. Within 20 days after the conclusion of each meeting of the committee, the Board shall publish a summary setting forth the proceedings and determinations of the committee. The summary must not identify any person involved in the complaint that is the subject of the proceedings.
Sec. 52. NRS 630.318 is hereby amended to read as follows:
630.318 1. If the Board or any investigative committee of the Board has reason to believe that the conduct of any physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist has raised a reasonable question as to his or her competence to practice medicine, respiratory care or perfusion , [or] practice as a physician assistant [,] or assist in the practice of medicine, as applicable, with reasonable skill and safety to patients, or if the Board has received a report pursuant to the provisions of NRS 630.3067, 630.3068 or 690B.250 indicating that a judgment has been rendered or an award has been made against a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist regarding an action or claim for malpractice or that such an action or claim against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist has been resolved by settlement, the Board or committee may order that the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist undergo a mental or physical examination, an examination testing his or her competence to practice medicine, respiratory care or perfusion , [or] practice as a physician assistant [,] or assist in the practice of medicine, as applicable, or any other examination designated by the Board to assist the Board or committee in determining the fitness of the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist to practice medicine, respiratory care or perfusion , [or] practice as a physician assistant [,] or assist in the practice of medicine, as applicable.
2. For the purposes of this section:
(a) Every physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist who applies for a license or who is licensed under this chapter shall be deemed to have given consent to submit to a mental or physical examination or an examination testing his or her competence to practice medicine, respiratory care or perfusion , [or] practice as a physician assistant [,] or assist in the practice of medicine, as applicable, when ordered to do so in writing by the Board or an investigative committee of the Board.
(b) The testimony or reports of a person who conducts an examination of a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist on behalf of the Board or an investigative committee of the Board pursuant to this section are not privileged communications.
3. Except in extraordinary circumstances, as determined by the Board, the failure of a physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist licensed under this chapter to submit to an examination when directed as provided in this section constitutes [an] :
κ2025 Statutes of Nevada, Page 1625 (CHAPTER 246, AB 319)κ
(a) Grounds for the immediate suspension of the license of the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist pending further disciplinary proceedings; and
(b) An admission of the charges against the physician, physician assistant, anesthesiologist assistant, practitioner of respiratory care or perfusionist.
Sec. 53. NRS 630.323 is hereby amended to read as follows:
630.323 1. The Executive Director of the Board or his or her designee shall review and evaluate any complaint or information received from the Investigation Division of the Department of Public Safety or the State Board of Pharmacy, including, without limitation, information provided pursuant to NRS 453.164, or from a law enforcement agency, professional licensing board or any other source indicating that:
(a) A licensee has issued a fraudulent, illegal, unauthorized or otherwise inappropriate prescription for a controlled substance listed in schedule II, III or IV;
(b) A pattern of prescriptions issued by a licensee indicates that the licensee has issued prescriptions in the manner described in paragraph (a); or
(c) A patient of a licensee has acquired, used or possessed a controlled substance listed in schedule II, III or IV in a fraudulent, illegal, unauthorized or otherwise inappropriate manner.
2. If the Executive Director of the Board or his or her designee receives information described in subsection 1 concerning the licensee, the Executive Director or his or her designee must notify the licensee as soon as practicable after receiving the information.
3. A review and evaluation conducted pursuant to subsection 1 must include, without limitation:
(a) A review of relevant information contained in the database of the program established pursuant to NRS 453.162; and
(b) A request for additional relevant information from the licensee who is the subject of the review and evaluation.
4. If, after a review and evaluation conducted pursuant to subsection 1, the Executive Director or his or her designee determines that a licensee may have issued a fraudulent, illegal, unauthorized or otherwise inappropriate prescription for a controlled substance listed in schedule II, III or IV, the Board must proceed as if a written complaint had been filed against the licensee. If, after conducting an investigation and a hearing in accordance with the provisions of this chapter, the Board determines that the licensee issued a fraudulent, illegal, unauthorized or otherwise inappropriate prescription, the Board must impose appropriate disciplinary action.
5. When deemed appropriate, the Executive Director of the Board may:
(a) Refer information acquired during a review and evaluation conducted pursuant to subsection 1 to another professional licensing board, law enforcement agency or other appropriate governmental entity for investigation and criminal or administrative proceedings.
(b) Postpone any notification, review or part of such a review required by this section if he or she determines that it is necessary to avoid interfering with any pending administrative or criminal investigation into the suspected fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, dispensing or use of a controlled substance.
κ2025 Statutes of Nevada, Page 1626 (CHAPTER 246, AB 319)κ
6. The Board shall:
(a) Adopt regulations providing for disciplinary action against a licensee for inappropriately prescribing a controlled substance listed in schedule II, III or IV or violating the provisions of NRS 639.2391 to 639.23916, inclusive, and any regulations adopted by the State Board of Pharmacy pursuant thereto. Such disciplinary action must include, without limitation, requiring the licensee to complete additional continuing education concerning prescribing controlled substances listed in schedules II, III and IV.
(b) Develop and disseminate to each physician and physician assistant licensed pursuant to this chapter or make available on the Internet website of the Board an explanation or a technical advisory bulletin to inform those physicians and physician assistants of the requirements of this section and NRS [630.324,] 639.23507 and 639.2391 to 639.23916, inclusive, and any regulations adopted pursuant thereto. The Board shall update the explanation or bulletin as necessary to include any revisions to those provisions of law or regulations. The explanation or bulletin must include, without limitation, an explanation of the requirements that apply to specific controlled substances or categories of controlled substances.
Sec. 54. NRS 630.326 is hereby amended to read as follows:
630.326 1. If an investigation by the Board regarding a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care reasonably determines that the health, safety or welfare of the public or any patient served by the licensee is at risk of imminent or continued harm, the Board may :
(a) Summarily restrict the practice of the licensee, including, without limitation, restricting or suspending the ability of the licensee to prescribe and dispense controlled substances, practice in a specialty area, perform specific tasks or procedures or treat a specific population of patients pending the conclusion of a hearing to consider a formal charging document filed against the licensee; or
(b) In accordance with subsection 3 of NRS 233B.127, summarily suspend the license of the licensee pending the conclusion of a hearing to consider a formal [complaint] charging document against the licensee. The order of summary suspension may be issued only by the Board or an investigative committee of the Board.
2. [If the Board or an investigative committee of the Board issues an order summarily suspending the license of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care pursuant to subsection 1, the Board shall hold a hearing not later than 60 days after the date on which the order is issued, unless the Board and the licensee mutually agree to a longer period, to determine whether a reasonable basis exists to continue the suspension of the license pending the conclusion of a hearing to consider a formal complaint against the licensee. If no formal complaint against the licensee is pending before the Board on the date on which a hearing is held pursuant to this section, the Board shall reinstate the license of the licensee.
3.] If the Board or an investigative committee of the Board issues an order summarily suspending the license of a licensee or restricting the practice of a licensee pursuant to subsection 1 and the Board requires the licensee to submit to a mental or physical examination or an examination testing his or her competence to practice, the examination must be conducted and the results obtained not later than 30 days after the order is issued.
κ2025 Statutes of Nevada, Page 1627 (CHAPTER 246, AB 319)κ
Sec. 55. NRS 630.329 is hereby amended to read as follows:
630.329 If the Board issues an order summarily suspending the license of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care or summarily restricting the practice of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care pending proceedings for disciplinary action, [including, without limitation, a summary suspension pursuant to NRS 233B.127,] the court shall not stay that order.
Sec. 56. NRS 630.336 is hereby amended to read as follows:
630.336 1. Any deliberations conducted or vote taken by the Board or any investigative committee of the Board regarding its ordering of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care to undergo a physical or mental examination or any other examination designated to assist the Board or committee in determining the fitness of a physician, perfusionist, physician assistant, anesthesiologist assistant or practitioner of respiratory care are not subject to the requirements of NRS 241.020.
2. Except as otherwise provided in subsection 3 or 4, all applications for a license to practice medicine, perfusion or respiratory care, any charges filed by the Board, financial records of the Board, formal hearings on any charges heard by the Board or a panel selected by the Board, records of such hearings and any order or decision of the Board or panel must be open to the public.
3. Except as otherwise provided in NRS 239.0115, the following may be kept confidential:
(a) Any statement, evidence, credential or other proof submitted in support of or to verify the contents of an application;
(b) Any report concerning the fitness of any person to receive or hold a license to practice medicine, perfusion or respiratory care; and
(c) Any communication between:
(1) The Board and any of its committees or panels; and
(2) The Board or its staff, investigators, experts, committees, panels, hearing officers, advisory members or consultants and counsel for the Board.
4. Except as otherwise provided in subsection 5 and NRS 239.0115, a complaint filed with the Board pursuant to NRS 630.307, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to initiate disciplinary action are confidential.
5. The formal [complaint or other] charging document filed by the Board to initiate disciplinary action and all documents and information considered by the Board when determining whether to impose discipline are public records.
6. The Board shall, to the extent feasible, communicate or cooperate with or provide any documents or other information to any other licensing board or agency or any agency which is investigating a person, including a law enforcement agency. Such cooperation may include, without limitation, providing the board or agency with minutes of a closed meeting, [transcripts of oral examinations and] the results of [oral examinations.] any examination conducted pursuant to NRS 630.318, a copy of any such examination or any documents or transcripts relating to such an examination.
κ2025 Statutes of Nevada, Page 1628 (CHAPTER 246, AB 319)κ
7. To the extent practicable and authorized by a licensee, the Board may communicate with, cooperate with or provide any documents to the employer of a licensee or any other person or entity responsible for credentialing a licensee to provide health care on behalf of the person or entity.
Sec. 57. NRS 630.339 is hereby amended to read as follows:
630.339 1. If a committee designated by the Board to conduct an investigation of a complaint decides to proceed with disciplinary action, it shall bring charges against the licensee by filing a formal [complaint.] charging document. The formal [complaint] charging document must include a written statement setting forth the charges alleged and setting forth in concise and plain language each act or omission of the respondent upon which the charges are based. The formal [complaint] charging document must be prepared with sufficient clarity to ensure that the respondent is able to prepare a defense. The formal [complaint] charging document must specify any applicable law or regulation that the respondent is alleged to have violated. The formal [complaint] charging document may be signed by the chair of the investigative committee or the legal counsel for the Board.
2. The respondent may file an answer to the formal [complaint within 20 days after service of the complaint upon the respondent.] charging document pursuant to NRS 622A.320. An answer must state in concise and plain language the respondents defenses to each charge set forth in the [complaint] charging document and must admit or deny the averments stated in the [complaint.] charging document. If a party fails to file an answer within the time prescribed, the party shall be deemed to have denied generally the allegations of the formal [complaint] charging document and the Board or an investigative committee of the Board may proceed pursuant to this section in the same manner as if the answer were timely filed.
3. Within 20 days after the filing of an answer or 20 days after the date on which an answer is due, whichever is earlier, the parties shall hold an early case conference at which the parties and a hearing officer appointed by the Board or a member of the Board must preside. At the early case conference, the parties shall in good faith:
(a) Set the earliest possible hearing date agreeable to the parties and the hearing officer, panel of the Board or the Board, including the estimated duration of the hearing;
(b) Set dates:
(1) By which all documents must be exchanged;
(2) By which all prehearing motions and responses thereto must be filed;
(3) On which to hold the prehearing conference; and
(4) For any other foreseeable actions that may be required for the matter;
(c) Discuss or attempt to resolve all or any portion of the evidentiary or legal issues in the matter;
(d) Discuss the potential for settlement of the matter on terms agreeable to the parties; and
(e) Discuss and deliberate any other issues that may facilitate the timely and fair conduct of the matter.
4. [If the Board receives a report pursuant to subsection 5 of NRS 228.420, such a hearing must be held within 30 days after receiving the report.
κ2025 Statutes of Nevada, Page 1629 (CHAPTER 246, AB 319)κ
report. The Board shall notify the licensee of the charges brought against him or her, the time and place set for the hearing, and the possible sanctions authorized in NRS 630.352.
5.] A formal hearing must be held at the time and date set at the early case conference by:
(a) The Board;
(b) A hearing officer;
(c) A member of the Board designated by the Board or an investigative committee of the Board;
(d) A panel of members of the Board designated by an investigative committee of the Board or the Board;
(e) A hearing officer together with not more than one member of the Board designated by an investigative committee of the Board or the Board; or
(f) A hearing officer together with a panel of members of the Board designated by an investigative committee of the Board or the Board. If the hearing is before a panel, at least one member of the panel must not be a physician.
[6. At any hearing at which at least one member of the Board presides, whether in combination with a hearing officer or other members of the Board, the final determinations regarding credibility, weight of evidence and whether the charges have been proven must be made by the members of the Board. If a hearing officer presides together with one or more members of the Board, the hearing officer shall:
(a) Conduct the hearing;
(b) In consultation with each member of the Board, make rulings upon any objections raised at the hearing;
(c) In consultation with each member of the Board, make rulings concerning any motions made during or after the hearing; and
(d) Within 30 days after the conclusion of the hearing, prepare and file with the Board written findings of fact and conclusions of law in accordance with the determinations made by each member of the Board.]
Sec. 58. NRS 630.344 is hereby amended to read as follows:
630.344 1. Except as otherwise provided in subsection 2 [,] and chapter 622A of NRS, service of process under this chapter [must] :
(a) Must be made on a licensee personally, or by [registered or] certified mail [with return receipt requested] addressed to the licensee at his or her last known mailing address [. If personal service cannot be made and if notice by mail is returned undelivered, the President or Secretary-Treasurer of the Board shall cause notice to be published once a week for 4 consecutive weeks in a newspaper published in the county of the last known address of the licensee or, if no newspaper is published in that county, then in a newspaper widely distributed in that county.] , as indicated in the records of the Board.
(b) Shall be deemed complete:
(1) For personal service, on the date on which the process is delivered to the person; or
(2) For service by certified mail, on the date on which the process is mailed.
2. In lieu of the methods of service of process set forth in subsection 1, if the Board obtains written consent from the licensee, service of process under this chapter may be made by electronic mail on the licensee at an electronic mail address designated by the licensee in the written consent.
κ2025 Statutes of Nevada, Page 1630 (CHAPTER 246, AB 319)κ
electronic mail address designated by the licensee in the written consent. A licensee with a mailing address outside of the United States must consent to service of process by electronic mail.
3. Proof of service of process [or publication of notice made] in connection with a contested case under this chapter must be filed with the Board and may be recorded in the minutes of the Board [.] , if applicable.
4. As used in this section, contested case has the meaning ascribed to it in NRS 622A.020.
Sec. 59. NRS 630.352 is hereby amended to read as follows:
630.352 1. Any member of the Board, other than a member of an investigative committee of the Board who participated in any determination regarding a complaint or the filing of a formal [complaint] charging document in the matter or any member serving on a panel of the Board at the hearing of the matter, may participate in an adjudication to obtain the final order of the Board. At the adjudication, the Board shall consider any findings of fact and conclusions of law submitted after the hearing and shall allow:
(a) Counsel for the Board to present a disciplinary recommendation and argument in support of the disciplinary recommendation subject to the provisions of NRS 622A.200 and 622A.210; and
(b) The respondent or counsel of the respondent to present a disciplinary recommendation and argument in support of the disciplinary recommendation . [; and
(c) The complainant in the matter to make a statement to the Board regarding the disciplinary recommendations by the parties and to address the effect of the respondents conduct upon the complainant or the patient involved, if other than the complainant.]
Κ The Board may limit the time within which the parties [and the complainant] may make their arguments and statements.
2. At the conclusion of the presentations of the parties , [and the complainant,] the Board shall deliberate and may by a majority vote impose discipline based upon the findings of fact and conclusions of law and the presentations of the parties . [and the complainant.]
3. If, in the findings of fact and conclusions of law, the Board, hearing officer or panel of the Board determines that no violation has occurred, the Board shall dismiss the charges, in writing, and notify the respondent that the charges have been dismissed.
4. Except as otherwise provided in subsection 5, if the Board finds that a violation has occurred, it shall by order take one or more of the following actions:
(a) Place the person on probation for a specified period on any of the conditions specified in the order;
(b) Administer a written public reprimand to the person;
(c) Limit the persons practice or exclude one or more specified branches of medicine from his or her practice;
(d) Suspend the persons license for a specified period or until further order of the Board;
(e) Revoke the persons license;
(f) Require the person to participate in a program to correct an alcohol or other substance use disorder or any other impairment;
(g) Require supervision of the persons practice;
(h) Impose a fine not to exceed $10,000 for each violation;
κ2025 Statutes of Nevada, Page 1631 (CHAPTER 246, AB 319)κ
(i) Require the person to perform community service without compensation;
(j) Require the person to take a physical or mental examination or an examination testing his or her competence; and
(k) Require the person to fulfill certain training or educational requirements.
5. If the Board finds that the respondent has violated the provisions of NRS 439B.425, the Board shall suspend the respondents license for a specified period or until further order of the Board.
6. The Board shall not administer a private reprimand if the Board finds that a violation has occurred.
7. Within 30 days after the conclusion of the adjudication by the Board, the Board shall issue a final order, certified by the Secretary-Treasurer of the Board, that imposes discipline and incorporates the findings of fact and conclusions of law obtained from the hearing. An order that imposes discipline and the findings of fact and conclusions of law supporting that order are public records.
Sec. 60. NRS 630.355 is hereby amended to read as follows:
630.355 1. If the respondent or a [person,] witness in a proceeding before the Board, a hearing officer or a panel of the Board:
(a) Disobeys or resists a lawful order;
(b) Refuses to take an oath or affirmation as a witness;
(c) Refuses to be examined; or
(d) Engages in conduct during a hearing or so near the place thereof as to obstruct the proceeding,
Κ the Board, hearing officer or panel may certify the facts to the district court of the county in which the proceeding is being conducted. Such a certification operates as a stay of all related disciplinary proceedings. The court shall issue an order directing the [person] respondent or witness, as applicable, to appear before the court and show cause why he or she should not be held in contempt.
2. A copy of the statement of the Board, hearing officer or panel, and the order of the district court issued pursuant to subsection 1, must be served on the [person.] respondent or witness, as applicable. Thereafter, the court has jurisdiction of the matter.
3. The same proceedings must be had, the same penalties may be imposed and the [person] respondent or witness, as applicable, may purge himself or herself of the contempt in the same way as in the case of a person who has committed a contempt in the trial of a civil action.
Sec. 61. NRS 630.356 is hereby amended to read as follows:
630.356 1. Any person aggrieved by a final order of the Board is entitled to judicial review of the Boards order.
2. Every order that imposes a sanction against a licensee pursuant to subsection 4 or 5 of NRS 630.352 or any regulation of the Board is effective from the date the Secretary-Treasurer certifies the order until the date the order is modified or reversed by a final judgment of the court. [The court shall not stay the order of the Board pending a final determination by the court.]
3. The district court shall give a petition for judicial review of the Boards order priority over other civil matters which are not expressly given priority by law.
κ2025 Statutes of Nevada, Page 1632 (CHAPTER 246, AB 319)κ
Sec. 62. NRS 630.358 is hereby amended to read as follows:
630.358 1. Any person:
(a) Whose practice of medicine, perfusion or respiratory care has been limited; or
(b) Whose license to practice medicine, perfusion or respiratory care has been [:
(1) Suspended] suspended until further order [; or
(2) Revoked,
Κ by an order] of the Board,
Κ may [apply to] petition the Board for removal of the limitation or [restoration of the license.] suspension.
2. In hearing [the application,] a petition received pursuant to subsection 1, the Board:
(a) May require the person to submit to a mental or physical examination or an examination testing his or her competence to practice [medicine, perfusion or respiratory care by physicians, perfusionists or practitioners] as a physician, physician assistant, anesthesiologist assistant, perfusionist or practitioner of respiratory care, as appropriate, or other examinations it designates and submit such other evidence of changed conditions and of fitness as it deems proper;
(b) Shall determine whether under all the circumstances the time of the [application] petition is reasonable; and
(c) May deny the [application] petition or modify or rescind its order as it deems the evidence and the public safety warrants.
3. The licensee has the burden of proving by clear and convincing evidence that the requirements for [restoration of the license or] removal of the limitation or suspension have been met.
4. The Board shall not [restore a license] remove a limitation or suspension unless it is satisfied that the person has complied with all of the terms and conditions set forth in the final order of the Board and that the person is capable of practicing [medicine, perfusion or respiratory care] as a physician, physician assistant, anesthesiologist assistant, perfusionist or practitioner of respiratory care, as appropriate, in a safe manner.
5. To restore a license that has been revoked by the Board, [the applicant] a person must apply for a license and [take an examination] meet all of the requirements for the issuance of the license at the time of the application as though the applicant had never been licensed under this chapter.
Sec. 63. NRS 630.364 is hereby amended to read as follows:
630.364 1. Any person or organization who furnishes information concerning an applicant for a license or a licensee in good faith in accordance with the provisions of this chapter is immune from any civil action for furnishing that information.
2. The Board and any of its members and its staff, counsel, investigators, experts, peer reviewers, committees, panels, hearing officers, consultants and the employees or volunteers of a diversion program are immune from any civil liability for:
(a) Any decision or action taken in good faith in response to information acquired by the Board.
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(b) Disseminating information concerning an applicant for a license or a licensee to other boards or agencies of the State, the Attorney General, any hospitals, medical societies, insurers, employers, patients and their families or any law enforcement agency.
3. Except as otherwise provided in subsection 4, the Board shall not commence an investigation, impose any disciplinary action or take any other adverse action against a [physician] licensee for:
(a) Disclosing to a governmental entity in good faith a violation of any law, rule or regulation by an applicant for a license [to practice medicine] or by a [physician;] licensee; or
(b) Cooperating in good faith with a governmental entity that is conducting an investigation, hearing or inquiry into such a violation, including, without limitation, providing testimony concerning the violation.
4. A [physician] licensee who discloses information to or cooperates with a governmental entity pursuant to subsection 3 with respect to the violation of any law, rule or regulation by the [physician] licensee is subject to investigation and any other administrative or disciplinary action by the Board under the provisions of this chapter for such violation.
5. As used in this section:
(a) Diversion program means a program approved by the Board to correct a licensees alcohol or other substance use disorder or any other impairment.
(b) Governmental entity includes, without limitation:
(1) A federal, state or local officer, employee, agency, department, division, bureau, board, commission, council, authority or other subdivision or entity of a public employer;
(2) A federal, state or local employee, committee, member or commission of the Legislative Branch of Government;
(3) A federal, state or local representative, member or employee of a legislative body or a county, town, village or any other political subdivision or civil division of the State;
(4) A federal, state or local law enforcement agency or prosecutorial office, or any member or employee thereof, or police or peace officer; and
(5) A federal, state or local judiciary, or any member or employee thereof, or grand or petit jury.
Sec. 64. NRS 630.371 is hereby amended to read as follows:
630.371 Laser surgery or intense pulsed light therapy on the globe of the eye of a patient may be performed only by a licensed physician who has completed a program of progressive postgraduate education in ophthalmology as a resident in the United States or [Canada] an equivalent foreign country in a program approved by the Board, the Accreditation Council for Graduate Medical Education , or [the Council on Medical Education of the Canadian Medical Association.] its successor organization, or an organization that accredits graduate medical education in an equivalent foreign country and is nationally recognized in that country.
Sec. 65. NRS 630.373 is hereby amended to read as follows:
630.373 1. [A] Except as otherwise provided in subsection 2, a physician , physician assistant or anesthesiologist assistant shall not administer or supervise directly the administration of general anesthesia, tumescent anesthesia, conscious sedation or deep sedation to patients unless the general anesthesia, tumescent anesthesia, conscious sedation or deep sedation is administered:
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tumescent anesthesia, conscious sedation or deep sedation to patients unless the general anesthesia, tumescent anesthesia, conscious sedation or deep sedation is administered:
(a) In an office of a physician or osteopathic physician which holds a permit pursuant to NRS 449.435 to 449.448, inclusive;
(b) In a facility which holds a permit pursuant to NRS 449.435 to 449.448, inclusive;
(c) In a medical facility as that term is defined in NRS 449.0151; or
(d) Outside of this State.
2. The Board may adopt regulations that authorize a physician, physician assistant or anesthesiologist assistant to administer or supervise directly the administration of tumescent anesthesia in a location that does not meet the requirements of subsection 1.
3. As used in this section:
(a) Conscious sedation has the meaning ascribed to it in NRS 449.436.
(b) Deep sedation has the meaning ascribed to it in NRS 449.437.
(c) General anesthesia has the meaning ascribed to it in NRS 449.438.
(d) Tumescent anesthesia means local anesthesia caused by the subcutaneous injection of a dilute mixture that includes, without limitation, local anesthetic and epinephrine.
Sec. 66. Chapter 632 of NRS is hereby amended by adding thereto the provisions set forth as sections 67 and 68 of this act.
Sec. 67. 1. Medical assistant means a person who:
(a) Performs clinical tasks under the supervision of a registered nurse, including, without limitation, an advanced practice registered nurse; and
(b) Does not hold a license, certificate or registration issued by a professional licensing or regulatory board in this State to perform such clinical tasks.
2. The term does not include a person who performs only administrative, clerical, executive or other nonclinical tasks.
Sec. 68. Each time an advanced practice registered nurse performs a routine physical examination of a person who is at least 12 years of age but not more than 18 years of age, the advanced practice registered nurse shall ask the person the questions prescribed in the Medical History Form and the Physical Examination Form of the Preparticipation Physical Evaluation Form developed jointly by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Sports Medicine, the American Medical Society for Sports Medicine, the American Orthopaedic Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine, or any successor form.
Sec. 69. NRS 632.010 is hereby amended to read as follows:
632.010 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 632.011 to 632.0195, inclusive, and section 67 of this act have the meanings ascribed to them in those sections.
Sec. 70. NRS 632.120 is hereby amended to read as follows:
632.120 1. The Board shall:
(a) Adopt regulations establishing reasonable standards:
(1) For the denial, renewal, suspension and revocation of, and the placement of conditions, limitations and restrictions upon, a license to practice professional or practical nursing or a certificate to practice as a nursing assistant or medication aide - certified.
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(2) Of professional conduct for the practice of nursing.
(3) For prescribing and dispensing controlled substances and dangerous drugs in accordance with applicable statutes.
(4) For the psychiatric training and experience necessary for an advanced practice registered nurse to be authorized to make the diagnoses, evaluations and examinations described in NRS 432B.6078, 432B.60816, 433A.162, 433A.240, 433A.335, 433A.390, 433A.430, 484C.300 and 484C.320 to 484C.350, inclusive, the certifications described in NRS 432B.6075, 432B.60814, 433A.170, 433A.195 and 433A.200 and the sworn statements or declarations described in NRS 433A.210 and 433A.335.
(b) Prepare and administer examinations for the issuance of a license or certificate under this chapter.
(c) Investigate and determine the eligibility of an applicant for a license or certificate under this chapter.
(d) Carry out and enforce the provisions of this chapter and the regulations adopted pursuant thereto.
(e) Develop and disseminate annually to each registered nurse who cares for children information concerning the signs and symptoms of pediatric cancer.
2. The Board may adopt regulations establishing reasonable:
(a) Qualifications for the issuance of a license or certificate under this chapter.
(b) Standards for the continuing professional competence of licensees or holders of a certificate. The Board may evaluate licensees or holders of a certificate periodically for compliance with those standards.
(c) Requirements governing the supervision of a medical assistant, including, without limitation, regulations which prescribe limitations on the possession and administration of a dangerous drug by a medical assistant.
3. The Board may adopt regulations establishing a schedule of reasonable fees and charges, in addition to those set forth in NRS 632.345, for:
(a) Investigating licensees or holders of a certificate and applicants for a license or certificate under this chapter;
(b) Evaluating the professional competence of licensees or holders of a certificate;
(c) Conducting hearings pursuant to this chapter;
(d) Duplicating and verifying records of the Board; and
(e) Surveying, evaluating and approving schools of practical nursing, and schools and courses of professional nursing,
Κ and collect the fees established pursuant to this subsection.
4. For the purposes of this chapter, the Board shall, by regulation, define the term in the process of obtaining accreditation.
5. The Board may adopt such other regulations, not inconsistent with state or federal law, as may be necessary to carry out the provisions of this chapter relating to nursing assistant trainees, nursing assistants and medication aides - certified.
6. The Board may adopt such other regulations, not inconsistent with state or federal law, as are necessary to enable it to administer the provisions of this chapter.
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Sec. 70.5. NRS 632.2397 is hereby amended to read as follows:
632.2397 1. A certified registered nurse anesthetist may:
(a) Under the supervision of a physician licensed pursuant to chapter 630 or 633 of NRS, order, prescribe, possess and administer controlled substances, poisons, dangerous drugs and devices to treat a patient under the care of a licensed physician in a critical access hospital or a hospital located in a city whose population is less than 25,000 in preparation for surgery or childbirth, during surgery or childbirth and while a patient recovers from surgery or childbirth.
(b) Possess and administer controlled substances, poisons, dangerous drugs and devices in other circumstances under which a registered nurse is authorized to possess and administer controlled substances, poisons, dangerous drugs and devices.
2. A certified registered nurse anesthetist shall not order or prescribe a controlled substance, poison, dangerous drug or device except as authorized by paragraph (a) of subsection 1.
3. As used in this section, critical access hospital means a hospital which has been certified as a critical access hospital by the Secretary of Health and Human Services pursuant to 42 U.S.C. 1395i-4(e).
Sec. 71. NRS 632.347 is hereby amended to read as follows:
632.347 1. The Board may deny, revoke or suspend any license or certificate applied for or issued pursuant to this chapter, or take other disciplinary action against a licensee or holder of a certificate, upon determining that the licensee or certificate holder:
(a) Is guilty of fraud or deceit in procuring or attempting to procure a license or certificate pursuant to this chapter.
(b) Is guilty of any offense:
(1) Involving moral turpitude; or
(2) Related to the qualifications, functions or duties of a licensee or holder of a certificate,
Κ in which case the record of conviction is conclusive evidence thereof.
(c) Has been convicted of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive.
(d) Is unfit or incompetent by reason of gross negligence or recklessness in carrying out usual nursing functions.
(e) Uses any controlled substance, dangerous drug as defined in chapter 454 of NRS, or intoxicating liquor to an extent or in a manner which is dangerous or injurious to any other person or which impairs his or her ability to conduct the practice authorized by the license or certificate.
(f) Is a person with mental incompetence.
(g) Is guilty of unprofessional conduct, which includes, but is not limited to, the following:
(1) Conviction of practicing medicine without a license in violation of chapter 630 of NRS, in which case the record of conviction is conclusive evidence thereof.
(2) Impersonating any applicant or acting as proxy for an applicant in any examination required pursuant to this chapter for the issuance of a license or certificate.
(3) Impersonating another licensed practitioner or holder of a certificate.
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(4) Permitting or allowing another person to use his or her license or certificate to practice as a licensed practical nurse, registered nurse, nursing assistant or medication aide - certified.
(5) Repeated malpractice, which may be evidenced by claims of malpractice settled against the licensee or certificate holder.
(6) Physical, verbal or psychological abuse of a patient.
(7) Conviction for the use or unlawful possession of a controlled substance or dangerous drug as defined in chapter 454 of NRS.
(h) Has willfully or repeatedly violated the provisions of this chapter. The voluntary surrender of a license or certificate issued pursuant to this chapter is prima facie evidence that the licensee or certificate holder has committed or expects to commit a violation of this chapter.
(i) Is guilty of aiding or abetting any person in a violation of this chapter.
(j) Has falsified an entry on a patients medical chart concerning a controlled substance.
(k) Has falsified information which was given to a physician, pharmacist, podiatric physician or dentist to obtain a controlled substance.
(l) Has knowingly procured or administered a controlled substance or a dangerous drug as defined in chapter 454 of NRS that is not approved by the United States Food and Drug Administration, unless the unapproved controlled substance or dangerous drug:
(1) Was procured through a retail pharmacy licensed pursuant to chapter 639 of NRS;
(2) Was procured through a Canadian pharmacy which is licensed pursuant to chapter 639 of NRS and which has been recommended by the State Board of Pharmacy pursuant to subsection 4 of NRS 639.2328;
(3) Is cannabis being used for medical purposes in accordance with chapter 678C of NRS; or
(4) Is an individualized investigational treatment or investigational drug or biological product prescribed to a patient pursuant to NRS 630.3735 or 633.6945.
(m) Has been disciplined in another state in connection with a license to practice nursing or a certificate to practice as a nursing assistant or medication aide - certified, or has committed an act in another state which would constitute a violation of this chapter.
(n) Has engaged in conduct likely to deceive, defraud or endanger a patient or the general public.
(o) Has willfully failed to comply with a regulation, subpoena or order of the Board.
(p) Has operated a medical facility at any time during which:
(1) The license of the facility was suspended or revoked; or
(2) An act or omission occurred which resulted in the suspension or revocation of the license pursuant to NRS 449.160.
Κ This paragraph applies to an owner or other principal responsible for the operation of the facility.
(q) Is an advanced practice registered nurse who has failed to obtain any training required by the Board pursuant to NRS 632.2375.
(r) Is an advanced practice registered nurse who has failed to comply with the provisions of NRS 453.163, 453.164, 453.226, 639.23507, 639.23535 and 639.2391 to 639.23916, inclusive, and any regulations adopted by the State Board of Pharmacy pursuant thereto.
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(s) Has engaged in the fraudulent, illegal, unauthorized or otherwise inappropriate prescribing, administering or dispensing of a controlled substance listed in schedule II, III or IV.
(t) Has violated the provisions of NRS 454.217 or 629.086.
(u) Has performed or supervised the performance of a pelvic examination in violation of NRS 629.085.
(v) Has failed to comply with the provisions of NRS 441A.315 or any regulations adopted pursuant thereto.
(w) Has failed to supervise adequately a medical assistant pursuant to the regulations of the Board.
2. For the purposes of this section, a plea or verdict of guilty or guilty but mentally ill or a plea of nolo contendere constitutes a conviction of an offense. The Board may take disciplinary action pending the appeal of a conviction.
3. A licensee or certificate holder is not subject to disciplinary action solely for administering auto-injectable epinephrine pursuant to a valid order issued pursuant to NRS 630.374 or 633.707.
4. As used in this section:
(a) Individualized investigational treatment has the meaning ascribed to it in NRS 454.690.
(b) Investigational drug or biological product has the meaning ascribed to it in NRS 454.351.
Sec. 72. Chapter 633 of NRS is hereby amended by adding thereto a new section to read as follows:
Each time an osteopathic physician or physician assistant performs a routine physical examination of a person who is at least 12 years of age but not more than 18 years of age, the physician or physician assistant shall ask the person the questions prescribed in the Medical History Form and the Physical Examination Form of the Preparticipation Physical Evaluation Form developed jointly by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Sports Medicine, the American Medical Society for Sports Medicine, the American Orthopaedic Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine, or any successor form.
Sec. 73. NRS 633.2815 is hereby amended to read as follows:
633.2815 1. On or before the last day of each quarter, the Board shall provide the Board of Medical Examiners a list of all anesthesiologist assistants licensed by the Board.
2. The Board and the Board of Medical Examiners shall share information as necessary to enforce the provisions of NRS 630.26835, 630.2684, 630.26845 and 633.4256.
Sec. 74. NRS 633.2815 is hereby amended to read as follows:
633.2815 1. On or before the last day of each quarter, the Board shall provide the Board of Medical Examiners a list of all anesthesiologist assistants licensed by the Board.
2. The Board and the Board of Medical Examiners shall share information as necessary to enforce the provisions of NRS 630.26835, 630.2684, 630.26845, 633.4256, 633.4258 and 633.426.
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Sec. 75. NRS 633.282 is hereby amended to read as follows:
633.282 1. On or before the last day of each quarter, the Board shall provide to the Board of Medical Examiners a list of all physician assistants licensed by the Board.
2. The Board and the Board of Medical Examiners shall share information as necessary to enforce the provisions of NRS 630.2677, 630.2735, 630.2755, 633.4332, 633.438, 633.4718.
Sec. 76. NRS 633.4256 is hereby amended to read as follows:
633.4256 1. A person applying for a license to practice as an anesthesiologist assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS;
[2.] (b) Apply for a license to practice as an anesthesiologist assistant to:
[(a)] (1) The Board pursuant to this chapter; and
[(b)] (2) The Board of Medical Examiners pursuant to chapter 630 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501; and
[(b)] (2) The fee for application for and issuance of a simultaneous license as an anesthesiologist assistant established pursuant to NRS 630.268.
2. If a person who applies for an anesthesiologist assistant license pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS and pays the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501 and the person does not pay the fee for application for and issuance of a simultaneous license as an anesthesiologist assistant established pursuant to NRS 630.268 within 1 year after the issuance of his or her license pursuant to this chapter:
(a) The State Board of Osteopathic Medicine shall notify the person that he or she is required to pay to the Board the difference between:
(1) The application and initial license fee for an anesthesiologist assistant established pursuant to NRS 633.501; and
(2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 633.501; and
(b) The person shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 77. NRS 633.4258 is hereby amended to read as follows:
633.4258 1. A person applying to renew an anesthesiologist assistant license pursuant to the provisions of this chapter who wishes to hold a simultaneous anesthesiologist assistant license pursuant to the provisions of chapter 630 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS;
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[2.] (b) Apply:
[(a)] (1) To renew an anesthesiologist assistant license to the Board pursuant to this chapter; and
[(b)] (2) For an anesthesiologist assistant license to the Board of Medical Examiners pursuant to chapter 630 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for [initial] biennial simultaneous renewal of an anesthesiologist assistant license [as an anesthesiologist assistant] established pursuant to NRS 633.501; and
[(b)] (2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 630.268.
2. If an applicant to renew an anesthesiologist assistant license pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS and pays the fee for biennial simultaneous renewal of an anesthesiologist assistant license established pursuant to NRS 633.501 but does not pay the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 630.268 within 1 year after the renewal of his or her license pursuant to this chapter:
(a) The State Board of Osteopathic Medicine shall notify the anesthesiologist assistant that he or she is required to pay to the Board the difference between:
(1) The fee for biennial renewal of an anesthesiologist assistant license established pursuant to NRS 633.501; and
(2) The fee for biennial simultaneous renewal of an anesthesiologist assistant license established pursuant to NRS 633.501; and
(b) The anesthesiologist assistant shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 78. NRS 633.426 is hereby amended to read as follows:
633.426 1. If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license as an anesthesiologist assistant pursuant to the provisions of chapter 630 of NRS, the person must:
[1.] (a) Apply for an anesthesiologist assistant license to the Board of Medical Examiners pursuant to chapter 630 of NRS; and
[2.] (b) Pay all applicable fees, including, without limitation:
[(a)] (1) The fee for biennial simultaneous [registration] renewal of an anesthesiologist assistant license established pursuant to NRS 633.501; and
[(b)] (2) The application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 630.268.
2. If a person licensed as an anesthesiologist assistant pursuant to the provisions of this chapter pays the fee for biennial simultaneous renewal of an anesthesiologist assistant license established pursuant to NRS 633.501 in accordance with subparagraph (1) of paragraph (b) of subsection 1 but does not pay the application and initial simultaneous license fee for an anesthesiologist assistant established pursuant to NRS 630.268 within 1 year after the next time the person renews his or her license pursuant to this chapter:
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(a) The State Board of Osteopathic Medicine shall notify the anesthesiologist assistant that he or she is required to pay to the Board the difference between:
(1) The fee for biennial renewal of an anesthesiologist assistant license established pursuant to NRS 633.501; and
(2) The fee for biennial simultaneous renewal of an anesthesiologist assistant license established pursuant to NRS 633.501; and
(b) The anesthesiologist assistant shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 79. NRS 633.4332 is hereby amended to read as follows:
633.4332 1. A person applying for a license to practice as a physician assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS;
[2.] (b) Apply for a license to practice as a physician assistant to:
[(a)] (1) The Board pursuant to this chapter; and
[(b)] (2) The Board of Medical Examiners pursuant to chapter 630 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501; and
[(b)] (2) The fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268.
2. If a person who applies for a license to practice as a physician assistant pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS and pays the application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501 but does not pay the fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268 within 1 year after the issuance of his or her license pursuant to this chapter:
(a) The State Board of Osteopathic Medicine shall notify the person that he or she is required to pay to the Board the difference between:
(1) The application and initial license fee for a physician assistant established pursuant to NRS 633.501; and
(2) The application and initial simultaneous license fee for a physician assistant established pursuant to NRS 633.501; and
(b) The person shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 80. NRS 633.438 is hereby amended to read as follows:
633.438 1. If a person licensed to practice as a physician assistant pursuant to the provisions of this chapter is not applying to renew his or her license and wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS, the person must:
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[1.] (a) Apply for a license to practice as a physician assistant to the Board of Medical Examiners pursuant to chapter 630 of NRS; and
[2.] (b) Pay all applicable fees, including, without limitation:
[(a)] (1) The annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501; and
[(b)] (2) The fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268.
2. If a person licensed as a physician assistant pursuant to the provisions of this chapter pays the annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501 in accordance with subparagraph (1) of paragraph (b) of subsection 1 but does not pay the fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268 within 1 year after the next time the person renews his or her license pursuant to this chapter:
(a) The State Board of Osteopathic Medicine shall notify the person that he or she is required to pay to the Board the difference between:
(1) The annual registration fee for a physician assistant established pursuant to NRS 633.501; and
(2) The annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501; and
(b) The person shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 81. NRS 633.4718 is hereby amended to read as follows:
633.4718 1. A person applying to renew a license to practice as a physician assistant pursuant to the provisions of this chapter who wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS must:
[1.] (a) Indicate in the application that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS;
[2.] (b) Apply:
[(a)] (1) To renew a license to practice as a physician assistant to the Board pursuant to this chapter; and
[(b)] (2) For a license to practice as a physician assistant to the Board of Medical Examiners pursuant to chapter 630 of NRS; and
[3.] (c) Pay all applicable fees, including, without limitation:
[(a)] (1) The annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501; and
[(b)] (2) The fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268.
2. If an applicant to renew a license to practice as a physician assistant pursuant to the provisions of this chapter indicates that he or she wishes to hold a simultaneous license to practice as a physician assistant pursuant to the provisions of chapter 630 of NRS and pays the annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501 but does not pay the fee for application for and issuance of a simultaneous license as a physician assistant established pursuant to NRS 630.268 within 1 year after the renewal of his or her license pursuant to this chapter:
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(a) The State Board of Osteopathic Medicine shall notify the physician assistant that he or she is required to pay to the Board the difference between:
(1) The annual registration fee for a physician assistant established pursuant to NRS 633.501; and
(2) The annual simultaneous registration fee for a physician assistant established pursuant to NRS 633.501; and
(b) The physician assistant shall pay to the State Board of Osteopathic Medicine the amount required by paragraph (a) not later than 30 days after the date of the notice provided pursuant to paragraph (a).
Sec. 82. NRS 652.210 is hereby amended to read as follows:
652.210 1. Except as otherwise provided in [subsection] subsections 2 and 3 and NRS 126.121 and 652.186, no person other than a licensed physician, a licensed optometrist, a licensed practical nurse, a registered nurse, a perfusionist, a physician assistant licensed pursuant to chapter 630 or 633 of NRS, a certified advanced emergency medical technician, a certified paramedic, a practitioner of respiratory care licensed pursuant to chapter 630 of NRS, a licensed anesthesiologist assistant, a licensed dentist or a registered pharmacist may manipulate a person for the collection of specimens. [The] Except as otherwise provided in subsection 2, the persons described in this subsection may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations without obtaining certification as an assistant in a medical laboratory pursuant to NRS 652.127.
2. In addition to the laboratory tests authorized by subsection 1, a practitioner of respiratory care licensed pursuant to chapter 630 of NRS may perform any laboratory test which is classified as a waived test pursuant to Subpart A of Part 493 of Title 42 of the Code of Federal Regulations without obtaining certification as an assistant in a medical laboratory pursuant to NRS 652.127 if:
(a) The practitioner of respiratory care has been properly trained to perform the test; and
(b) Performing the test is within the scope of practice of a practitioner of respiratory care.
3. The technical personnel of a laboratory may collect blood, remove stomach contents, perform certain diagnostic skin tests or field blood tests or collect material for smears and cultures.
Sec. 83. 1. A special license or a restricted license issued pursuant to NRS 630.261 expires on January 1, 2026.
2. A special purpose license issued pursuant to NRS 630.261 before January 1, 2026, shall be deemed equivalent to a telemedicine license issued pursuant to NRS 630.261, as amended by section 25 of this act, on or after January 1, 2026.
3. The amendatory provisions of sections 29, 31, 32, 33, 38 and 42 of this act apply to any person who has indicated to the Board of Medical Examiners that he or she intends to apply to the State Board of Osteopathic Medicine for a simultaneous license as a physician assistant or anesthesiologist assistant, as applicable, before, on or after January 1, 2026.
4. The amendatory provisions of sections 76, 79, 80 and 81 of this act apply to any person who has indicated to the State Board of Osteopathic Medicine that he or she intends to apply to the Board of Medical Examiners for a simultaneous license as a physician assistant or anesthesiologist assistant, as applicable, before, on or after January 1, 2026.
κ2025 Statutes of Nevada, Page 1644 (CHAPTER 246, AB 319)κ
Medicine that he or she intends to apply to the Board of Medical Examiners for a simultaneous license as a physician assistant or anesthesiologist assistant, as applicable, before, on or after January 1, 2026.
5. Notwithstanding the amendatory provisions of section 65 of this act, a physician, physician assistant or anesthesiologist assistant who is administering or supervising directly the administration of tumescent anesthesia in a location not authorized by NRS 630.373, as amended by section 65 of this act, on January 1, 2026, may continue to administer or supervise directly the administration of tumescent anesthesia in such a location until July 1, 2026.
Sec. 84. NRS 630.1606, 630.2692, 630.2693 and 630.324 are hereby repealed.
Sec. 85. 1. This section and section 70.5 of this act become effective upon passage and approval.
2. Sections 1 to 70, inclusive, 71, 72, 75, 76 and 79 to 84, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
3. Section 73 of this act becomes effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes,
Κ if and only if no bill is enacted by the Legislature and approved by the Governor this session to authorize the State Board of Osteopathic Medicine to charge fees for the renewal and simultaneous renewal of a license as an anesthesiologist assistant.
4. Sections 74, 77 and 78 of this bill become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes,
Κ if and only if a bill is enacted by the Legislature and approved by the Governor this session to authorize the State Board of Osteopathic Medicine to charge fees for the renewal and simultaneous renewal of a license as an anesthesiologist assistant.
________
κ2025 Statutes of Nevada, Page 1645κ
Assembly Bill No. 343Assemblymember Yeager
CHAPTER 247
[Approved: June 3, 2025]
AN ACT relating to health care; requiring hospitals to publish certain information relating to the pricing of goods and services; prohibiting a hospital from collecting medical debt that accrued while the hospital was out of compliance with that requirement; prescribing a procedure for the correction of violations of that requirement; authorizing certain investigations, civil actions and the imposition of certain administrative sanctions; providing for the publication of certain information relating to violations; requiring certain health care entities to provide certain information before taking any action to collect a medical debt; providing a penalty; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing federal regulations require a hospital to publish: (1) a list of standard charges for all items and services provided by the hospital; and (2) a consumer-friendly list of standard charges for a limited set of shoppable services, which are services provided by a hospital that can be scheduled by a consumer in advance. (45 C.F.R. §§ 180.20, 180.40-180.60) Sections 13-15 of this bill codify similar requirements into Nevada law. Specifically, section 13 requires a hospital to compile, publish and update annually a list of standard charges for all items and services provided by the hospital. Section 14 requires a hospital to maintain an online price-estimator tool or compile, publish and update annually: (1) a list of shoppable services provided by the hospital; and (2) a list of the shoppable services that appear on a list of certain shoppable services specified by the Federal Government and that the hospital does not provide. Section 15 requires a hospital to publish the most current version of each list required by sections 13 and 14 on the most prominent publicly available Internet website maintained by the hospital. Section 15 prescribes certain requirements governing the manner in which those lists must be published. Section 16 of this bill requires a hospital to annually report to the Department of Health and Human Services concerning facility fees for outpatient services provided in off-campus facilities. Section 16 requires the Department to publish those reports on a publicly available Internet website.
Section 17 of this bill prohibits a hospital from taking certain actions to collect a medical debt for goods or services provided to a patient while the hospital is not in compliance with the requirements of sections 13-15 or the corresponding federal requirements. Section 17 provides that such prohibited actions, when taken knowingly, constitute deceptive trade practices, thereby subjecting a hospital that commits such a violation to the civil and criminal penalties that may be imposed for deceptive trade practices generally. (Chapter 598 of NRS) Section 17 also authorizes a medical debtor who is aggrieved by such a prohibited action to file a claim with the Bureau of Consumer Protection in the Office of the Attorney General. Section 24.5 of this bill requires the Governors Consumer Health Advocate to assist patients with the filing of such claims. If the Bureau determines that a hospital has taken an action prohibited by section 17 to collect a medical debt, section 17 requires the hospital to cancel the debt and refund any portion of the debt that has been paid.
κ2025 Statutes of Nevada, Page 1646 (CHAPTER 247, AB 343)κ
Sections 18-21 of this bill provide for the administrative enforcement of sections 2-21. Specifically, section 18: (1) authorizes any person or entity to file a complaint against a hospital that fails to comply with sections 2-21; and (2) requires the Department to monitor the compliance of hospitals with sections 2-21. Section 19 prescribes a procedure for the correction of a violation of sections 2-21, and section 20 requires the Department to impose administrative penalties against a hospital that commits such a violation. Section 21 provides for the publication of certain documents relating to violations of sections 2-21. Sections 21 and 25 of this bill provide that a complaint alleging such a violation and certain initial investigatory documents are confidential.
Section 22 of this bill requires certain health care entities, before taking any action to collect a medical debt, to provide: (1) the patient with an itemized statement of the medical debt and certain other information; and (2) the medical debtor with a receipt for each payment made on the debt. Section 22 authorizes a patient or medical debtor who is aggrieved by a violation of those requirements to file a claim with the Bureau of Consumer Protection in the Office of the Attorney General. Section 24.5 requires the Governors Consumer Health Advocate to assist patients with the filing of such claims. If the Bureau determines that a health care entity has taken an action to collect a medical debt where prohibited by section 22, section 22 requires the health care entity to cancel the debt and refund any portion of the debt that has been paid. Section 22 also provides that attempting to collect a debt under such prohibited circumstances constitutes a deceptive trade practice. Sections 3-12 of this bill define certain terms, and section 2 of this bill establishes the applicability of those definitions. Sections 23 and 27 of this bill make conforming changes to clarify the applicability of an existing definition.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 439B of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 22, inclusive, of this act.
Sec. 2. As used in sections 2 to 22, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 3 to 12, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 3. Diagnosis-related group means groupings of medical diagnostic categories used as a basis for hospital payment schedules by Medicare and other health benefit plans offered by third parties.
Sec. 4. Healing art means any system, treatment, operation, diagnosis, prescription or practice for the ascertainment, cure, relief, palliation, adjustment or correction of any human disease, ailment, deformity, injury or unhealthy or abnormal physical or mental condition for the practice of which long periods of specialized education and training and a degree of specialized knowledge of an intellectual as well as physical nature are required.
Sec. 5. Health benefit plan means a policy, contract, certificate or agreement offered or issued by a third party to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.
Sec. 5.5. Health care entity means:
1. Any facility licensed pursuant to chapter 449 of NRS;
2. A practitioner group practice;
3. An entity that provides staffing or services of practitioners; or
4. Any other entity that provides health care specified by regulation of the Department.
κ2025 Statutes of Nevada, Page 1647 (CHAPTER 247, AB 343)κ
Sec. 6. (Deleted by amendment.)
Sec. 7. Medical debt means an obligation or alleged obligation owed by a consumer of health care to pay money to a health care entity or its assignee for medical services, products or devices, regardless of whether the obligation is past due. The term includes, without limitation, any amount which has been paid toward the partial or total satisfaction of the debt.
Sec. 8. Medical debtor means a natural person who:
1. Owes a medical debt; or
2. Is the guarantor of a natural person who owes a medical debt.
Sec. 9. National Drug Code means the numerical code assigned to a prescription drug by the United States Food and Drug Administration.
Sec. 10. Practitioner group practice means any business entity organized for the purpose of the practice of one or more healing arts by more than one practitioner.
Sec. 11. Small practitioner group practice means a practitioner group practice consisting of a number of practitioners less than or equal to the maximum number of practitioners established by regulation of the Department for a small practitioner group practice.
Sec. 12. Third party means any insurer, governmental entity or other organization providing health coverage or benefits in accordance with state or federal law.
Sec. 13. 1. A hospital shall compile, publish in accordance with section 15 of this act and update annually a list of:
(a) Each item or service provided by the hospital for which the hospital has established a standard charge, including, where applicable:
(1) A fee for:
(I) Supplies and procedures;
(II) Room and board; or
(III) The services of physicians and other practitioners employed by the hospital; and
(2) A fee for the use of the hospital or an item; and
(b) For each item or service described in paragraph (a):
(1) A description of the item or service;
(2) The amount, in dollars, of the charge for the item or service that is reflected on the charge master maintained pursuant to NRS 449.490, absent any discount;
(3) The amount, in dollars, of the highest charge that the hospital has negotiated with a third party for the item or service, listed without identifying the third party;
(4) The amount, in dollars, of the lowest charge that the hospital has negotiated with a third party for the item or service, listed without identifying the third party;
(5) The amount, in dollars, that the hospital charges a natural person who pays immediately in cash for the item or service;
(6) Except as otherwise provided in subsection 4, the amount, in dollars, of each charge negotiated with a third party for an item or service, listed in a manner that clearly associates the negotiated charge with the third party and any applicable health benefit plan offered by the third party; and
κ2025 Statutes of Nevada, Page 1648 (CHAPTER 247, AB 343)κ
(7) Any code or similar identifier that the hospital uses for the purpose of accounting or billing for the item or service, which may include, without limitation:
(I) The code set forth in Current Procedural Terminology published by the American Medical Association;
(II) The code set forth in the Healthcare Common Procedure Coding System published by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services;
(III) The diagnosis-related group; and
(IV) The National Drug Code.
2. If a hospital operates multiple facilities in this State, the hospital shall compile a separate list pursuant to subsection 1 for each facility.
3. A hospital is not required to include the information described in subparagraph (6) of paragraph (b) of subsection 1 as part of the list compiled pursuant to subsection 1 if such information is not required to be included in the information published pursuant to 42 U.S.C. § 300gg-18(e) and the regulations adopted pursuant thereto.
4. As used in this section, standard charge means the regular rate established by a hospital for an item or service provided to a specific group of patients. The term includes, without limitation:
(a) A charge that is reflected on the charge master maintained pursuant to NRS 449.490, absent any discount;
(b) A charge negotiated with a third party; and
(c) The amount charged to a natural person who pays immediately in cash for the item or service.
Sec. 14. 1. Except as otherwise provided in subsection 7, a hospital shall compile, publish in accordance with section 15 of this act and update annually:
(a) A list of shoppable services provided by the hospital and, for each such shoppable service, the information required by subsection 3. The list must include at least 300 shoppable services or, if the hospital provides fewer than 300 shoppable services, each shoppable service that the hospital provides. Such shoppable services must include, without limitation, each shoppable service provided by the hospital that appears on the list of 70 shoppable services specified by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services pursuant to 45 C.F.R. § 180.60.
(b) A list of each shoppable service that appears on the list of 70 shoppable services specified by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services pursuant to 45 C.F.R. § 180.60 that is not offered by the hospital.
2. In deciding whether to include a shoppable service on the list compiled pursuant to paragraph (a) of subsection 1, a hospital shall:
(a) Consider the frequency with which the hospital provides the shoppable service and the rate that the hospital charges for the shoppable service; and
(b) Prioritize for inclusion on the list the shoppable services that the hospital most frequently provides.
κ2025 Statutes of Nevada, Page 1649 (CHAPTER 247, AB 343)κ
3. The list compiled pursuant to paragraph (a) of subsection 1 must include, for each shoppable service:
(a) A description, in plain language, of the shoppable service;
(b) Except as otherwise provided in subsection 6, the amount, in dollars, of each charge negotiated with a third party for the shoppable service and any services ancillary to the shoppable service, listed in a manner that clearly associates the negotiated charge with the third party and any applicable health benefit plan offered by the third party;
(c) The amount, in dollars, that the hospital charges a natural person who pays immediately in cash for the shoppable service and any services ancillary to the shoppable service;
(d) The amount, in dollars, of the highest charge that the hospital has negotiated with a third party for the shoppable service and any services ancillary to the shoppable service, listed without identifying the third party;
(e) The amount, in dollars, of the lowest charge that the hospital has negotiated with a third party for the shoppable service and any services ancillary to the shoppable service, listed without identifying the third party;
(f) Any code or similar identifier that the hospital uses for the purpose of accounting or billing for the shoppable service, which may include, without limitation:
(1) The code set forth in Current Procedural Terminology published by the American Medical Association;
(2) The code set forth in the Healthcare Common Procedure Coding System published by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services;
(3) The diagnosis-related group; and
(4) The National Drug Code; and
(g) If the hospital provides the shoppable service to both inpatients and outpatients, whether each charge specified pursuant to paragraphs (b) to (e), inclusive, applies to the shoppable service when provided to an inpatient or an outpatient.
4. If a hospital operates multiple facilities in this State, the hospital shall compile a separate list pursuant to subsection 1, to the extent required by this section, for each facility.
5. A hospital is not required to include the information described in paragraph (b) of subsection 3 as part of the list compiled and published pursuant to paragraph (a) of subsection 1 if such information is not required to be included in the information published pursuant to 42 U.S.C. § 300gg-18(e) and the regulations adopted pursuant thereto.
6. A hospital is not required to compile and publish the list of shoppable services described in paragraph (a) of subsection 1 if the hospital maintains a price-estimator tool that:
(a) Allows a user to obtain an estimate of the amount that the user will be obligated to pay to the hospital if the person receives a shoppable service or service ancillary to the shoppable service that would otherwise be included on a list compiled and published pursuant to subsection 1.
(b) Is available in a prominent location on the most prominent publicly available Internet website operated by the hospital. If a hospital operates multiple facilities with separate Internet websites, the price-estimator tool must be available on the most prominent publicly available Internet website of each such facility.
κ2025 Statutes of Nevada, Page 1650 (CHAPTER 247, AB 343)κ
(c) Is available at all times and free of charge, without having to establish a user account or password and without having to submit personally identifiable information, enter a code or overcome any other impediment.
(d) Is accessible to a common commercial operator of an Internet search engine to the extent necessary for the search engine to index the price-estimator tool and display the price-estimator tool in response to a search by a user of the search engine.
7. Any price-estimator tool that is deemed by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to meet the requirements of 45 C.F.R. § 180.60(a)(2) shall be deemed to also meet the requirements of subsection 7.
8. As used in this section, shoppable service means a service that a patient may schedule in advance.
Sec. 15. 1. A hospital shall:
(a) Publish the most current version of each list compiled pursuant to section 13 or 14 of this act in a single digital file that is presented in a machine-readable format without additional rows or spacing between data and in the manner required by subsection 2. Each such list must be made available in a prominent location on the most prominent publicly available Internet website operated by the hospital. If a hospital operates multiple facilities with separate Internet websites, the lists pertaining to each facility must be available on the most prominent publicly available Internet website for the facility to which the list pertains.
(b) Indicate on each list compiled pursuant to section 13 or 14 of this act or in a manner clearly associated with the list the date on which the list was most recently updated.
2. Each list published pursuant to subsection 1 must be:
(a) Available at all times and free of charge, without having to establish a user account or password and without having to submit personally identifiable information, enter a code or overcome any other impediment;
(b) Accessible to a common commercial operator of an Internet search engine to the extent necessary for the search engine to index the list and display the list in response to a search by a user of the search engine; and
(c) Digitally searchable.
3. As used in this section, machine-readable format means a digital representation of information in a file that is capable of being imported or read into a computerized system for further processing. The term includes, without limitation, .XML, .JSON and .CSV formats.
Sec. 16. 1. On or before July 1 of each year, a hospital shall submit to the Department in the form prescribed by the Department:
(a) A report which includes the information prescribed by subsection 2; and
(b) A statement signed by a senior official or executive of the hospital under penalty of perjury affirming the accuracy and completeness of the information in the report.
2. A report submitted pursuant to paragraph (a) of subsection 1 must include, for the immediately preceding calendar year:
(a) The name and location of each health care facility, other than a small practitioner group practice, owned or operated by the hospital that charges a facility fee for any service;
κ2025 Statutes of Nevada, Page 1651 (CHAPTER 247, AB 343)κ
(b) The number of patient visits to each health care facility described in paragraph (a);
(c) The number, total amount and types of facility fees paid at each health care facility described in paragraph (a) by Medicare;
(d) The number, total amount and types of facility fees paid at each health care facility described in paragraph (a) by nongovernmental third parties;
(e) For each health care facility described in paragraph (a), the total number of facility fees charged and the total amount of revenue received from facility fees;
(f) The total amount of facility fees charged and the total amount of revenue received from facility fees by the hospital for all health care facilities described in paragraph (a);
(g) The 10 services provided by the hospital, including, without limitation, all health care facilities owned or operated by the hospital, that generated the largest amount of gross revenue through facility fees and, for each such service:
(1) The code set forth in Current Procedural Terminology published by the American Medical Association;
(2) The total number of times the hospital provided the service;
(3) The gross and net revenue generated by the hospital through the provision of the service; and
(4) The net revenue received by the hospital through facility fees associated with the service;
(h) The 10 services provided by the hospital most frequently for which the hospital charged a facility fee and, for each such service:
(1) The code set forth in Current Procedural Terminology published by the American Medical Association;
(2) The total number of times the hospital provided the service;
(3) The gross and net revenue generated by the hospital through the provision of the service; and
(4) The net revenue received by the hospital through facility fees associated with the service; and
(i) Any other information prescribed by regulation of the Department.
3. The Department shall publish each report received pursuant to subsection 1 available on a publicly accessible Internet website maintained by the Department not later than 45 days after receiving the report.
4. As used in this section:
(a) Facility fee means a fee that is charged by a hospital for outpatient services provided in an off-campus health care facility operated by the hospital and that is intended to compensate the hospital for the expenses of providing health care. The term does not include a fee charged by a practitioner for medical services.
(b) Health care facility means:
(1) An off-campus location of a hospital;
(2) Any facility independently licensed pursuant to chapter 449 of NRS;
(3) A practitioner group practice; and
(4) Any other facility that provides health care specified by regulation of the Department.
κ2025 Statutes of Nevada, Page 1652 (CHAPTER 247, AB 343)κ
Sec. 17. 1. A hospital shall not take any action described in subsection 2 with regard to any medical debt while the hospital is not in compliance with any provision of section 13, 14 or 15 of this act or 45 C.F.R. § 180.40, 180.50 or 180.60.
2. A hospital shall not, with regard to any medical debt described in subsection 1:
(a) Refer the medical debt to a collection agency or other third party for collection;
(b) File a civil action or seek arbitration or mediation to collect the medical debt; or
(c) Directly or indirectly cause the reporting of the medical debt to a reporting agency.
3. If a medical debtor believes that a hospital has taken an action described in subsection 2 in violation of subsection 1 with respect to a medical debt owed by the medical debtor, the medical debtor may file a claim with the Bureau of Consumer Protection in the Office of the Attorney General. A medical debtor who files such a claim shall immediately notify the hospital that he or she has filed the claim.
4. Upon the filing of a claim pursuant to subsection 3, the Bureau of Consumer Protection shall investigate the claim. The hospital shall not take any action described in subsection 2 to collect the medical debt that is the subject of the investigation while the investigation is pending.
5. If, at the conclusion of an investigation pursuant to subsection 4, the Bureau of Consumer Protection determines that the hospital has taken an action described in subsection 2 in violation of subsection 1, the hospital shall cancel the medical debt that is the subject of the investigation and any related medical debt and refund any amount of the medical debt or any related medical debt which has been paid by the medical debtor.
6. A knowing violation of this section constitutes a deceptive trade practice for the purposes of NRS 598.0903 to 598.0999, inclusive.
7. As used in this section, reporting agency has the meaning ascribed to it in NRS 598C.100.
Sec. 18. 1. Any person who believes that a hospital has failed to comply with the provisions of sections 2 to 21, inclusive, of this act may submit a complaint to the Department. The Department shall:
(a) Create an electronic form for the submission of such complaints and post the form on an Internet website operated by the Department; and
(b) Accept such complaints through a telephone number dedicated for that purpose.
2. The Department shall monitor the compliance of hospitals with the provisions of sections 2 to 21, inclusive, of this act by:
(a) Evaluating complaints submitted pursuant to subsection 1 and other available information concerning compliance with sections 2 to 21, inclusive, of this act;
(b) Reviewing any available analysis of noncompliance with sections 2 to 21, inclusive, of this act prepared in good faith by a qualified person or entity; and
(c) Auditing the Internet websites maintained by hospitals in this State.
3. The Department shall adopt such regulations as are necessary to carry out the provisions of sections 17 to 21, inclusive, of this act, including, without limitation, regulations prescribing the procedure to appeal any action taken by the Department pursuant to section 19 or 20 of this act.
κ2025 Statutes of Nevada, Page 1653 (CHAPTER 247, AB 343)κ
including, without limitation, regulations prescribing the procedure to appeal any action taken by the Department pursuant to section 19 or 20 of this act. That procedure must include, without limitation, the opportunity for a hearing.
Sec. 19. 1. If the Department determines that a hospital has failed to comply with the provisions of sections 2 to 21, inclusive, of this act, the Department shall issue to the hospital a notice of the violation. The notice must include, without limitation:
(a) A description of the violation;
(b) A requirement that the hospital:
(1) Take action to correct the violation within 30 days after the date of the notice, if the Department determines that the violation is capable of correction within that time period; or
(2) Submit a plan of correction within 30 days after the date of the notice, in all other cases; and
(c) If the Department requires a hospital to submit a plan of correction, notice of:
(1) The form and manner in which the hospital must submit the plan of correction;
(2) The date by which the hospital must submit the plan of correction or a notice of appeal; and
(3) The date by which the hospital must correct the violation.
2. If the Department requires a hospital to take action to correct a violation pursuant to subparagraph (1) of paragraph (b) of subsection 1, the hospital shall, within 30 days after the date of the notice, submit to the Department written confirmation that the hospital has taken such action or a notice of appeal.
3. A plan of correction submitted pursuant to subparagraph (2) of paragraph (b) of subsection 1 must state:
(a) The manner in which the hospital will correct the violation identified in the notice provided pursuant to subsection 1; and
(b) The date by which the hospital will correct the violation.
4. Upon the submission of a plan of correction pursuant to subparagraph (2) of paragraph (b) of subsection 1, the Department may:
(a) Approve the plan of correction as submitted; or
(b) Notify the hospital that additional corrective actions are necessary and require the hospital to submit a revised plan of correction.
5. The Department must approve a plan of correction before it becomes effective. After approving a plan of correction, the Department shall monitor and evaluate the compliance of the hospital with the plan of correction.
Sec. 20. 1. The Department shall impose an administrative penalty against a hospital that the Department determines, after notice and the opportunity for a hearing in accordance with sections 18 and 19 of this act and any regulations adopted pursuant thereto, has violated any provision of sections 2 to 21, inclusive, of this act, or failed to comply with any requirement imposed by the Department pursuant to section 19 of this act or any plan of correction approved by the Department pursuant to section 19 of this act.
2. An administrative penalty imposed pursuant to this section must be in an amount of:
κ2025 Statutes of Nevada, Page 1654 (CHAPTER 247, AB 343)κ
(a) Not less than $600 for a hospital with not more than 30 beds;
(b) Not less than $20 for each bed in a hospital with at least 31 and not more than 550 beds; and
(c) Not less than $11,000 for a hospital with more than 550 beds.
3. For the purposes of this section, each day that a hospital has failed to correct a violation beyond the date prescribed pursuant to subparagraph (1) of paragraph (b) of subsection 1 of section 19 of this act or subparagraph (3) of paragraph (c) of subsection 1 of section 19 of this act, as applicable, or failed to submit a plan of correction or a notice of appeal beyond the date prescribed pursuant to subparagraph (2) of paragraph (b) of subsection 1 of section 19 of this act constitutes a separate violation.
4. In determining the amount of an administrative penalty imposed pursuant to this section, the Department shall consider:
(a) Previous violations by the operator of the hospital;
(b) The seriousness of the violation;
(c) The demonstrated good faith of the operator of the hospital; and
(d) Such other matters as justice may require.
5. Any money collected as administrative penalties pursuant to this section must be accounted for separately and used by the Department to carry out the provisions of sections 2 to 22, inclusive, of this act.
Sec. 21. 1. The Department shall:
(a) Maintain a publicly available Internet website to inform the public concerning violations of sections 2 to 21, inclusive, of this act; and
(b) Not later than 30 days after finding, after notice and the opportunity for a hearing in accordance with sections 18 and 19 of this act and the regulations adopted pursuant thereto, that a hospital has violated any provision of sections 2 to 21, inclusive, of this act, post to the Internet website maintained pursuant to paragraph (a):
(1) The name of the hospital;
(2) A description of the violation that the hospital was found to have committed;
(3) Any corrective action that the hospital was ordered to take pursuant to section 19 of this act or included in a plan of correction approved pursuant to that section and, if applicable, the date on which the hospital took such corrective action; and
(4) The amount of any administrative penalty imposed on the hospital pursuant to section 20 of this act.
2. Except as otherwise provided in subsection 3 and NRS 239.0115, a complaint filed with the Department pursuant to section 18 of this act, all documents and other information filed with the complaint and all documents and other information compiled as a result of an investigation conducted to determine whether to issue a notice of violation pursuant to section 19 of this act are confidential.
3. Any notice provided by the Department, plan of correction approved by the Department or confirmation that a hospital has taken a corrective action required by the Department pursuant to section 19 of this act, any order of the Department imposing an administrative penalty pursuant to section 20 of this act and any documents or information considered by the Department when determining whether to approve a plan of correction or impose an administrative penalty are public records.
κ2025 Statutes of Nevada, Page 1655 (CHAPTER 247, AB 343)κ
Sec. 22. 1. Before taking any action to collect a medical debt or authorizing a collection agency or any other person or entity to take any action to collect a medical debt, a health care entity shall provide to the patient in writing, electronically or through an Internet portal:
(a) An itemized statement of the medical debt owed by the patient to the health care entity, which must:
(1) Be easy to understand;
(2) Where applicable, comply with the requirements of NRS 449.193, 449.243 or 629.071 or any other requirements of state or federal law regarding billing for health care; and
(3) Include, without limitation, the applicable billing codes, including modifiers, for each item or service for which the medical debt is owed. Those codes must use a commonly recognized system of billing codes that is identified in the statement.
(b) Information concerning any available language assistance services for persons with limited English proficiency.
(c) The name, telephone number and electronic mail address of a person or office at the health care entity that is authorized to discuss the itemized statement described in paragraph (a) with the patient and make changes relating to the medical debt, including, without limitation, reducing or cancelling the medical debt.
2. Not later than 30 days after a medical debtor makes any payment related to a medical debt to the health care entity or a collection agency acting on behalf of the health care entity, the health care entity shall provide an itemized receipt to the medical debtor. A health care entity shall not take any action to collect a medical debt or authorize a collection agency or other entity to take any action to collect a medical debt if the health care entity has failed to timely provide any receipt required by this subsection to the medical debtor.
3. If a medical debtor believes that a health care entity has taken an action in violation of subsection 1 or 2 with respect to a medical debt owed by the medical debtor, the medical debtor may file a claim with the Bureau of Consumer Protection in the Office of the Attorney General. A medical debtor who files such a claim shall immediately notify the health care entity that he or she has filed the claim.
4. Upon the filing of a claim pursuant to subsection 3, the Bureau of Consumer Protection shall investigate the claim. The health care entity shall not take any action to collect the medical debt that is the subject of the investigation or authorize a collection agency or other entity to take any action to collect that medical debt while the investigation is pending.
5. If, at the conclusion of an investigation pursuant to subsection 4, the Bureau of Consumer Protection determines that the health care entity has taken an action in violation of subsection 1 or 2, the health care entity shall cancel the medical debt that is the subject of the investigation and any related medical debt and refund any amount of the medical debt or any related medical debt which has been paid by the medical debtor.
6. A knowing violation of this section constitutes a deceptive trade practice for the purposes of NRS 598.0903 to 598.0999, inclusive.
7. The provisions of this section do not apply to a small practitioner group practice.
8. As used in this section collection agency has the meaning ascribed to it in NRS 649.020.
κ2025 Statutes of Nevada, Page 1656 (CHAPTER 247, AB 343)κ
Sec. 23. NRS 439B.320 is hereby amended to read as follows:
439B.320 1. A hospital shall provide, without charge, in each fiscal year, care for indigent inpatients in an amount which represents 0.6 percent of its net revenue for the hospitals preceding fiscal year.
2. The Department shall compute the obligation of each hospital for care of indigent inpatients for each fiscal year based upon the net revenue of the hospital in its preceding fiscal year and shall provide this information to the board of county commissioners of the county in which the hospital is located.
3. The board of county commissioners shall maintain a record of discharge forms submitted by each hospital located within the county, together with the amount accruing to the hospital. The amount accruing to the hospital for the care, until the hospital has met its obligation pursuant to this section, is the highest amount the county is paying to any hospital in the county for that care. Except as otherwise provided in subsection 2 of NRS 439B.330, no payment for indigent care may be made to the hospital until the total amount so accruing to the hospital exceeds the minimum obligation of the hospital for the fiscal year, and a hospital may only receive payment from the county for indigent care provided in excess of its obligation pursuant to this section. After a hospital has met its obligation pursuant to this section, the county may reimburse the hospital for care of indigent inpatients at any rate otherwise authorized by law.
4. As used in this section, net revenue means all revenues earned from inpatient medical care provided to patients by a hospital.
Sec. 24. (Deleted by amendment.)
Sec. 24.5. NRS 232.459 is hereby amended to read as follows:
232.459 1. The Advocate shall:
(a) Respond to written and telephonic inquiries received from consumers and injured employees regarding concerns and problems related to health care and workers compensation;
(b) Assist consumers and injured employees in understanding their rights and responsibilities under health care plans, including, without limitation, the Public Employees Benefits Program and the Public Option, and policies of industrial insurance;
(c) Identify and investigate complaints of consumers and injured employees regarding their health care plans, including, without limitation, the Public Employees Benefits Program and the Public Option, and policies of industrial insurance and assist those consumers and injured employees to resolve their complaints, including, without limitation:
(1) Referring consumers and injured employees to the appropriate agency, department or other entity that is responsible for addressing the specific complaint of the consumer or injured employee; and
(2) Providing counseling and assistance to consumers and injured employees concerning health care plans, including, without limitation, the Public Employees Benefits Program and the Public Option, and policies of industrial insurance;
(d) Provide information to consumers and injured employees concerning health care plans, including, without limitation, the Public Employees Benefits Program and the Public Option, and policies of industrial insurance in this State;
κ2025 Statutes of Nevada, Page 1657 (CHAPTER 247, AB 343)κ
(e) Establish and maintain a system to collect and maintain information pertaining to the written and telephonic inquiries received by the Office for Consumer Health Assistance;
(f) Take such actions as are necessary to ensure public awareness of the existence and purpose of the services provided by the Advocate pursuant to this section;
(g) In appropriate cases and pursuant to the direction of the Advocate, refer a complaint or the results of an investigation to the Attorney General for further action;
(h) Provide information to and applications for prescription drug programs for consumers without insurance coverage for prescription drugs or pharmaceutical services;
(i) Establish and maintain an Internet website which includes:
(1) Information concerning purchasing prescription drugs from Canadian pharmacies that have been recommended by the State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328;
(2) Links to websites of Canadian pharmacies which have been recommended by the State Board of Pharmacy for inclusion on the Internet website pursuant to subsection 4 of NRS 639.2328; and
(3) A link to the website established and maintained pursuant to NRS 439A.270 which provides information to the general public concerning the charges imposed and the quality of the services provided by the hospitals and surgical centers for ambulatory patients in this State;
(j) Assist consumers with accessing a navigator, case manager or facilitator to help the consumer obtain health care services;
(k) Assist consumers with scheduling an appointment with a provider of health care who is in the network of providers under contract to provide services to participants in the health care plan under which the consumer is covered;
(l) Assist consumers with filing complaints against health care facilities and health care professionals;
(m) Assist consumers with filing claims with the Bureau of Consumer Protection in the Office of the Attorney General pursuant to sections 17 and 22 of this act;
(n) Assist consumers with filing complaints with the Commissioner of Insurance against issuers of health care plans; and
[(n)] (o) On or before January 31 of each year, compile a report of aggregated information submitted to the Office for Consumer Health Assistance pursuant to NRS 687B.675, aggregated for each type of provider of health care for which such information is provided and submit the report to the Director of the Legislative Counsel Bureau for transmittal to:
(1) In even-numbered years, the Joint Interim Standing Committee on Health and Human Services; and
(2) In odd-numbered years, the next regular session of the Legislature.
2. The Advocate may adopt regulations to carry out the provisions of this section and NRS 232.461 and 232.462.
3. As used in this section:
(a) Health care facility has the meaning ascribed to it in NRS 162A.740.
κ2025 Statutes of Nevada, Page 1658 (CHAPTER 247, AB 343)κ
(b) Navigator, case manager or facilitator has the meaning ascribed to it in NRS 687B.675.
(c) Public Option means the Public Option established pursuant to NRS 695K.200.
Sec. 25. NRS 239.010 is hereby amended to read as follows:
239.010 1. Except as otherwise provided in this section and NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.0397, 41.071, 49.095, 49.293, 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 119A.653, 119A.677, 119B.370, 119B.382, 120A.640, 120A.690, 125.130, 125B.140, 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 159A.044, 164.041, 172.075, 172.245, 176.01334, 176.01385, 176.015, 176.0625, 176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 178.5717, 179.495, 179A.070, 179A.165, 179D.160, 180.600, 200.3771, 200.3772, 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3923, 209.3925, 209.419, 209.429, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 218F.150, 218G.130, 218G.240, 218G.350, 218G.615, 224.240, 226.462, 226.796, 228.270, 228.450, 228.495, 228.570, 231.069, 231.1285, 231.1473, 232.1369, 233.190, 237.300, 239.0105, 239.0113, 239.014, 239B.026, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 239C.230, 239C.250, 239C.270, 239C.420, 240.007, 241.020, 241.030, 241.039, 242.105, 244.264, 244.335, 247.540, 247.545, 247.550, 247.560, 250.087, 250.130, 250.140, 250.145, 250.150, 268.095, 268.0978, 268.490, 268.910, 269.174, 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 281A.750, 281A.755, 281A.780, 284.4068, 284.4086, 286.110, 286.118, 287.0438, 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 293.504, 293.558, 293.5757, 293.870, 293.906, 293.908, 293.909, 293.910, 293B.135, 293D.510, 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 353A.049, 353A.085, 353A.100, 353C.240, 353D.250, 360.240, 360.247, 360.255, 360.755, 361.044, 361.2242, 361.610, 365.138, 366.160, 368A.180, 370.257, 370.327, 372A.080, 378.290, 378.300, 379.0075, 379.008, 379.1495, 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.033, 391.035, 391.0365, 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 392.317, 392.325, 392.327, 392.335, 392.850, 393.045, 394.167, 394.16975, 394.1698, 394.447, 394.460, 394.465, 396.1415, 396.1425, 396.143, 396.159, 396.3295, 396.405, 396.525, 396.535, 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 412.153, 414.280, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 425.400, 427A.1236, 427A.872, 427A.940, 432.028, 432.205, 432B.175, 432B.280, 432B.290, 432B.4018, 432B.407, 432B.430, 432B.560, 432B.5902, 432C.140, 432C.150, 433.534, 433A.360, 439.4941, 439.4988, 439.5282, 439.840, 439.914, 439A.116, 439A.124, 439B.420, 439B.754, 439B.760, 439B.845, 440.170, 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 442.774, 445A.665, 445B.570, 445B.7773, 449.209, 449.245, 449.4315, 449A.112, 450.140, 450B.188, 450B.805, 453.164, 453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.
κ2025 Statutes of Nevada, Page 1659 (CHAPTER 247, AB 343)κ
450B.805, 453.164, 453.720, 458.055, 458.280, 459.050, 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.535, 480.545, 480.935, 480.940, 481.063, 481.091, 481.093, 482.170, 482.368, 482.5536, 483.340, 483.363, 483.575, 483.659, 483.800, 484A.469, 484B.830, 484B.833, 484E.070, 485.316, 501.344, 503.452, 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 598.098, 598A.110, 598A.420, 599B.090, 603.070, 603A.210, 604A.303, 604A.710, 604D.500, 604D.600, 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 618.425, 622.238, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.043, 629.047, 629.069, 630.133, 630.2671, 630.2672, 630.2673, 630.2687, 630.30665, 630.336, 630A.327, 630A.555, 631.332, 631.368, 632.121, 632.125, 632.3415, 632.3423, 632.405, 633.283, 633.301, 633.427, 633.4715, 633.4716, 633.4717, 633.524, 634.055, 634.1303, 634.214, 634A.169, 634A.185, 634B.730, 635.111, 635.158, 636.262, 636.342, 637.085, 637.145, 637B.192, 637B.288, 638.087, 638.089, 639.183, 639.2485, 639.570, 640.075, 640.152, 640A.185, 640A.220, 640B.405, 640B.730, 640C.580, 640C.600, 640C.620, 640C.745, 640C.760, 640D.135, 640D.190, 640E.225, 640E.340, 641.090, 641.221, 641.2215, 641A.191, 641A.217, 641A.262, 641B.170, 641B.281, 641B.282, 641C.455, 641C.760, 641D.260, 641D.320, 642.524, 643.189, 644A.870, 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 645C.220, 645C.225, 645D.130, 645D.135, 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 648.197, 649.065, 649.067, 652.126, 652.228, 653.900, 654.110, 656.105, 657A.510, 661.115, 665.130, 665.133, 669.275, 669.285, 669A.310, 670B.680, 671.365, 671.415, 673.450, 673.480, 675.380, 676A.340, 676A.370, 677.243, 678A.470, 678C.710, 678C.800, 679B.122, 679B.124, 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 686A.289, 686B.170, 686C.306, 687A.060, 687A.115, 687B.404, 687C.010, 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 21 of this act, sections 35, 38 and 41 of chapter 478, Statutes of Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 and unless otherwise declared by law to be confidential, all public books and public records of a governmental entity must be open at all times during office hours to inspection by any person, and may be fully copied or an abstract or memorandum may be prepared from those public books and public records. Any such copies, abstracts or memoranda may be used to supply the general public with copies, abstracts or memoranda of the records or may be used in any other way to the advantage of the governmental entity or of the general public. This section does not supersede or in any manner affect the federal laws governing copyrights or enlarge, diminish or affect in any other manner the rights of a person in any written book or record which is copyrighted pursuant to federal law.
2. A governmental entity may not reject a book or record which is copyrighted solely because it is copyrighted.
3. A governmental entity that has legal custody or control of a public book or record shall not deny a request made pursuant to subsection 1 to inspect or copy or receive a copy of a public book or record on the basis that the requested public book or record contains information that is confidential if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
κ2025 Statutes of Nevada, Page 1660 (CHAPTER 247, AB 343)κ
if the governmental entity can redact, delete, conceal or separate, including, without limitation, electronically, the confidential information from the information included in the public book or record that is not otherwise confidential.
4. If requested, a governmental entity shall provide a copy of a public record in an electronic format by means of an electronic medium. Nothing in this subsection requires a governmental entity to provide a copy of a public record in an electronic format or by means of an electronic medium if:
(a) The public record:
(1) Was not created or prepared in an electronic format; and
(2) Is not available in an electronic format; or
(b) Providing the public record in an electronic format or by means of an electronic medium would:
(1) Give access to proprietary software; or
(2) Require the production of information that is confidential and that cannot be redacted, deleted, concealed or separated from information that is not otherwise confidential.
5. An officer, employee or agent of a governmental entity who has legal custody or control of a public record:
(a) Shall not refuse to provide a copy of that public record in the medium that is requested because the officer, employee or agent has already prepared or would prefer to provide the copy in a different medium.
(b) Except as otherwise provided in NRS 239.030, shall, upon request, prepare the copy of the public record and shall not require the person who has requested the copy to prepare the copy himself or herself.
Sec. 26. 1. The provisions of section 17 of this act apply to any medical debt incurred before, on or after January 1, 2026.
2. The provisions of section 22 of this act apply to any medical debt incurred on or after January 1, 2026.
3. As used in this section, medical debt has the meaning ascribed to it in NRS 649.036.
Sec. 27. NRS 439B.140 is hereby repealed.
Sec. 28. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 27, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On January 1, 2026, for all other purposes.
________
κ2025 Statutes of Nevada, Page 1661κ
Assembly Bill No. 350Committee on Judiciary
CHAPTER 248
[Approved: June 3, 2025]
AN ACT relating to cemeteries; revising provisions relating to the disinterment and removal of human remains from certain cemeteries; revising certain requirements applicable to certain cemetery owners; expanding eligibility for interment in a veterans cemetery to include certain additional veterans; requiring the Director of the Department of Veterans Services to charge certain fees relating to the interment of such veterans; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law authorizes a cemetery authority to order the disinterment and removal of all human remains interred in all or any part of a cemetery if: (1) a governmental authority other than the cemetery authority makes certain determinations relating to the maintenance of the cemetery in accordance with the health, safety and comfort of the public; or (2) the cemetery authority determines that a financial provision must be made for the future care of certain gravesites. (NRS 451.070) Section 1 of this bill instead provides that, before a cemetery authority may disinter or remove human remains interred in all or any part of a cemetery: (1) the cemetery authority must petition the district court of the county in which a cemetery is located for an order authorizing the disinterment and removal; and (2) the court must issue an order authorizing the disinterment and removal. Sections 2-4 of this bill make conforming changes relating to the issuance by the court, rather than the cemetery authority, of an order for the disinterment and removal of human remains interred in a cemetery.
Existing law: (1) requires the owner of a cemetery to keep the cemetery in an orderly condition; and (2) authorizes a board of county commissioners to make rules relating to this requirement. (NRS 452.030) Section 5 of this bill removes the authority of a board of county commissioners to make such rules. Instead, section 5 requires the owner of a cemetery to take certain specific actions to ensure that a cemetery is kept in an orderly condition.
Existing law provides for the establishment, operation and maintenance of veterans cemeteries and sets forth the eligibility requirements for the interment of veterans in such cemeteries. (NRS 417.210) Section 6 of this bill expands the eligibility requirements to include certain veterans who were members of a reserve component of the National Guard or who received a commemorative plaque or urn furnished by the United States Department of Veterans Affairs. Section 6 also requires the Director of the Department of Veterans Services to charge a fee for: (1) the interment of a veteran made eligible under the expanded criteria set forth in section 6; and (2) a headstone or marker provided by the Department for certain veterans made eligible for interment under the expanded criteria set forth in section 6.
κ2025 Statutes of Nevada, Page 1662 (CHAPTER 248, AB 350)κ
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 451.070 is hereby amended to read as follows:
451.070 1. Except as otherwise provided in [NRS 451.075,] subsection 7, a cemetery authority shall not disinter or remove human remains interred in all or any part of a cemetery owned, leased or operated by the cemetery authority without a court order authorizing the cemetery authority to do so.
2. A cemetery authority may petition the district court of the county in which a cemetery is located for an order authorizing the disinterment and removal of [all] human remains interred in all or any part of [any] a cemetery [if:
1. A governmental authority other than the cemetery authority determines that:] owned, leased or operated by the cemetery authority. The petition must:
(a) Contain a concise statement as to the necessity of the proposed action; and
(b) Be accompanied by adequate documentation to justify a hearing on the petition.
3. Upon the filing of a petition pursuant to subsection 2, the court shall fix a time for a hearing on the matter. The petitioner shall provide notice and a copy of the petition to every person who owns, holds or has the right of interment in any plot of the cemetery or part affected whose name appears on the records of the cemetery or upon the real property assessment roll of the county in which the cemetery is located. If a person who receives such notice wishes to oppose the petition, the person must appear before the court at the hearing. If the person appears before the court at the hearing, the court must provide the person an opportunity to be heard on the matter.
4. After the hearing described in subsection 3, the court may issue an order authorizing the disinterment and removal of human remains from all or any part of the cemetery if:
(a) The court finds by clear and convincing evidence that:
(1) The maintenance of all or any part of the cemetery that is the subject of the petition as a burial place for the human dead is not in accordance with the health, safety, comfort or welfare of the public;
[(b)] (2) The cemetery authority is unable to restore the cemetery or part of the cemetery that is the subject of the petition to a condition where the maintenance of the cemetery as a burial place for the human dead is in accordance with the health, safety, comfort and welfare of the public; and
[(c)] (3) The cemetery authority is unable, at current market rates, to sell or lease the cemetery that is the subject of the petition to or enter into a contract with another cemetery authority that will maintain the cemetery that is the subject of the petition as a burial place for the human dead in accordance with the health, safety, comfort and welfare of the public; or
[2.] (b) The [cemetery authority determines] court finds by clear and convincing evidence that such disinterment and removal is necessary because of the financial [provision must be made] obligations of the cemetery authority for future care of gravesites within a specified area.
κ2025 Statutes of Nevada, Page 1663 (CHAPTER 248, AB 350)κ
because of the financial [provision must be made] obligations of the cemetery authority for future care of gravesites within a specified area.
5. Upon the issuance of an order pursuant to subsection 4, a cemetery authority may proceed to disinter and remove the remains in accordance with the provisions of NRS 451.069 to 451.330, inclusive.
6. The cemetery authority shall:
(a) Maintain a written record for each person whose remains are disinterred and removed, which must include, without limitation:
(1) The name of the person;
(2) A description of the plot from which the remains were removed; and
(3) The location where the remains are reinterred, if known; and
(b) Provide a copy of any such record described in paragraph (a) to a local health officer, county coroner or the Nevada Funeral and Cemetery Services Board upon request.
7. The provisions of this section do not apply to:
(a) The disinterment and removal of human remains:
(1) Interred in a burial plot that is owned in fee simple by a person other than the cemetery authority; or
(2) By a cemetery authority if the cemetery authority is acting at the direction of a:
(I) Person to whom a permit for disinterment has been issued pursuant to NRS 451.045;
(II) County coroner, in the performance of his or her official duties; or
(III) Person who is authorized to order the burial or cremation of human remains pursuant to NRS 451.024;
(b) Any area within a cemetery that contains a historical marker or is designated as a historical site, including, without limitation, any tomb, monument, gravestone or other structure marked as historical or located on land designated as part of a historical site; or
(c) A historic cemetery owned or operated by a county.
8. As used in this section, historic has the meaning ascribed to it in NRS 381.195.
Sec. 2. NRS 451.075 is hereby amended to read as follows:
451.075 Notwithstanding any other provision of law, including, without limitation, any provision of NRS 451.069 to 451.330, inclusive, a cemetery authority shall not [:
1. Order the disinterment and removal of human remains interred in a burial plot that is owned in fee simple by a person other than the cemetery authority; or
2. Sell,] sell, mortgage or encumber or require the sale, mortgage or encumbrance of [such] a burial plot [.] owned in fee simple by a person other than the cemetery authority.
Sec. 3. NRS 451.080 is hereby amended to read as follows:
451.080 1. The cemetery authority may prescribe reasonable regulations governing the manner of making disinterments and removals and providing for reinterment in a portion of the existing cemetery or in any other cemetery or for deposit of the remains in any memorial mausoleum or columbarium or for providing appropriate future care.
κ2025 Statutes of Nevada, Page 1664 (CHAPTER 248, AB 350)κ
2. The cemetery authority must prescribe a reasonable time of not less than 1 year after the date on which [it] a court orders the disinterment and removal of remains pursuant to NRS 451.070, after which the cemetery authority may proceed to disinter and remove the remains and reinter them in a portion of the existing cemetery or another cemetery or deposit them in a memorial mausoleum or columbarium.
Sec. 4. NRS 451.310 is hereby amended to read as follows:
451.310 If, before receiving [notice of any determination made by a governmental authority] an order authorizing the disinterment and removal of human remains interred in all or any part of a cemetery pursuant to NRS 451.070, [any] a cemetery authority has in good faith entered into [any] an agreement to sell or has granted [any] an option to buy all or any portion of its cemetery lands for a price reasonable at the time the agreement to sell was made, or the option granted, the district court shall confirm the sale at the price stipulated in the agreement to sell or the option to buy.
Sec. 5. NRS 452.030 is hereby amended to read as follows:
452.030 1. [Every] Except as otherwise provided in subsection 4, every owner of a cemetery shall keep the same in an orderly condition, [and authority is conferred on the board of county commissioners of each county to make such rules as will carry out the intent of this section.
2.] including, without limitation, by:
(a) Mowing any grass within the limits of the cemetery at least once per month during the growing season, based on the climate of the area, unless:
(1) Grass growth is dormant due to temperature conditions; or
(2) Mowing is impracticable due to irrigation restrictions imposed during a drought by a governmental entity with authority over water resource management or distribution in the area, including, without limitation, a water district, water authority, water utility, water system or irrigation district;
(b) Regularly removing or treating weeds within the limits of the cemetery;
(c) Replenishing, pruning or replacing landscaping elements within the limits of the cemetery as necessary to preserve the appearance and dignity of the cemetery;
(d) Maintaining pathways and entryways that lead into or through the cemetery in safe condition for pedestrian traffic, including, without limitation, by ensuring that:
(1) Such pathways and entryways are free of debris and erosion; and
(2) Landscaping elements that encroach on such pathways and entryways within the limits of the cemetery are trimmed;
(e) Removing litter and garbage within the limits of the cemetery without undue delay;
(f) Except as otherwise provided in paragraph (g), ensuring that any tomb, monument, gravestone or other structure within the limits of the cemetery is properly placed in accordance with any sales or interment records maintained by the owner of the cemetery or available to the owner; and
κ2025 Statutes of Nevada, Page 1665 (CHAPTER 248, AB 350)κ
(g) Permitting the temporary removal and subsequent replacement of a tomb, monument, gravestone or other structure within the limits of the cemetery as necessary to allow access for equipment, the installation of a memorial or the performance of any other activity required for the normal operation of the cemetery.
2. Except as otherwise provided in subsection [4,] 5, [in addition to any action that may be taken pursuant to the rules described in subsection 1,] the district attorney of the county in which a cemetery is located or a relative of any person interred in a cemetery may bring an action in a court of competent jurisdiction to enforce the [provisions of] requirements set forth in subsection 1. If the court finds that the owner of the cemetery has failed to keep the cemetery in an orderly condition, the court may [:
(a) Order] order the owner of the cemetery to take any action necessary to bring the cemetery into such a condition . [; or
(b)] If the [court also determines that continued ownership of the cemetery by the] owner [is not in accordance with the health, safety, comfort or welfare] of the [public, transfer title to the cemetery to the city or, if the] cemetery [is located in an unincorporated area of a county, the county in which the cemetery is located, if] fails to comply with any such order, the city or county [accepts such a transfer of title.] in which the cemetery is located may, at the expense of the owner, take any action necessary to comply with the order and restore the cemetery to the required condition.
3. [A city or county to which title] An owner of a cemetery [is transferred pursuant to this section] who conducts an annual weed treatment shall [:
(a) Operate the cemetery;
(b) Lease the cemetery to a cemetery authority to operate the cemetery;
(c) Enter into a contract with a cemetery authority to operate the cemetery; or
(d) Transfer title of the cemetery] be deemed to [a nonprofit organization acting as] have complied with the [cemetery authority] requirements prescribed by paragraph (b) of [the cemetery.] subsection 1.
4. The provisions of subsection 1 do not apply to:
(a) Any area within a cemetery that contains a historical marker or is designated as a historical site, including, without limitation, any tomb, monument, gravestone or other structure marked as historical or located on land designated as part of a historical site; or
(b) A historic cemetery owned or operated by a county.
5. The provisions of subsection 2 do not apply to [a] :
(a) A cemetery owned by a city or county [.] ;
(b) A veterans cemetery; or
(c) A cemetery that is funded, in whole or in part, by the Federal Government.
6. As used in this section:
(a) Historic has the meaning ascribed to it in NRS 381.195.
(b) Landscaping element includes, without limitation, any tree, shrub or plant within the limits of a cemetery.
(c) Orderly condition means the comprehensive upkeep and preservation of a cemetery in a manner that honors the deceased, promotes public safety and ensures accessibility upon request.
κ2025 Statutes of Nevada, Page 1666 (CHAPTER 248, AB 350)κ
Sec. 6. NRS 417.210 is hereby amended to read as follows:
417.210 1. A person is eligible for interment in a veterans cemetery in this State if the person:
(a) Is a veteran who is eligible for interment in a national cemetery pursuant to the provisions of 38 U.S.C. § 2402 [is eligible for interment in a veterans cemetery in this State.] ; or
(b) Does not meet the criteria set forth in paragraph (a), but otherwise meets the definition of veteran set forth in NRS 417.005 and:
(1) Was a member of a reserve component of the National Guard; or
(2) Received a commemorative plaque or urn furnished by the United States Department of Veterans Affairs pursuant to 38 U.S.C. § 2306(h).
2. An eligible veteran, or a member of his or her immediate family, or a veterans organization recognized by the Director may apply for a plot in a cemetery for veterans in this State by submitting a request to the cemetery superintendent on a form to be supplied by the cemetery superintendent. The application for interment must provide for a selection to have the area immediately above and surrounding the interred remains of the applicant landscaped with natural grass or xeriscaping. The cemetery superintendent shall assign available plots in the order in which applications are received. A specific plot may not be reserved before it is needed for burial. No charge may be made for a plot or for the interment of a veteran [.] described in paragraph (a) of subsection 1.
3. One plot is allowed for the interment of each eligible veteran and for each member of his or her immediate family, except where the conditions of the soil or the number of the decedents of the family requires more than one plot.
4. The Director shall charge a fee for [the] :
(a) The interment of a [family] :
(1) Family member [,] of an eligible veteran, but the fee may not exceed the actual cost of interment.
(2) Veteran described in paragraph (b) of subsection 1, but the fee must not exceed the burial allowance established by the United States Department of Veterans Affairs for the interment of veterans in a national cemetery.
(b) A headstone or marker provided by the Department for a veteran described in paragraph (b) of subsection 1 for placement on a plot where the veteran is interred, but the fee must not exceed the actual cost of the headstone or marker.
5. As used in this section [, immediate] :
(a) Eligible veteran means a person who is eligible for interment in a veterans cemetery in this State pursuant to subsection 1.
(b) Immediate family means the spouse, minor child or, when the Director deems appropriate, the unmarried adult child of an eligible veteran.
________
κ2025 Statutes of Nevada, Page 1667κ
Assembly Bill No. 351Committee on Judiciary
CHAPTER 249
[Approved: June 3, 2025]
AN ACT relating to juvenile justice; granting the juvenile court limited jurisdiction over certain persons who are 21 years of age or older; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law grants the juvenile court limited jurisdiction over a person who is 21 years of age or older if: (1) the person is charged with the commission of a delinquent act that occurred when the person was at least 16 years of age but less than 18 years of age; (2) the delinquent act would have been a category A or B felony if committed by an adult; and (3) certain other requirements are met. (NRS 62B.335) The Nevada Supreme Court has held that existing law does not grant any court in this State jurisdiction over a person who is 21 years of age or older who is charged with the commission of certain delinquent acts that occurred when the person was less than 16 years of age. (Zalyaul v. State, 138 Nev. 760 (2022)) Section 1 of this bill addresses this jurisdictional gap by granting the juvenile court limited jurisdiction over a person who is 21 years of age or older if a petition charging the person with the commission of certain delinquent acts that occurred when the person was at least 13 years of age but less than 18 years of age is filed and certain other requirements are met.
In general, existing law requires the juvenile court to hold a hearing to determine whether the case of a person over whom the juvenile court has limited jurisdiction should be: (1) dismissed; or (2) transferred from the juvenile court to the district court for criminal proceedings. (NRS 62B.335) By granting the juvenile court limited jurisdiction over a person who is 21 years of age or older who is charged with the commission of a delinquent act that occurred when the person was less than 18 years of age, section 1 requires the juvenile court to hold a hearing and consider certain factors relating to the interests of justice and need for protection of the public to determine whether the case of any such person should be dismissed or transferred to the district court for criminal proceedings.
Section 2 of this bill makes the amendatory provisions of section 1 applicable to offenses committed on or after October 1, 2013.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 62B.335 is hereby amended to read as follows:
62B.335 1. [If:
(a) A] The juvenile court shall conduct a hearing to determine whether there is probable cause to believe that a person [is charged with the commission of] committed a delinquent act [that occurred when the person was at least 16 years of age but less than 18 years of age;
(b) The delinquent act would have been a category A or B felony if committed by an adult;
(c) ] that occurred when the person was:
(a) At least 16 years of age but less than 18 years of age if:
(1) A petition is filed charging the person with a category A or B felony and a writ of attachment is issued pursuant to NRS 62C.320 before the date on which the person reaches 21 years of age; and
κ2025 Statutes of Nevada, Page 1668 (CHAPTER 249, AB 351)κ
(2) The writ is not served before the date on which the person reaches 21 years of age.
(b) At least 14 years of age but less than 16 years of age if:
(1) A petition is filed charging the person with a category A or B felony involving the use or threatened use of a deadly weapon and:
(I) A writ of attachment is issued pursuant to NRS 62C.320 before the date on which the person reaches 21 years of age; and
(II) The writ is not served before the date on which the person reaches 21 years of age; or
(2) The person is not identified by law enforcement as having committed the delinquent act before the date on which the person reaches 21 years of age . [; and
(d) The person is apprehended by law enforcement after the person reaches 21 years of age,
Κ the juvenile court has jurisdiction over the person to conduct a hearing and make the determinations required by this section in accordance with the provisions of this section.]
(c) Except as otherwise provided in NRS 62B.330, at least 13 years of age if:
(1) A petition is filed charging the person with murder or attempted murder and:
(I) A writ of attachment is issued pursuant to NRS 62C.320 before the date on which the person reaches 21 years of age; and
(II) The writ is not served before the date on which the person reaches 21 years of age; or
(2) The person is not identified by law enforcement as having committed the delinquent act before the date on which the person reaches 21 years of age.
2. [The juvenile court shall conduct a hearing to determine whether there is probable cause to believe that the person committed the delinquent act.
3.] If the juvenile court determines that there is not probable cause to believe that the person committed the delinquent act, the juvenile court shall dismiss the charges and discharge the person.
[4.] 3. If the juvenile court determines that there is probable cause to believe that the person committed the delinquent act, the juvenile court shall determine whether, based upon clear and convincing evidence and considering the interests of justice and the need for protection of the public, to:
(a) Dismiss the charges; or
(b) Transfer the case for proper criminal proceedings to any court that would have jurisdiction over the delinquent act if the delinquent act were committed by an adult.
[5.] 4. In determining the interests of justice and the need for protection of the public, the juvenile court shall consider:
(a) The number, date, nature and gravity of the delinquent acts committed by the person.
(b) Whether the delinquent acts involved the use of a weapon, violence or infliction of serious bodily injury.
(c) The impact to any victim of the person.
(d) The extent to which the person has already received punishment, counseling, therapy or treatment after the commission of the delinquent acts, and the response of the person to any such punishment, counseling, therapy or treatment.
κ2025 Statutes of Nevada, Page 1669 (CHAPTER 249, AB 351)κ
(e) The behavior of the person since the date on which the person committed the delinquent acts, including, without limitation, the character, maturity, educational progress and work history of the person.
(f) Any evidence that the person engaged in recent threats against any person or expressed the intent to commit a crime in the future.
(g) Psychological or psychiatric evidence that indicates a risk of recidivism.
(h) Any emotional or mental health condition that existed at the time of the commission of the delinquent act.
(i) Any physical conditions that minimize the risk of recidivism, including, without limitation, physical disability or illness.
(j) Any reason for delay between the alleged delinquent act and arrest.
(k) The effect of time on the reliability of any witness and evidence.
(l) Any other factor the juvenile court finds relevant.
[6.] 5. If the case is transferred for criminal proceedings pursuant to this section, the court shall also transfer any other related offense arising out of the same facts as the delinquent act, regardless of the nature of the related offense.
[7.] 6. The court to which the case is transferred has original jurisdiction over the person.
[8.] 7. A person held in custody pursuant to this section must be held in the state prison, a county or city jail or detention facility for adults and is entitled to bail as established in criminal proceedings.
Sec. 2. The amendatory provisions of this act apply to offenses committed on or after October 1, 2013.
Sec. 3. This act becomes effective upon passage and approval.
________
Assembly Bill No. 368Assemblymember Carter
CHAPTER 250
[Approved: June 3, 2025]
AN ACT relating to health care; authorizing a patient in certain facilities or a resident of a living community for persons with disabilities or his or her representative to request the installation and use of an electronic communication device in the living quarters of the patient or the bedroom of the resident; prohibiting such a facility or living community or an employee of such a facility or living community from taking certain additional actions; prohibiting a provider of supported living arrangement services from taking certain actions with regard to the installation and use of an electronic communication device in the home of a recipient of such services; providing penalties; and providing other matters properly relating thereto.
κ2025 Statutes of Nevada, Page 1670 (CHAPTER 250, AB 368)κ
Legislative Counsels Digest:
Existing law authorizes a patient in a facility for skilled nursing or the representative of the patient to request the installation and use of an electronic communication device in the living quarters of the patient. Existing law requires any roommate of the patient to consent before such a device may be installed. However, if the roommate of a patient refuses to consent, existing law requires the facility for skilled nursing to make reasonable attempts to accommodate the patient, including by moving either the patient or the roommate with the consent of the person being moved. (NRS 449A.182) If a facility for skilled nursing approves a request to install an electronic communication device, existing law provides that the patient or the representative of the patient who submitted the request is responsible for choosing the device and paying certain costs associated with the device. (NRS 449A.184) Existing law limits the persons who are authorized to view or listen to the images or sounds which are displayed, broadcast or recorded by an electronic communication device or temporarily disable or turn off an electronic communication device. Existing law also prohibits a facility for skilled nursing from discriminating or retaliating against a patient because of a decision to request the installation and use of an electronic communication device. (NRS 449A.186) Existing law establishes civil and criminal penalties that may be imposed against: (1) a facility for skilled nursing which violates that prohibition; (2) a person, other than the patient or the representative of the patient, who obstructs, tampers with or destroys an electronic communication device or any recording made by an electronic communication device; or (3) a person who views or listens to images or sounds which are displayed, broadcast or recorded by an electronic communication device without authorization. (NRS 449A.189, 449A.188) Existing law requires a facility for skilled nursing to post a notice in a conspicuous place at the entrance to the living quarters of a patient which contains an electronic communication device stating that such a device is in that living quarters. Existing law prohibits an employee of a facility for skilled nursing from refusing to enter into the living quarters of a patient which contains an electronic communication device or failing to perform his or her duties because such a device is in use. (NRS 449A.190) Existing law: (1) authorizes the State Board of Health to adopt regulations governing electronic communication devices in facilities for skilled nursing; and (2) provides that the provisions governing such electronic communication devices do not apply to certain devices installed by a law enforcement agency. (NRS 449A.192)
Sections 8-14 of this bill broaden the applicability of those provisions to authorize a patient in certain facilities, referred to as covered facilities, to install an electronic communication device under the same conditions as existing law establishes for a patient in a facility for skilled nursing. Section 3 of this bill defines the term covered facility to mean: (1) a facility for intermediate care; (2) a facility for skilled nursing; (3) a home for individual residential care; (4) a unit for the provision of long-term care in a hospital; (5) a residential facility for groups; or (6) assisted living services provided in a senior living community. Sections 4-6 of this bill define the terms facility for intermediate care, home for individual residential care and senior living community, respectively, to have the meanings ascribed to them in existing law. Section 7 of this bill establishes the applicability of those definitions. Section 1.5 of this bill authorizes the Division of Public and Behavioral Health of the Department of Health and Human Services to deny an application for a license for or suspend or revoke the license of a covered facility that fails to comply with provisions governing the installation and use of electronic communication devices.
κ2025 Statutes of Nevada, Page 1671 (CHAPTER 250, AB 368)κ
Sections 24-31 of this bill enact provisions governing the installation of electronic communication devices by residents of living communities for persons with disabilities. Sections 24-30 authorize a resident of such a living community or the representative of the resident to request the installation and use of an electronic communication device in the bedroom of the resident under similar conditions to those that currently apply to a patient in a facility for skilled nursing. Section 24 of this bill prescribes the requirements for a person to serve as the representative of a resident. Section 28 establishes civil and criminal penalties that may be imposed against a living community or person who engages in certain prohibited conduct relating to electronic communication devices in living communities. Section 31 prohibits a person from posting or otherwise uploading onto an Internet website an image or a sound of an employee or independent contractor of a living community displayed, broadcasted or recorded on an electronic commination device. Section 32 of this bill prohibits a provider of supported living arrangement services in the home of a recipient of such services from: (1) entering into a contract that prohibits the recipient from installing and using an electronic communication device in his or her home; or (2) taking certain actions against a recipient because the recipient has installed or used an electronic communication device in his or her home. Sections 20-23 of this bill define certain terms, and section 18 of this bill establishes the applicability of those definitions. Section 30 authorizes the Administrator of the Aging and Disability Services Division of the Department to adopt regulations as necessary to carry out sections 18-32. Section 33 of this bill makes the definition of supported living arrangement services applicable to sections 18-32. Sections 1, 15, 16 and 34-36 of this bill update references to that definition and make other technical updates related to the change made in section 33.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 449.0185 is hereby amended to read as follows:
449.0185 Supported living arrangement services has the meaning ascribed to it in NRS [435.3315.] 435.007.
Sec. 1.5. NRS 449.160 is hereby amended to read as follows:
449.160 1. The Division may deny an application for a license or may suspend or revoke any license issued under the provisions of NRS 449.029 to 449.2428, inclusive, upon any of the following grounds:
(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410, 449.029 to 449.245, inclusive, or 449A.100 to 449A.124, inclusive, and 449A.270 to 449A.286, inclusive, or of any other law of this State or of the standards, rules and regulations adopted thereunder.
(b) Aiding, abetting or permitting the commission of any illegal act.
(c) Conduct inimical to the public health, morals, welfare and safety of the people of the State of Nevada in the maintenance and operation of the premises for which a license is issued.
(d) Conduct or practice detrimental to the health or safety of the occupants or employees of the facility.
(e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or 439A.102 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required, including, without limitation, the closure or conversion of any hospital in a county whose population is 100,000 or more that is owned by the licensee without approval pursuant to NRS 439A.102.
κ2025 Statutes of Nevada, Page 1672 (CHAPTER 250, AB 368)κ
limitation, the closure or conversion of any hospital in a county whose population is 100,000 or more that is owned by the licensee without approval pursuant to NRS 439A.102.
(f) Failure to comply with the provisions of NRS 441A.315 and any regulations adopted pursuant thereto or NRS 449.2486.
(g) Violation of the provisions of NRS 458.112.
(h) Failure to comply with the provisions of NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act and any regulation adopted pursuant thereto.
(i) Violation of the provisions of NRS 629.260.
2. In addition to the provisions of subsection 1, the Division may revoke a license to operate a facility for the dependent if, with respect to that facility, the licensee that operates the facility, or an agent or employee of the licensee:
(a) Is convicted of violating any of the provisions of NRS 202.470;
(b) Is ordered to but fails to abate a nuisance pursuant to NRS 244.360, 244.3603 or 268.4124; or
(c) Is ordered by the appropriate governmental agency to correct a violation of a building, safety or health code or regulation but fails to correct the violation.
3. The Division shall maintain a log of any complaints that it receives relating to activities for which the Division may revoke the license to operate a facility for the dependent pursuant to subsection 2. The Division shall provide to a facility for the care of adults during the day:
(a) A summary of a complaint against the facility if the investigation of the complaint by the Division either substantiates the complaint or is inconclusive;
(b) A report of any investigation conducted with respect to the complaint; and
(c) A report of any disciplinary action taken against the facility.
Κ The facility shall make the information available to the public pursuant to NRS 449.2486.
4. On or before February 1 of each odd-numbered year, the Division shall submit to the Director of the Legislative Counsel Bureau a written report setting forth, for the previous biennium:
(a) Any complaints included in the log maintained by the Division pursuant to subsection 3; and
(b) Any disciplinary actions taken by the Division pursuant to subsection 2.
Sec. 2. Chapter 449A of NRS is hereby amended by adding thereto the provisions set forth as sections 3 to 6, inclusive, of this act.
Sec. 3. Covered facility means:
1. A facility for intermediate care;
2. A facility for skilled nursing;
3. A home for individual residential care;
4. A unit for the provision of long-term care in a hospital;
5. A residential facility for groups; or
6. A unit in a senior living community for the provision of assisted living services or a senior living community that provides only assisted living services.
Sec. 4. Facility for intermediate care has the meaning ascribed to it in NRS 449.0038.
κ2025 Statutes of Nevada, Page 1673 (CHAPTER 250, AB 368)κ
Sec. 5. Home for individual residential care has the meaning ascribed to it in NRS 449.0105.
Sec. 6. Senior living community has the meaning ascribed to it in NRS 449.0179.
Sec. 7. NRS 449A.170 is hereby amended to read as follows:
449A.170 As used in NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act, unless the context otherwise requires, the words and terms defined in NRS 449A.172 to 449A.178, inclusive, and sections 3 to 6, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 8. NRS 449A.180 is hereby amended to read as follows:
449A.180 A person may serve as the representative of a patient in a covered facility , [for skilled nursing,] including, without limitation, a patient who is the roommate of a patient who wishes to submit or has submitted a request pursuant to NRS 449A.182, for the purposes of NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act, if the person:
1. Is the guardian of the patient whom he or she is representing and:
(a) The power to make decisions on behalf of the patient pursuant to NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act is specifically authorized under the existing guardianship; or
(b) The guardian has separately petitioned for and been granted such power by the court that has jurisdiction over the guardianship; or
2. Has been given power of attorney to make decisions concerning health care for the patient pursuant to NRS 162A.700 to 162A.870, inclusive, and the power to make decisions on behalf of the patient pursuant to NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act is specifically delegated to the person in the power of attorney.
Sec. 9. NRS 449A.182 is hereby amended to read as follows:
449A.182 1. A patient in a covered facility [for skilled nursing] or the representative of the patient may request the installation and use of an electronic communication device in the living quarters of the patient by submitting to the covered facility : [for skilled nursing:]
(a) A completed form prescribed by the facility pursuant to subsection 3; or
(b) If the facility has not prescribed a form pursuant to subsection 3, a written request that meets the requirements of subsection 2.
2. A request submitted pursuant to subsection 1 must include or be accompanied by:
(a) Information regarding the type, function and expected use of the electronic communication device which will be installed and used;
(b) The name and contact information for any person other than the patient or his or her representative who is authorized to view or listen to the images or sounds which are displayed, broadcast or recorded by the electronic communication device pursuant to subsection 3 of NRS 449A.186;
(c) An agreement by the patient or the representative of the patient to, except as otherwise provided by NRS 449A.186:
(1) Waive the patients right to privacy in connection with use of the electronic communication device; and
(2) Release the covered facility [for skilled nursing] and any employee of the facility from any administrative, civil or criminal liability for a violation of the patients right to privacy in connection with use of the electronic communication device;
κ2025 Statutes of Nevada, Page 1674 (CHAPTER 250, AB 368)κ
(d) If the patient has a roommate:
(1) The written consent of the roommate or the representative of the roommate to the installation and use of an electronic communication device in the living quarters of the patient; and
(2) An agreement by the roommate or the representative of the roommate to, except as otherwise provided in NRS 449A.186:
(I) Waive the roommates right to privacy in connection with use of the electronic communication device; and
(II) Release the covered facility [for skilled nursing] and any employee of the facility from any administrative, civil or criminal liability for a violation of the roommates right to privacy in connection with the use of the electronic communication device; and
(e) If the request is submitted by the representative of the patient, proof that the representative of the patient meets the requirements of NRS 449A.180.
3. A covered facility [for skilled nursing] may prescribe a form for use by a patient or the representative of a patient to request to install and use an electronic communication device in the living quarters of the patient. To the extent practicable, such a form must be provided in a language chosen by the patient or the representative of the patient. Such a form must include, without limitation:
(a) An explanation of the provisions of NRS 449A.170 to 449A.192, inclusive [;] , and sections 3 to 6, inclusive, of this act; and
(b) Places to record the information, agreements and consent described in paragraphs (a) to (d), inclusive, of subsection 2.
4. A covered facility [for skilled nursing] shall approve a request by a patient or the representative of a patient pursuant to this section if the request meets the requirements of this section.
5. If the roommate or the representative of the roommate of a patient who wishes to submit a request pursuant to subsection 1, or whose representative wishes to submit such a request, refuses to provide consent and enter into the agreement required by paragraph (d) of subsection 2, the covered facility [for skilled nursing] shall make reasonable attempts to accommodate the patient. Such reasonable attempts may include, without limitation, moving either the patient or his or her roommate to different living quarters with the consent of the person being moved or his or her representative.
6. A patient or the representative of a patient who has submitted a request pursuant to subsection 1, a roommate who has provided consent pursuant to paragraph (d) of subsection 2 or the representative of such a roommate may withdraw the request or consent at any time, including, without limitation, after the request has been approved or after an electronic communication device has been installed, by submitting a written revocation to the covered facility . [for skilled nursing.] Not later than 24 hours after the submission of such a written revocation, the covered facility [for skilled nursing] shall cause the removal of any electronic communication device that has been installed.
Sec. 10. NRS 449A.184 is hereby amended to read as follows:
449A.184 1. If a covered facility [for skilled nursing] approves a request to install and use an electronic communication device in the living quarters of a patient pursuant to NRS 449A.182, the patient or the representative of the patient is solely responsible for:
κ2025 Statutes of Nevada, Page 1675 (CHAPTER 250, AB 368)κ
(a) Choosing the electronic communication device, subject to the limitations prescribed by subsection 3;
(b) The cost of the electronic communication device;
(c) The cost of installing, maintaining and removing the electronic communication device, if applicable, other than the cost of electricity used to power the electronic communication device; and
(d) The cost of any repairs required due to the installation or removal of the device.
2. A patient who is discharged from a covered facility [for skilled nursing] or the representative of such a patient remains solely responsible for the costs described in subsection 1, including, without limitation, such costs that are incurred after the discharge of the patient.
3. An electronic communication device chosen by a patient or the representative of a patient pursuant to subsection 1 must:
(a) Be capable of being temporarily disabled or turned on and off; and
(b) If the device communicates using video or other visual transmission, to the greatest extent practicable, be installed:
(1) With a fixed viewpoint of the living quarters; or
(2) In a manner that avoids capturing images of activities such as bathing, dressing and toileting.
Sec. 11. NRS 449A.186 is hereby amended to read as follows:
449A.186 1. Except as otherwise provided in this section, a person other than the patient or the representative of the patient who has requested the installation and use of an electronic communication device pursuant to NRS 449A.182 shall not intentionally:
(a) Obstruct, tamper with or destroy the electronic communication device or any recording made by the electronic communication device; or
(b) View or listen to any images or sounds which are displayed, broadcast or recorded by the electronic communication device.
2. The following persons may view or listen to the images or sounds which are displayed, broadcast or recorded by an electronic communication device installed and used pursuant to NRS 449A.182 or temporarily disable or turn off such a device:
(a) A representative of a law enforcement agency who is conducting an investigation;
(b) A representative of the Aging and Disability Services Division or the Division of Public and Behavioral Health of the Department of Health and Human Services who is conducting an investigation;
(c) The State Long-Term Care Ombudsman; and
(d) An attorney who is representing the patient or a roommate of the patient and acting within the scope of that representation.
3. A patient or the representative of the patient who has requested the installation and use of an electronic communication device pursuant to NRS 449A.182 may authorize a person other than a person described in subsection 2 to view or listen to the images or sounds which are displayed, broadcast or recorded by the electronic communication device. Any such authorization must be made in writing. The patient or representative, as applicable, may provide a copy of the authorization to the facility and the roommate of the patient or the representative of the roommate, if any.
4. A person who temporarily disables or turns off an electronic communication device pursuant to subsection 2 shall ensure that the functions of the electronic communication device are appropriately enabled or turned back on before exiting the living quarters of the patient.
κ2025 Statutes of Nevada, Page 1676 (CHAPTER 250, AB 368)κ
5. A covered facility [for skilled nursing] shall not deny admission to or discharge a patient from the facility or otherwise discriminate or retaliate against a patient because of a decision to request the installation and use of an electronic communication device in the living quarters of the patient pursuant to NRS 449A.182.
Sec. 12. NRS 449A.188 is hereby amended to read as follows:
449A.188 1. A natural person who violates subsection 1 of NRS 449A.186:
(a) For a first offense, is liable for a civil penalty not to exceed $5,000.
(b) For a second and any subsequent offense:
(1) Is liable for a civil penalty not to exceed $10,000 for each violation; and
(2) Is guilty of a misdemeanor.
2. In addition to any disciplinary action imposed pursuant to chapter 449 of NRS, a covered facility [for skilled nursing] or any person, partnership, association or corporation establishing, conducting, managing or operating a covered facility [for skilled nursing] who violates subsection 1 or 5 of NRS 449A.186:
(a) For a first offense, is liable for a civil penalty not to exceed $10,000.
(b) For a second and any subsequent offense:
(1) Is liable for a civil penalty not to exceed $20,000 for each violation; and
(2) Is guilty of a misdemeanor.
3. The Attorney General or any district attorney may recover any civil penalty assessed pursuant to this section in a civil action brought in the name of the State of Nevada in any court of competent jurisdiction.
Sec. 13. NRS 449A.190 is hereby amended to read as follows:
449A.190 1. A covered facility [for skilled nursing] shall post a notice in a conspicuous place at the entrance to the living quarters of a patient which contains an electronic communication device stating that such a device is in use in that living quarters.
2. An employee of a covered facility [of skilled nursing] shall not refuse to enter the living quarters of a patient which contains an electronic communication device installed pursuant to NRS 449A.182 or fail to perform any of the duties of the employee on the grounds that such a device is in use.
Sec. 14. NRS 449A.192 is hereby amended to read as follows:
449A.192 1. The State Board of Health may adopt regulations necessary to carry out the provisions of NRS 449A.170 to 449A.192, inclusive [.] , and sections 3 to 6, inclusive, of this act.
2. The provisions of NRS 449A.170 to 449A.192, inclusive, and sections 3 to 6, inclusive, of this act, do not apply if an electronic communication device is installed by a law enforcement agency and used solely for a legitimate law enforcement purpose.
Sec. 15. NRS 159.081 is hereby amended to read as follows:
159.081 1. A guardian of the person shall make and file in the guardianship proceeding for review of the court a written report on the condition of the protected person and the exercise of authority and performance of duties by the guardian:
(a) Annually, not later than 60 days after the anniversary date of the appointment of the guardian;
(b) Within 10 days of moving a protected person to a secured residential long-term care facility; and
(c) At such other times as the court may order.
κ2025 Statutes of Nevada, Page 1677 (CHAPTER 250, AB 368)κ
2. A report filed pursuant to paragraph (b) of subsection 1 must:
(a) Include a copy of the written recommendation upon which the transfer was made; and
(b) Except as otherwise provided in subsection 6, be served, without limitation, on the protected person and any attorney for the protected person.
3. The court may prescribe the form for filing a report described in subsection 1. Such a report must include, without limitation:
(a) The physical condition of the protected person;
(b) The place of residence of the protected person;
(c) The name of all other persons living with the protected person unless the protected person is residing at a secured residential long-term care facility, group home, supportive living facility, home in which supported living arrangement services are provided, assisted living facility or other facility for long-term care; and
(d) Any other information required by the court.
4. The guardian of the person shall give to the guardian of the estate, if any, a copy of each report not later than 30 days after the date the report is filed with the court.
5. The court is not required to hold a hearing or enter an order regarding the report.
6. The court may waive the requirement set forth in paragraph (b) of subsection 2 that a report filed pursuant to paragraph (b) of subsection 1 must be served on a protected person upon a showing that such service is detrimental to the physical or mental health of the protected person.
7. As used in this section:
(a) Facility for long-term care has the meaning ascribed to it in NRS 427A.028.
(b) Supported living arrangement services has the meaning ascribed to it in NRS [435.3315.] 435.007.
Sec. 16. NRS 427A.0292 is hereby amended to read as follows:
427A.0292 Living arrangement services means:
1. Community-based living arrangement services, as defined in NRS 449.0026, that include:
(a) Intensive services and overnight supervision of recipients who require training concerning behavioral skills, self-care and management of medications; or
(b) Services in the home for recipients with chronic medical conditions and severe mental illness who require habilitation or rehabilitation services, or both; and
2. Supported living arrangement services, as defined in NRS [435.3315,] 435.007 that include 24-hour care.
Sec. 17. Chapter 435 of NRS is hereby amended by adding thereto the provisions set forth as sections 18 to 32, inclusive, of this act.
Sec. 18. As used in sections 18 to 32, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 20 to 23, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 19. (Deleted by amendment.)
Sec. 20. Guardian has the meaning ascribed to it in NRS 159.017.
Sec. 21. Living community for persons with disabilities or living community means:
1. A provider-operated residential supported living arrangement; and
2. Any other housing arrangement that provides assistance, food, shelter or limited supervision to persons with intellectual disabilities or physical disabilities for compensation and is not a covered facility, as defined in section 3 of this act.
κ2025 Statutes of Nevada, Page 1678 (CHAPTER 250, AB 368)κ
disabilities or physical disabilities for compensation and is not a covered facility, as defined in section 3 of this act.
Sec. 21.5. Provider-operated residential supported living arrangement means a residential setting that is owned, operated or otherwise controlled by a provider of supported living arrangement services.
Sec. 22. Representative means a person who is authorized to serve as the representative of a resident pursuant to section 24 of this act.
Sec. 23. Resident means a person who resides in a living community for persons with disabilities.
Sec. 24. A person may serve as the representative of a resident, including, without limitation, a resident who is the roommate of a resident who wishes to submit or has submitted a request pursuant to section 25 of this act, for the purposes of sections 24 to 29, inclusive, of this act, if the person:
1. Is the guardian of the resident whom he or she is representing and:
(a) The power to make decisions on behalf of the resident pursuant to sections 24 to 29, inclusive, of this act is specifically authorized under the existing guardianship; or
(b) The guardian has separately petitioned for and been granted such power by the court that has jurisdiction over the guardianship; or
2. Has been given power of attorney to make decisions concerning health care for the resident pursuant to NRS 162A.700 to 162A.870, inclusive, and the power to make decisions on behalf of the resident pursuant to sections 24 to 29, inclusive, of this act is specifically delegated to the person in the power of attorney.
Sec. 25. 1. A resident or the representative of a resident may request the installation and use of an electronic communication device in the bedroom of the resident by submitting to the living community in which he or she resides:
(a) A completed form prescribed by the living community pursuant to subsection 3; or
(b) If the living community has not prescribed a form pursuant to subsection 3, a written request that meets the requirements of subsection 2.
2. A request submitted pursuant to subsection 1 must include or be accompanied by:
(a) Information regarding the type, function and expected use of the electronic communication device which will be installed and used;
(b) The name and contact information for any person other than the resident or his or her representative who is authorized to view or listen to the images or sounds which are displayed, broadcast or recorded by the electronic communication device pursuant to subsection 3 of section 27 of this act;
(c) An agreement by the resident or the representative of the resident to, except as otherwise provided by section 27 of this act:
(1) Waive the residents right to privacy in connection with use of the electronic communication device; and
(2) Release the living community and any employee of the living community from any administrative, civil or criminal liability for a violation of the residents right to privacy in connection with use of the electronic communication device;
κ2025 Statutes of Nevada, Page 1679 (CHAPTER 250, AB 368)κ
(d) If the resident has a roommate:
(1) The written consent of the roommate or the representative of the roommate to the installation and use of an electronic communication device in the bedroom of the resident; and
(2) An agreement by the roommate or the representative of the roommate to, except as otherwise provided in section 27 of this act:
(I) Waive the roommates right to privacy in connection with use of the electronic communication device; and
(II) Release the living community and any employee of the living community from any administrative, civil or criminal liability for a violation of the roommates right to privacy in connection with the use of the electronic communication device; and
(e) If the request is submitted by the representative of the resident, proof that the representative of the resident meets the requirements of section 24 of this act.
3. A living community may prescribe a form for use by a resident or the representative of a resident to request to install and use an electronic communication device in the bedroom of the resident. To the extent practicable, such a form must be provided in a language chosen by the resident or the representative of the resident. Such a form must include, without limitation:
(a) An explanation of the provisions of sections 24 to 29, inclusive, of this act; and
(b) Places to record the information, agreements and consent described in paragraphs (a) to (d), inclusive, of subsection 2.
4. A living community shall approve a request by a resident or the representative of a resident pursuant to this section if the request meets the requirements of this section.
5. If the roommate or the representative of the roommate of a resident who wishes to submit a request pursuant to subsection 1, or whose representative wishes to submit such a request, refuses to provide consent and enter into the agreement required by paragraph (d) of subsection 2, the living community shall make reasonable attempts to accommodate the resident. Such reasonable attempts may include, without limitation, moving either the resident or his or her roommate to a different bedroom within the living community with the consent of the resident being moved or his or her representative.
6. A resident or the representative of a resident who has submitted a request pursuant to subsection 1, a roommate who has provided consent pursuant to paragraph (d) of subsection 2 or the representative of such a roommate may withdraw the request or consent at any time, including, without limitation, after the request has been approved or after an electronic communication device has been installed, by submitting a written revocation to the living community. Not later than 24 hours after the submission of such a written revocation, the living community shall cause the removal of any electronic communication device that has been installed.
Sec. 26. 1. If a living community approves a request to install and use an electronic communication device in the bedroom of a resident pursuant to section 25 of this act, the resident or the representative of the resident is solely responsible for:
(a) Choosing the electronic communication device, subject to the limitations prescribed by subsection 3;
κ2025 Statutes of Nevada, Page 1680 (CHAPTER 250, AB 368)κ
(b) The cost of the electronic communication device;
(c) The cost of installing, maintaining and removing the electronic communication device, if applicable, other than the cost of electricity used to power the electronic communication device if the resident does not pay for electricity for his or her bedroom; and
(d) The cost of any repairs required due to the installation or removal of the device.
2. A resident who ceases to reside in a living community or the representative of such a resident remains solely responsible for the costs described in subsection 1, including, without limitation, such costs that are incurred after the person leaves the living community.
3. An electronic communication device chosen by a resident or the representative of a resident pursuant to subsection 1 must:
(a) Be capable of being temporarily disabled or turned on and off; and
(b) If the device communicates using video or other visual transmission, to the greatest extent practicable, be installed:
(1) With a fixed viewpoint; or
(2) In a manner that avoids capturing images of activities such as bathing, dressing and toileting.
Sec. 27. 1. Except as otherwise provided in this section, a person, other than the resident or the representative of the resident who has requested the installation and use of an electronic communication device pursuant to section 25 of this act, shall not intentionally:
(a) Obstruct, tamper with or destroy the electronic communication device or any recording made by the electronic communication device; or
(b) View or listen to any images or sounds which are displayed, broadcast or recorded by the electronic communication device.
2. The following persons may view or listen to the images or sounds which are displayed, broadcast or recorded by an electronic communication device installed and used pursuant to section 25 of this act or temporarily disable or turn off such a device:
(a) A representative of a law enforcement agency who is conducting an investigation;
(b) A representative of the Division who is conducting an investigation; or
(c) An attorney who is representing the resident or a roommate of the resident and acting within the scope of that representation.
3. A resident or the representative of the resident who has requested the installation and use of an electronic communication device pursuant to section 25 of this act may authorize a person other than a person described in subsection 2 to view or listen to the images or sounds which are displayed, broadcast or recorded by the electronic communication device. Any such authorization must be made in writing. The resident or representative, as applicable, may provide a copy of the authorization to the living community and the roommate of the resident or the representative of the roommate, if any.
4. A person who temporarily disables or turns off an electronic communication device pursuant to subsection 2 shall ensure that the functions of the electronic communication device are appropriately enabled or turned back on before exiting the bedroom of the resident.
5. A living community shall not evict a resident, refuse to renew a contract with a resident or otherwise require a resident to leave the living community or discriminate or retaliate against a resident because of a decision to request the installation and use of an electronic communication device in the bedroom of the resident pursuant to section 25 of this act.
κ2025 Statutes of Nevada, Page 1681 (CHAPTER 250, AB 368)κ
decision to request the installation and use of an electronic communication device in the bedroom of the resident pursuant to section 25 of this act.
6. A person shall not use an electronic communication device to control the actions of a resident or otherwise violate any right that a resident has pursuant to 42 C.F.R. § 441.301(c)(4), where applicable.
Sec. 28. 1. A natural person who violates subsection 1 of section 27 of this act:
(a) For a first offense, is liable for a civil penalty not to exceed $5,000.
(b) For a second and any subsequent offense:
(1) Is liable for a civil penalty not to exceed $10,000 for each violation; and
(2) Is guilty of a misdemeanor.
2. In addition to any disciplinary action imposed pursuant to regulations adopted pursuant to NRS 435.333, where applicable, a living community that violates subsection 1 or 5 of section 27 of this act:
(a) For a first offense, is liable for a civil penalty not to exceed $10,000.
(b) For a second and any subsequent offense:
(1) Is liable for a civil penalty not to exceed $20,000 for each violation; and
(2) Is guilty of a misdemeanor.
3. The Attorney General or any district attorney may recover any civil penalty assessed pursuant to this section in a civil action brought in the name of the State of Nevada in any court of competent jurisdiction.
Sec. 29. 1. A living community shall post a notice in a conspicuous place at the entrance to the bedroom of a resident which contains an electronic communication device stating that such a device is in use in the bedroom.
2. An employee of a living community shall not refuse to enter the bedroom of a resident which contains an electronic communication device installed pursuant to section 25 of this act or fail to perform any of the duties of the employee on the grounds that such a device is in use.
Sec. 30. 1. The Administrator may adopt regulations necessary to carry out the provisions of section 18 to 32, inclusive, of this act.
2. The provisions of sections 18 to 31, inclusive, of this act do not apply if an electronic communication device is installed by a law enforcement agency and used solely for a legitimate law enforcement purpose.
Sec. 31. 1. A resident of a living community or any other person who has authority to view or listen to the images or sounds which are displayed, broadcast or recorded by the electronic communication device pursuant to subsection 3 of section 27 of this act may not post, upload or otherwise share any images or sounds displayed, broadcasted or recorded by the electronic communication device of an employee or independent contractor of a living community on an Internet website or technology application, including, without limitation, a social media, image sharing or open communication Internet website.
2. For a first violation of this section, a living community shall notify the resident and his or her representative, if applicable, that a second violation will authorize the living community to take the actions authorized by subsection 3.
3. For a second or subsequent violation of this section, a living community may:
κ2025 Statutes of Nevada, Page 1682 (CHAPTER 250, AB 368)κ
(a) Refuse to provide services to the resident when the electronic communication device is on; or
(b) Revoke the authority of the resident to have an electronic communication device in his or her bedroom.
Sec. 32. 1. A provider of supported living arrangement services that provides such services in the home of a person receiving such services shall not enter into a contract or agreement that prohibits the installation or use of an electronic communication device in the home of the person. Any contract or agreement that is entered into in violation of this subsection is void.
2. A provider of supported living arrangement services or an employee or independent contractor of such a provider shall not:
(a) Refuse to enter the home of a person who is receiving supported living arrangement services;
(b) Refuse to provide supported living arrangement services to a person; or
(c) Otherwise discriminate or retaliate against a person,
Κ because an electronic communication device has been installed or is in use in the home of the person.
3. As used in this section, home does not include a provider-operated residential supported living arrangement.
Sec. 33. NRS 435.007 is hereby amended to read as follows:
435.007 As used in this chapter, unless the context otherwise requires:
1. Administrative officer means a person with overall executive and administrative responsibility for those state or nonstate intellectual and developmental disability centers designated by the Administrator.
2. Administrator means the Administrator of the Division.
3. Child means any person under the age of 18 years who may be eligible for intellectual disability services or developmental disability services.
4. Department means the Department of Health and Human Services.
5. Developmental disability means autism, cerebral palsy, epilepsy, a fetal alcohol spectrum disorder or any other neurological condition diagnosed by a qualified professional that:
(a) Is manifested before the person affected attains the age of 22 years;
(b) Is likely to continue indefinitely;
(c) Results in substantial functional limitations, as measured by a qualified professional, in three or more of the following areas of major life activity:
(1) Taking care of oneself;
(2) Understanding and use of language;
(3) Learning;
(4) Mobility;
(5) Self-direction; and
(6) Capacity for independent living; and
(d) Results in the person affected requiring a combination of individually planned and coordinated services, support or other assistance that is lifelong or has an extended duration.
6. Director of the Department means the administrative head of the Department.
7. Division means the Aging and Disability Services Division of the Department.
κ2025 Statutes of Nevada, Page 1683 (CHAPTER 250, AB 368)κ
8. Division facility means any unit or subunit operated by the Division for the care, treatment and training of consumers.
9. Fetal alcohol spectrum disorder has the meaning ascribed to it in NRS 432B.0655.
10. Intellectual disability means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.
11. Intellectual and developmental disability center means an organized program for providing appropriate services and treatment to persons with intellectual disabilities and persons with developmental disabilities. An intellectual and developmental disability center may include facilities for residential treatment and training.
12. Medical director means the chief medical officer of any program of the Division for persons with intellectual disabilities or developmental disabilities.
13. Mental illness has the meaning ascribed to it in NRS 433.164.
14. Parent means the parent of a child. The term does not include the parent of a person who has attained the age of 18 years.
15. Person includes a child and any other consumer with an intellectual disability and a child or any other consumer with a developmental disability who has attained the age of 18 years.
16. Person professionally qualified in the field of psychiatric mental health has the meaning ascribed to it in NRS 433.209.
17. Residential facility for groups means a structure similar to a private residence which will house a small number of persons in a homelike atmosphere.
18. Supported living arrangement services means flexible, individualized services provided in the home, for compensation, to a person with an intellectual disability or a person with a developmental disability who is served by the Division that are designed and coordinated to assist the person in maximizing the persons independence, including, without limitation, training and habilitation services.
19. Training means a program of services directed primarily toward enhancing the health, welfare and development of persons with intellectual disabilities or persons with developmental disabilities through the process of providing those experiences that will enable the person to:
(a) Develop his or her physical, intellectual, social and emotional capacities to the fullest extent;
(b) Live in an environment that is conducive to personal dignity; and
(c) Continue development of those skills, habits and attitudes essential to adaptation in contemporary society.
[19.] 20. Treatment means any combination of procedures or activities, of whatever level of intensity and whatever duration, ranging from occasional counseling sessions to full-time admission to a residential facility.
Sec. 34. NRS 435.3305 is hereby amended to read as follows:
435.3305 As used in NRS 435.3305 to 435.339, inclusive, unless the context otherwise requires, [the words and terms defined in NRS 435.331 and 435.3315 have the meanings ascribed to them in those sections.] certificate means a certificate to provide supported living arrangement services that is issued pursuant to NRS 435.3305 to 435.339, inclusive, and the regulations adopted pursuant to NRS 435.3305 to 435.339, inclusive.
κ2025 Statutes of Nevada, Page 1684 (CHAPTER 250, AB 368)κ
Sec. 35. NRS 632.316 is hereby amended to read as follows:
632.316 The provisions of NRS 632.315 do not prohibit:
1. Gratuitous nursing by friends or by members of the family of a patient.
2. The incidental care of the sick by domestic servants or persons primarily employed as housekeepers as long as they do not practice nursing within the meaning of this chapter.
3. Nursing assistance in the case of an emergency.
4. The practice of nursing by students enrolled in accredited schools of nursing or by graduates of those schools or courses pending the results of the first licensing examination scheduled by the Board following graduation. A student or graduate may not work as a nursing assistant unless the student or graduate is certified to practice as a nursing assistant pursuant to the provisions of this chapter.
5. The practice of nursing in this State by any legally qualified nurse or nursing assistant of another state whose engagement requires the nurse or nursing assistant to accompany and care for a patient temporarily residing in this State during the period of one such engagement, not to exceed 6 months, if the person does not represent or hold himself or herself out as a nurse licensed to practice in this State or as a nursing assistant who holds a certificate to practice in this State.
6. The practice of nursing by any person who is employed by the United States Government, or any bureau, division or agency thereof, while in the discharge of his or her official duties in this State, including, without limitation, providing medical care in a hospital in accordance with an agreement entered into pursuant to NRS 449.2455.
7. Nonmedical nursing for the care of the sick, with or without compensation, if done by the adherents of, or in connection with, the practice of the religious tenets of any well-recognized church or religious denomination, if that nursing does not amount to the practice of practical or professional nursing as defined in NRS 632.017 and 632.018, respectively.
8. A personal assistant from performing services for a person with a disability pursuant to NRS 629.091.
9. A natural person from providing community-based living arrangement services if:
(a) That person has been issued a license pursuant to chapter 449 of NRS and the regulations adopted pursuant thereto; or
(b) That person is employed or retained as an independent contractor by a partnership, firm, corporation or association, state or local government or agency thereof that has been issued a license pursuant to chapter 449 of NRS and the regulations adopted pursuant thereto.
Κ As used in this subsection, community-based living arrangement services has the meaning ascribed to it in NRS 449.0026.
10. A natural person from providing supported living arrangement services if:
(a) That person has been issued a certificate pursuant to NRS 435.3305 to 435.339, inclusive, and the regulations adopted pursuant to NRS 435.3305 to 435.339, inclusive; or
(b) That person is employed or retained as an independent contractor by a partnership, firm, corporation or association, state or local government or agency thereof that has been issued a certificate pursuant to NRS 435.3305 to 435.339, inclusive, and the regulations adopted pursuant to NRS 435.3305 to 435.339, inclusive.
κ2025 Statutes of Nevada, Page 1685 (CHAPTER 250, AB 368)κ
Κ As used in this subsection, supported living arrangement services has the meaning ascribed to it in NRS [435.3315.] 435.007.
11. A natural person from providing jobs and day training services if:
(a) That person has been issued a certificate pursuant to NRS 435.130 to 435.310, inclusive, and the regulations adopted pursuant to NRS 435.130 to 435.310, inclusive; or
(b) That person is employed or retained as an independent contractor by a partnership, firm, corporation or association, state or local government or agency thereof that has been issued a certificate pursuant to NRS 435.130 to 435.310, inclusive, and the regulations adopted pursuant to NRS 435.130 to 435.310, inclusive.
Κ As used in this subsection, jobs and day training services has the meaning ascribed to it in NRS 435.176.
Sec. 36. NRS 435.331 and 435.3315 are hereby repealed.
Sec. 37. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 36, inclusive, of this act become effective:
(a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and
(b) On or before October 1, 2025, for all other purposes.
________
Assembly Bill No. 369Assemblymember Backus
CHAPTER 251
[Approved: June 3, 2025]
AN ACT relating to domestic violence; revising provisions governing certain orders for protection against domestic violence; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law provides that an order for protection against domestic violence issued by the court of another state, territory or Indian tribe within the United States is valid and must be accorded full faith and credit and enforced by the courts of this State as if it were issued by a court in this State. In enforcing such an order, a law enforcement officer is required to make an arrest for a violation of the order in the same manner that an officer would make an arrest for a violation of a temporary or extended order issued by a court of this State unless it is apparent to the officer that the order is not authentic on its face. In enforcing such an order, a law enforcement officer is authorized to rely on certain evidence. (NRS 33.085) This bill expands the type of evidence upon which a law enforcement officer may rely to include: (1) a hard copy or digital image of an order for protection against domestic violence that has been provided to the officer; and (2) any statement by the person against whom the order is being enforced. This bill also creates a process for a law enforcement officer of this State, when an otherwise valid order for protection against domestic violence is issued by the court of another state, territory or Indian tribe within the United States but the officer cannot confirm that the respondent has been notified or served with the order, to provide notice, attempt service and give reasonable opportunity for compliance before enforcing the order.
κ2025 Statutes of Nevada, Page 1686 (CHAPTER 251, AB 369)κ
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. NRS 33.085 is hereby amended to read as follows:
33.085 1. Except as otherwise provided in subsection 2, an order for protection against domestic violence issued by the court of another state, territory or Indian tribe within the United States, including, without limitation, any provisions in the order related to custody and support, is valid and must be accorded full faith and credit and enforced by the courts of this State as if it were issued by a court in this State, regardless of whether the order has been registered in this State, if the court in this State determines that:
(a) The issuing court had jurisdiction over the parties and the subject matter under the laws of the state, territory or Indian tribe in which the order was issued; and
(b) The adverse party was given reasonable notice and an opportunity to be heard before the order was issued or, in the case of an ex parte order, the adverse party was given reasonable notice and an opportunity to be heard within the time required by the laws of the issuing state, territory or tribe and, in any event, within a reasonable time after the order was issued.
2. If the order for protection against domestic violence issued by the court of another state, territory or Indian tribe is a mutual order for protection against domestic violence and:
(a) No counter or cross-petition or other pleading was filed by the adverse party; or
(b) A counter or cross-petition or other pleading was filed and the court did not make a specific finding of domestic violence by both parties,
Κ the court shall refuse to enforce the order against the applicant and may determine whether to issue its own temporary or extended order.
3. A law enforcement officer shall enforce an order for protection against domestic violence issued by the court of another state, territory or Indian tribe and shall make an arrest for a violation thereof in the same manner that a law enforcement officer would make an arrest for a violation of a temporary or extended order issued by a court of this State unless it is apparent to the officer that the order is not authentic on its face. An officer shall determine that an order is authentic on its face if the order contains:
(a) The names of the parties;
(b) Information indicating that the order has not expired; and
(c) Information indicating that the court which issued the order had legal authority to issue the order as evidenced by a certified copy of the order, a file-stamped copy of the order, an authorized signature or stamp of the court which issued the order or another indication of the authority of the court which issued the order.
Κ An officer may determine that any other order is authentic on its face.
4. In enforcing an order for protection against domestic violence issued by the court of another state, territory or Indian tribe or arresting a person for a violation of such an order, a law enforcement officer may rely upon:
(a) A hard copy or digital image of an order for protection against domestic violence that has been provided to the officer;
κ2025 Statutes of Nevada, Page 1687 (CHAPTER 251, AB 369)κ
(b) An order for protection against domestic violence that is included in the Repository for Information Concerning Orders for Protection pursuant to NRS 33.095 or in any national crime information database;
(c) Oral or written confirmation from a law enforcement agency or court in the jurisdiction in which the order for protection against domestic violence was issued that the order is valid and effective; or
(d) An examination of the totality of the circumstances concerning the existence of a valid and effective order for protection against domestic violence, including, without limitation, the statement of a person protected by the order that the order remains in effect [.] and any statement by the person against whom the order is being enforced.
5. If a law enforcement officer of this State determines that an otherwise valid order for protection against domestic violence was issued by the court of another state, territory or Indian tribe within the United States but cannot confirm that the respondent has been notified or served with the order, the officer shall:
(a) Inform the respondent of the order, including, without limitation, by providing verbal notice of the terms of the order, which shall be deemed sufficient notice;
(b) Make a reasonable effort to serve the order upon the respondent; and
(c) Allow the respondent a reasonable opportunity to comply with the order before enforcing the order.
6. A law enforcement officer shall document any actions taken pursuant to subsection 5 and cooperate with the court in the jurisdiction in which the order was issued for proof of service.
7. The fact that an order has not been registered or included in the Repository for Information Concerning Orders for Protection in the Central Repository for Nevada Records of Criminal History pursuant to NRS 33.095 or in any national crime information database is not grounds for a law enforcement officer to refuse to enforce the terms of the order unless it is apparent to the officer that the order is not authentic on its face.
[6.] 8. A court or law enforcement officer who enforces an order for protection against domestic violence issued by the court of another state, territory or Indian tribe based upon a reasonable belief that the order is valid or who refuses to enforce such an order based upon a reasonable belief that the order is not valid and the employer of such a law enforcement officer are immune from civil and criminal liability for any action taken or not taken based on that belief.
________
κ2025 Statutes of Nevada, Page 1688κ
Assembly Bill No. 383Assemblymembers Hansen, Dickman; Cole, Edgeworth, Gurr, Hafen, Hardy, Hibbetts, Nguyen and ONeill
CHAPTER 252
[Approved: June 3, 2025]
AN ACT relating to education; authorizing the State Board of Education to adopt regulations establishing criteria that a vendor that provides a high-impact tutoring program must satisfy to contract with the board of trustees of a school district or the governing body of a charter school to provide such a program; and providing other matters properly relating thereto.
Legislative Counsels Digest:
This bill authorizes the State Board of Education to adopt regulations establishing the criteria that a vendor that provides a high-impact tutoring program is required to satisfy to contract with the board of trustees of a school district or the governing body of a charter school to provide such a program. The regulations must establish the criteria, consistent with evidence-based best practices for high-impact tutoring, concerning: (1) the frequency of interactions between a pupil and a tutor; (2) the standards used by the program to determine which pupils will be selected to receive tutoring under the program; (3) the methods of tutoring under the program; (4) the requirements for a person to be a tutor, including, without limitation, training requirements; (5) the instructional materials used by the program; (6) the collection and reporting of required data concerning the academic progress of a pupil receiving tutoring under the program; and (7) the security and privacy of data concerning pupils who are provided tutoring under the program.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 388 of NRS is hereby amended by adding thereto a new section to read as follows:
The State Board may adopt regulations establishing the criteria that a vendor that provides a high-impact tutoring program must satisfy to contract with the board of trustees of a school district or the governing body of a charter school to provide such a program. The regulations adopted pursuant to this subsection must establish criteria, consistent with evidence-based best practices for high-impact tutoring, concerning:
1. The frequency of interactions between a pupil and a tutor under the program.
2. The standards used by the program to determine which pupils will be selected to receive tutoring under the program.
3. The methods of tutoring under the program, including, without limitation, a maximum pupil-tutor ratio for the program.
4. The qualifications of a person to serve as a tutor under the program, including, without limitation, the training necessary for a person to serve as a tutor.
5. The instructional materials used by the program.
κ2025 Statutes of Nevada, Page 1689 (CHAPTER 252, AB 383)κ
6. The data required to be collected by the program to monitor the academic progress of pupils who are provided tutoring under the program and a requirement to report the academic progress of each pupil to:
(a) Administrators and teachers at the school in which the pupil is enrolled; and
(b) The parent or legal guardian of the pupil.
7. The methods used by the program to ensure the security and privacy of data concerning pupils who are provided tutoring under the program, which must be consistent with relevant state and federal privacy laws, including, without limitation, the Family Educational Rights and Privacy Act of 1974, 20 U.S.C. § 1232g.
Sec. 2. This act becomes effective on July 1, 2025.
________
Assembly Bill No. 387Committee on Judiciary
CHAPTER 253
[Approved: June 3, 2025]
AN ACT relating to guardianship; revising provisions relating to service of certain notices, petitions and citations relating to guardianships of minors; revising provisions relating to the appointment, modification, removal or termination of guardianships of minors; revising provisions relating to the powers and duties of guardians of minors; revising provisions relating to the management of the estates, property and other assets of protected minors; and providing other matters properly relating thereto.
Legislative Counsels Digest:
Existing law establishes procedures relating to the appointment of guardians of minors and prescribes the powers and duties of the guardians. (Chapter 159A of NRS) Specifically, existing law requires a notice of a petition in a guardianship proceeding for a minor, the petition and a citation relating to the time and place of the hearing on the petition to be served on certain persons. (NRS 159A.034, 159A.047, 159A.0475) Sections 3, 8 and 9 of this bill make various changes related to the persons who are required to be served with the notice, petition or citation.
Existing law prescribes the method of service related to certain petitions and citations required to be served in guardianship proceedings for minors. (NRS 159A.034, 159A.0475, 159A.052, 159A.053) Sections 3, 9, 13 and 14 of this bill make various changes related to the method of service.
Existing law requires a petition for the appointment of a guardian for a minor to include certain information. (NRS 159A.044) Similarly, existing law sets forth the information that must be contained in a petition for the appointment of a temporary guardian of a minor. (NRS 159A.053) Sections 4 and 14 of this bill revise the information that is required to be contained in the petition for the appointment of a guardian and a petition for the appointment of a temporary guardian, respectively.
Existing law requires a proposed guardian to file a proposed preliminary care plan and budget under certain circumstances. (NRS 159A.0445) Section 5 of this bill: (1) expands the circumstances under which a proposed guardian may be required to file a proposed preliminary care plan and budget; and (2) requires the annual review and revision of the budget under certain circumstances.
κ2025 Statutes of Nevada, Page 1690 (CHAPTER 253, AB 387)κ
Existing law authorizes a court to appoint an attorney to represent a protected minor or proposed protected minor in guardianship proceedings. (NRS 159A.045) Section 6 of this bill provides that if a court appoints an attorney to represent a protected minor or proposed protected minor in a jurisdiction where there are certain established programs for legal services, the court must appoint an attorney from that program in those circumstances. Section 6 also establishes provisions that address the scenario under which the program for legal services has insufficient funding to support the representation of each child who would otherwise qualify for the appointment of an attorney under the new procedures and requires such attorneys to comply with the Nevada Rules of Professional Conduct. Sections 7 and 10 of this bill make certain changes to reflect the procedures for the appointment of an attorney under section 6.
Section 11 of this bill deems a protected minor or proposed protected minor who is the subject of guardianship proceedings to be a party to the proceedings.
Existing law authorizes a court to determine that a petitioner is a vexatious litigant under certain circumstances. (NRS 159A.0486) Section 12 of this bill expands the circumstances under which a court may find that a petitioner is a vexatious litigant to include certain acts involving a parent of a protected minor or proposed protected minor.
Existing law authorizes a person to petition the court for the appointment of a temporary guardian under certain circumstances. (NRS 159A.052, 159A.053) Sections 13 and 14 make various changes to these procedures for the purpose of providing that a court may require a hearing on the petition before determining the need to appoint a temporary guardian.
Existing law requires a proposed protected minor to attend a hearing for the appointment of a guardian unless certain evidence is shown to the court. (NRS 159A.0535) Section 15 of this bill removes this requirement related to the evidence and instead authorizes the court to waive the requirement for physical attendance or remote appearance for good cause shown.
Existing law establishes various procedures related to the issuance of orders for the appointment of a guardian and the burden of proof for the petitioner and certain other persons. (NRS 159A.055, 159A.0565, 159A.061) Section 16 of this bill requires the petitioner to prove by clear and convincing evidence that the appointment of a guardian is in the best interests of the proposed protected minor. Sections 16-18 of this bill also make various changes related to the issuance of such orders.
Existing law requires a guardian of a protected minor to perform certain duties that are necessary for the proper care, maintenance, education and support of the protected minor. (NRS 159A.079) Section 20 of this bill additionally requires a guardian to facilitate appropriate contact between a protected minor and each parent of the protected minor under certain circumstances.
Existing law establishes certain requirements relating to the placement of a protected minor in a secured residential long-term care facility. (NRS 159A.079, 159A.0807) Sections 20 and 21 of this bill make these requirements applicable to the placement of a protected minor in a facility that provides residential treatment.
Sections 20 and 22 of this bill also remove certain unnecessary references to the employment of certain providers of health care by the Department of Veterans Affairs.
Existing law requires a guardian of a protected minor to file an annual report and prescribes the required contents of the report. (NRS 159A.081) Section 23 of this bill requires the report to include the frequency of visitation between the protected minor and any parent of the protected minor.
Existing law establishes the duties of a guardian of the estate of a protected minor. (NRS 159A.083) Section 24 of this bill revises and expands the duties of a guardian of the estate related to investing, financial accounting, the expenditure of money and the management of certain other property. Section 27 of this bill makes similar changes concerning the expenditure of money related to a guardian of a protected minor who is not a guardian of the estate of a protected minor. (NRS 159A.112) Sections 19, 25-31, 36 and 39 of this bill make various other changes related to the estate of a protected minor.
κ2025 Statutes of Nevada, Page 1691 (CHAPTER 253, AB 387)κ
Existing law requires a guardian to notify the court if the guardian is subject to certain disqualifying events. (NRS 159A.1852) Section 32 of this bill removes certain circumstances under which a guardian is required to provide such notice.
Existing law authorizes certain persons to petition the court to remove a guardian. (NRS 159A.1853) Section 33 of this bill revises the persons who may file such a petition by removing the authority of a public guardian to file the petition and additionally authorizing an attorney of a protected minor or agency which provides child welfare services to file the petition. Section 37 of this bill requires a court to consider certain factors related to petitions filed by the parent of a protected minor. (NRS 159A.1915)
Sections 33, 35, 38 and 40 of this bill revise the remedial actions that can be taken by a court under certain circumstances.
Existing law authorizes a court to appoint another guardian when a guardian dies or is removed by an order of the court. (NRS 159A.187) Section 34 of this bill requires the court to provide notice of the matter to an agency which provides child welfare services if a guardian dies or is removed and there is not a qualified guardian or temporary substitute guardian willing to serve.
Section 1 of this bill defines the term agency which provides child welfare services for the purposes of the provisions of law governing guardianships of minors. Section 2 of this bill makes a conforming change to indicate that the definition applies to the existing provisions of law.
Section 42 of this bill repeals various provisions of law related to the guardianship of minors. Sections 2-4, 8 and 9 of this bill make conforming changes relating to the repeal of such provisions.
EXPLANATION Matter in bolded italics is new; matter between
brackets [omitted material] is material to be
omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 159A of NRS is hereby amended by adding thereto a new section to read as follows:
Agency which provides child welfare services has the meaning ascribed to it in NRS 432B.030.
Sec. 2. NRS 159A.013 is hereby amended to read as follows:
159A.013 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS [159A.014] 159A.0145 to 159A.0265, inclusive, and section 1 of this act have the meanings ascribed to them in those sections.
Sec. 3. NRS 159A.034 is hereby amended to read as follows:
159A.034 1. Except as otherwise provided in this section, by specific statute or as ordered by the court, a petitioner in a guardianship proceeding shall give notice of the time and place of the hearing on any petition filed in the guardianship proceeding to:
(a) Any protected minor who is 14 years of age or older, regardless of whether the protected minor is considered to have the capacity to understand or appreciate the contents of the petition.
(b) The parent or legal guardian of any protected minor . [who is less than 14 years of age.]
(c) All known relatives of the protected minor who are within the second degree of consanguinity.
(d) Any other interested person or the persons attorney who has filed a request for notice in the guardianship proceedings and has served a copy of the request upon the guardian or the proposed guardian. [The request for notice must state the interest of the person filing the request and the persons name and address, or that of his or her attorney.]
κ2025 Statutes of Nevada, Page 1692 (CHAPTER 253, AB 387)κ
notice must state the interest of the person filing the request and the persons name and address, or that of his or her attorney.]
(e) The guardian, if the petitioner is not the guardian.
(f) Any person [or care provider] who is providing care for the protected minor, except that if the person [or care provider] is not related to the protected minor, such person [or care provider] must not receive copies of any inventory or accounting.
(g) [The Director of the Department of Health and Human Services if the protected minor has received or is receiving benefits from Medicaid.] An agency which provides child welfare services, if the proposed protected minor is in the care, custody or control of the agency which provides child welfare services.
(h) Those persons entitled to notice if a proceeding were brought in the protected minors home state.
2. The petitioner shall give notice not later than 10 days before the date set for the hearing:
(a) By mailing a copy of the notice by certified, registered or ordinary first-class mail to the residence, office or post office address of each person required to be notified pursuant to this section;
(b) By personal service; or
(c) In any other manner ordered by the court, upon a showing of good cause.
3. Except as otherwise provided in this subsection, if none of the persons entitled to notice of a hearing on a petition pursuant to this section can, after due diligence, be served by certified mail or personal service and this fact is proven by affidavit to the satisfaction of the court, service of the notice [must] may be made [by publication] in [the] any manner [provided] prescribed by the Nevada Rules of Civil Procedure. In all such cases, the notice must be [published] served not later than 10 days before the date set for the hearing. If, after the appointment of a guardian, a search for relatives of the protected minor listed in paragraph (c) of subsection 1 fails to find any such relative, the court may waive the notice [by publication] required by this subsection.
4. For good cause shown, the court may waive the requirement of giving notice.
5. A person entitled to notice pursuant to this section may waive such notice. Such a waiver must be in writing and filed with the court.
6. On or before the date set for the hearing, the petitioner shall file with the court proof of giving notice to each person entitled to notice pursuant to this section.
7. A request for notice filed pursuant to paragraph (d) of subsection 1:
(a) Must state the interest of the person filing the request and the name and address of the person or the attorney of the person; and
(b) Does not make the interested person a party to the guardianship proceeding.
Sec. 4. NRS 159A.044 is hereby amended to read as follows:
159A.044 1. Except as otherwise provided in NRS 127.045, a proposed protected minor, a governmental agency, a nonprofit corporation or any interested person may petition the court for the appointment of a guardian.
κ2025 Statutes of Nevada, Page 1693 (CHAPTER 253, AB 387)κ
2. To the extent the petitioner knows or reasonably may ascertain or obtain, the petition must include, without limitation:
(a) The name and address of the petitioner.
(b) The name, date of birth and current address of the proposed protected minor.
(c) A copy of one of the following forms of identification of the proposed protected minor which must be placed in the records relating to the guardianship proceeding and, except as otherwise provided in NRS 239.0115 or as otherwise required to carry out a specific statute, maintained in a confidential manner:
(1) A social security number;
(2) A birth certificate;
(3) A valid drivers license number;
(4) A valid identification card number;
(5) A valid passport number;
(6) A valid permanent resident card number; or
(7) A valid tribal identification card number.
Κ If the information required pursuant to this paragraph is not included with the petition, the information must be provided to the court not later than 120 days after the appointment of a guardian or as otherwise ordered by the court.
(d) The date on which the proposed protected minor will attain the age of majority and:
(1) Whether there is a current order concerning custody and, if so, the state in which the order was issued; and
(2) Whether the petitioner anticipates that the proposed protected minor will need guardianship after attaining the age of majority.
(e) Whether the proposed protected minor is a resident or nonresident of this State.
(f) The names and addresses of the relatives of the proposed protected minor who are within the second degree of consanguinity.
(g) The name, date of birth and current address of the proposed guardian. If the proposed guardian is a private professional guardian, the petition must include proof that the guardian meets the requirements of NRS 159A.0595. If the proposed guardian is not a private professional guardian, the petition must include a statement that the proposed guardian currently is not receiving compensation for services as a guardian to more than one protected person who is not related to the person by blood or marriage.
(h) A copy of one of the following forms of identification of the proposed guardian which must be placed in the records relating to the guardianship proceeding and, except as otherwise provided in NRS 239.0115 or as otherwise required to carry out a specific statute, maintained in a confidential manner:
(1) A social security number;
(2) A birth certificate;
(3) A valid drivers license number;
(4) A valid identification card number;
(5) A valid passport number;
(6) A valid permanent resident card number; or
(7) A valid tribal identification card number.
κ2025 Statutes of Nevada, Page 1694 (CHAPTER 253, AB 387)κ
(i) Whether the proposed guardian has ever been convicted of a felony and, if so, information concerning the crime for which the proposed guardian was convicted and whether the proposed guardian was placed on probation or parole.
(j) Whether the proposed guardian or any person who resides with the proposed guardian:
(1) Has ever been the subject of a report that has been assigned a disposition of substantiated pursuant to NRS 432B.305 or an equivalent disposition in another jurisdiction; or
(2) Is being investigated for child abuse or neglect by an agency which provides child welfare services.
(k) A summary of the reasons why a guardian is needed and any available documentation demonstrating the need for a guardianship, including, without limitation, any orders or other information from a court concerning the custody of the proposed protected minor.
[(k)] (l) A statement concerning the suitability of the proposed guardian to provide for the basic needs of the proposed protected minor, including, without limitation, food, shelter, clothing, medical care and education.
(m) A general description and the probable value of the property of the proposed protected minor and any income to which the proposed protected minor is or will be entitled, if the petition is for the appointment of a guardian of the estate.
[(l)] (n) The name and address of any person [or care provider] having the care, custody or control of the proposed protected minor.
[(m)] (o) A description of the relationship between the proposed guardian and the proposed protected minor.
(p) The name of each person who resides with the proposed guardian and a description of the relationship between any such person and:
(1) The proposed guardian; and
(2) The proposed protected minor.
(q) If a petitioner is not a parent of the proposed protected minor [, a] :
(1) A declaration explaining the relationship of the petitioner to the proposed protected minor or to the proposed protected minors parents and the interest, if any, of that petitioner in the appointment [.
(n)] ; and
(2) The expected amount of parental involvement in the life of the proposed protected minor, if any.
(r) Requests for any of the specific powers set forth in NRS 159A.165 to 159A.175, inclusive, necessary to enable the guardian to carry out the duties of the guardianship.
[(o)] (s) If the guardianship is sought as the result of an investigation of a report of abuse or neglect of the proposed protected minor, whether the referral was from a law enforcement agency or a state or county agency.
[(p)] (t) Whether the proposed protected minor or the proposed guardian is a party to any pending criminal or civil [litigation.
(q)] proceeding, including, without limitation:
(1) A proceeding for dependency; or
(2) A delinquency proceeding which is conducted pursuant to title 5 of NRS.
(u) Whether the guardianship is sought for the purpose of initiating litigation.
κ2025 Statutes of Nevada, Page 1695 (CHAPTER 253, AB 387)κ
[(r)] (v) Whether the proposed guardian has filed for or received protection under the federal bankruptcy laws within the immediately preceding 7 years.
Sec. 5. NRS 159A.0445 is hereby amended to read as follows:
159A.0445 [Upon the filing of a petition for the appointment of a guardian, the]
1. A court may require a proposed guardian to file a proposed preliminary care plan and budget [.] upon:
(a) The filing of a petition for the appointment of a guardian of the estate;
(b) The filing of a petition for the appointment of a guardian of the person and estate; or
(c) A finding of good cause shown.
2. The format of [such] a proposed preliminary care plan and budget [and the timing of the filing thereof] described in this section must be specified by a rule approved by the Supreme Court.
3. If a budget submitted pursuant to this section is approved, a court shall annually review the budget in conjunction with the annual accounting filed pursuant to NRS 159A.176 to 159A.184, inclusive.
4. If at any time the court determines that a budget is not reasonably calculated to meet the needs of a protected minor, the court may order the guardian to submit a revised proposed budget for review and approval by the court.
5. Nothing in this section shall be deemed to alleviate the duty of a parent to financially provide for the basic needs of a protected minor, including, without limitation, food, shelter, clothing and medical care.
Sec. 6. NRS 159A.045 is hereby amended to read as follows:
159A.045 1. On or after the date of the filing of a petition to appoint a guardian:
(a) [The] Subject to subsection 2, the court may appoint an attorney to represent the protected minor or proposed protected minor; and
(b) The attorney must represent the protected minor or proposed protected minor until relieved of that duty by court order.
2. [The] Except as otherwise provided in subsection 3, if a petition to appoint a guardian is filed in a jurisdiction where there is a program for legal services that receives the fees charged pursuant to NRS 19.031 for the operation of programs for the indigent and the protected minor or proposed protected minor would qualify for representation from the program in the guardianship proceeding, the court shall appoint an attorney from the program to represent the protected minor or proposed protected minor.
3. If a program for legal services described in subsection 2 has insufficient funds to support the representation of each child who would qualify for the appointment of an attorney pursuant to subsection 2, the program shall determine the number of protected minors or proposed protected minors supported from the available funds.
4. If an attorney appointed pursuant to subsection 1 is not compensated by any public money for the representation and the protected minor or proposed protected minor has an estate, the court may authorize an attorney [is entitled] to receive reasonable compensation from the estate . [of the protected minor or proposed protected minor.]
κ2025 Statutes of Nevada, Page 1696 (CHAPTER 253, AB 387)κ
5. If the court finds that a person has unnecessarily or unreasonably caused the appointment of an attorney, the court may order the person to pay to the estate of the protected minor or proposed protected minor all or part of the expenses associated with the appointment of the attorney.
[3.] 6. An attorney who is appointed pursuant to subsection 1 may not serve as a guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor.
7. An attorney appointed to represent a protected minor or proposed protected minor shall comply with the Nevada Rules of Professional Conduct.
8. The provisions of this section do not prohibit:
(a) A protected minor or proposed protected minor from retaining counsel; or
(b) An attorney from providing legal services on a pro bono basis to a protected minor or a proposed protected minor.
Sec. 7. NRS 159A.0455 is hereby amended to read as follows:
159A.0455 1. The court may appoint a guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor who is the subject of guardianship proceedings conducted pursuant to this chapter if the court believes that the minor could benefit from that appointment.
2. The court may not appoint an attorney as a guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor unless:
(a) [The] If an attorney has been appointed pursuant to subsection 1 of NRS 159A.045 or has otherwise been retained to represent the protected minor or proposed protected minor, the court believes that [an] the attorney [who represents the protected minor or proposed protected minor] is unable to provide information which is required by the court to make a determination on the best interests of the minor;
(b) [No] A volunteer is not available to serve as an advocate; or
(c) Extraordinary circumstances exist in which an attorney may assist the court as an advocate.
3. A guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor who is appointed pursuant to subsection 1:
(a) Is an officer of the court;
(b) Does not represent the protected minor or proposed protected minor;
(c) Shall not offer legal advice;
(d) Is not a party to the case;
(e) Shall advocate for the best interests of the protected minor or proposed protected minor;
(f) Shall provide information to the court in accordance with applicable court rule; and
(g) Shall serve until relieved of that duty by court order.
4. A guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor is entitled to reasonable compensation from the estate of the protected minor or proposed protected minor. If the protected minor or proposed protected minor is indigent, the court may order such compensation to be paid by the county.
5. If the court finds that a person has unnecessarily or unreasonably caused the appointment of a guardian ad litem or an advocate for the best interests of a protected minor or proposed protected minor, the court may order the person to pay to the estate of the protected minor or proposed protected minor all or part of the expenses associated with the appointment of the guardian ad litem or advocate for the best interests of the protected minor or proposed protected minor.
κ2025 Statutes of Nevada, Page 1697 (CHAPTER 253, AB 387)κ
interests of a protected minor or proposed protected minor, the court may order the person to pay to the estate of the protected minor or proposed protected minor all or part of the expenses associated with the appointment of the guardian ad litem or advocate for the best interests of the protected minor or proposed protected minor.
Sec. 8. NRS 159A.047 is hereby amended to read as follows:
159A.047 1. Except as otherwise provided in NRS 159A.0475, [159A.049,] 159A.052 and 159A.053, upon the filing of a petition under NRS 159A.044, the clerk shall issue a citation setting forth a time and place for the hearing and directing the persons [or care provider] referred to in subsection 2 to appear and show cause why a guardian should not be appointed for the proposed protected minor.
2. A citation issued under subsection 1, together with a copy of the petition filed under NRS 159A.044, must be served upon:
(a) A proposed protected minor who is 14 years of age or older, regardless of whether the proposed protected minor is considered to have the capacity to understand or appreciate the contents of the citation and petition;
(b) All known relatives of the proposed protected minor who are:
(1) Fourteen years of age or older; and
(2) Within the second degree of consanguinity;
(c) The parents and custodian of the proposed protected minor;
(d) Any person [or officer of a care provider] having the care, custody or control of the proposed protected minor; and
(e) The proposed guardian, if the petitioner is not the proposed guardian . [; and
(f) The Director of the Department of Health and Human Services if the proposed protected minor has received or is receiving any benefits from Medicaid.]
3. A person who serves notice upon a proposed protected minor pursuant to paragraph (a) of subsection 2 shall file with the court an affidavit stating that he or she served notice upon the proposed protected minor in accordance with the provisions of NRS 159A.0475.
Sec. 9. NRS 159A.0475 is hereby amended to read as follows:
159A.0475 1. A copy of the citation issued pursuant to NRS 159A.047, together with a copy of the petition filed under NRS 159A.044, must be served [:
(a) Except as otherwise ordered by the court, on a proposed protected minor who is 14 years of age or older by personal service in the manner provided pursuant to the Nevada Rules of Civil Procedure at least 10 days before the date set for the hearing; and
(b) On] on each person required to be served pursuant to NRS 159A.047 [other than a proposed protected minor] by:
[(1)] (a) Certified mail, with a return receipt requested, at least 20 days before the hearing; or
[(2)] (b) Personal service in the manner provided pursuant to the Nevada Rules of Civil Procedure at least 10 days before the date set for the hearing.
2. If none of the persons on whom the citation and petition is to be served can, after due diligence, be served by certified mail or personal service, as applicable, and this fact is proven by affidavit to the satisfaction of the court, service of the citation [must] may be made [by publication] in [the] any manner [provided] prescribed by the Nevada Rules of Civil Procedure.
κ2025 Statutes of Nevada, Page 1698 (CHAPTER 253, AB 387)κ
[the] any manner [provided] prescribed by the Nevada Rules of Civil Procedure. In all such cases, the citation must be [published] served at least [20] 10 days before the date set for the hearing.
3. A citation and petition need not be served on a person [or an officer of the care provider] who has signed the petition or a written waiver of service of the citation and petition or who makes a general appearance.
4. The court may find that notice is sufficient if:
(a) The citation and petition have been served by personal service on the proposed protected minor and an affidavit of such service has been filed with the court pursuant to subsection 3 of NRS 159A.047;
(b) The citation and petition have been served by certified mail, with a return receipt requested, or by personal service on the [care provider or] guardian required to be served pursuant to NRS 159A.047; and
(c) At least one relative of the proposed protected minor who is required to be served pursuant to NRS 159A.047 has been served, as evidenced by the return receipt or the certificate of service. If the court finds that at least one relative of the proposed protected minor has not received notice that is sufficient, the court will require service of the citation [to be published] pursuant to subsection 2.
Sec. 10. NRS 159A.048 is hereby amended to read as follows:
159A.048 The citation issued pursuant to NRS 159A.047 must state that:
1. A guardian may be appointed for the proposed protected minor;
2. The rights of the proposed protected minor and of any person having legal or physical custody of the proposed protected minor may be affected as specified in the petition;
3. The proposed protected minor has the right to appear at the hearing and to oppose the petition;
4. The proposed protected minor has the right to be represented by an attorney; and
5. At any time during proceedings on the citation, the court may appoint for the proposed protected minor:
(a) An attorney [.] pursuant to NRS 159A.045.
(b) A guardian ad litem or an advocate for the best interests of the proposed protected minor pursuant to NRS 159A.0455 [.] if an attorney has been appointed pursuant to NRS 159A.045 or for good cause shown.
Sec. 11. NRS 159A.0483 is hereby amended to read as follows:
159A.0483 1. A protected minor or proposed protected minor who is the subject of proceedings held pursuant to this chapter shall be deemed a party to the proceedings.
2. The protected minor or proposed protected minor may be represented by an attorney at all stages of the proceedings.
3. If the protected minor or proposed protected minor is represented by an attorney, the attorney has the same authority and rights as an attorney representing [a] another party to the proceedings.
Sec. 12. NRS 159A.0486 is hereby amended to read as follows:
159A.0486 1. A court may find that a petitioner is a vexatious litigant if a person, other than the protected minor [:] or proposed protected minor:
(a) Files a petition which is without merit or intended to harass or annoy the guardian [;] or a parent of the protected minor or proposed protected minor; and
κ2025 Statutes of Nevada, Page 1699 (CHAPTER 253, AB 387)κ
(b) Has previously filed pleadings in a guardianship proceeding that were without merit or intended to harass or annoy the guardian [.] or a parent of the protected minor or proposed protected minor.
2. If a court finds a person is a vexatious litigant pursuant to subsection 1, the court may impose sanctions on the petitioner . [in an amount sufficient to reimburse the estate of the protected minor for all or part of the expenses incurred by the estate of the protected minor to defend the petition, to respond to the petition and for any other pecuniary losses which are associated with the petition.]
Sec. 13. NRS 159A.052 is hereby amended to read as follows:
159A.052 1. A petitioner may request the court to appoint a temporary guardian for a proposed protected minor who is in need of immediate medical attention which he or she cannot obtain without the appointment of a temporary guardian. To support the request, the petitioner must set forth in a petition and present to the court under oath:
(a) Documentation which shows that the proposed protected minor needs immediate medical attention and, without the appointment of a temporary guardian, cannot obtain that medical attention. [Such documentation must include, without limitation, a copy of the birth certificate of the proposed protected minor or other documentation verifying the age of the proposed protected minor.]
(b) Facts which show that:
(1) The petitioner has tried in good faith to notify the persons entitled to notice pursuant to NRS 159A.047 by telephone or in writing before the filing of the petition;
(2) The proposed protected minor would be exposed to an immediate risk of physical harm if the petitioner were to provide notice to the persons entitled to notice pursuant to NRS 159A.047 before the court determines whether to appoint a temporary guardian; or
(3) Giving notice to the persons entitled to notice pursuant to NRS 159A.047 is not feasible under the circumstances.
2. The court may appoint a temporary guardian to serve for 10 days if the court:
(a) Finds reasonable cause to believe that the proposed protected minor is in need of immediate medical attention which he or she cannot obtain without the appointment of a temporary guardian; and
(b) [Is] Except as otherwise provided in subsection 3, is satisfied that the petitioner has tried in good faith to notify the persons entitled to notice pursuant to NRS 159A.047 or that giving notice to those persons is not feasible under the circumstances, or determines that such notice is not required pursuant to subparagraph (2) of paragraph (b) of subsection 1.
3. The court may require a hearing on the petition for the purpose of receiving additional evidence, including, without limitation, testimony, to determine the need for the appointment of a temporary guardian pursuant to this section and shall establish requirements for the provision of notice for any such hearing.
4. Except as otherwise provided in [subsection 4,] subsections 3 and 5, after the appointment of a temporary guardian, the petitioner shall attempt in good faith to notify the persons entitled to notice pursuant to NRS 159A.047, including, without limitation, notice of any hearing to extend the temporary guardianship. If the petitioner fails to make such an effort, the court may terminate the temporary guardianship.
κ2025 Statutes of Nevada, Page 1700 (CHAPTER 253, AB 387)κ
[4. If,]
5. Except as otherwise provided in subsection 3, if, before the appointment of a temporary guardian, the court was satisfied that giving notice to the persons entitled to notice pursuant to NRS 159A.047 was not feasible under the circumstances or determined that such notice was not required pursuant to subparagraph (2) of paragraph (b) of subsection 1, the petitioner shall notify the persons entitled to notice pursuant to NRS 159A.047 without undue delay, but not later than 48 hours after the appointment of the temporary guardian or not later than 48 hours after the petitioner discovers the existence, identity and location of the persons entitled to notice pursuant to that section. If the petitioner fails to provide such notice, the court may terminate the temporary guardianship.
[5.] 6. Not later than 10 days after the date of the appointment of a temporary guardian pursuant to subsection 2, the court shall hold a hearing to determine the need to extend the temporary guardianship. Except as otherwise provided in subsection [7,] 8, if the court finds by clear and convincing evidence that the protected minor continues to be in need of immediate medical attention which he or she cannot obtain without the extension of the temporary guardianship, the court may, pursuant to subsection [8,] 9, extend the temporary guardianship until a general guardian is appointed.
[6.] 7. If the court appoints a temporary guardian or extends a temporary guardianship pursuant to this section, the court shall limit the powers of the temporary guardian to those necessary to respond to the need for immediate medical attention.
[7.] 8. The court may not extend a temporary guardianship pursuant to subsection [5] 6 beyond the initial period of 10 days unless the petitioner demonstrates that:
(a) The provisions of NRS 159A.0475 have been satisfied; or
(b) Notice [by publication pursuant to] in any manner prescribed by the Nevada Rules of Civil Procedure is currently being undertaken.
[8.] 9. The court may extend the temporary guardianship, for good cause shown, for not more than two successive 60-day periods.
Sec. 14. NRS 159A.053 is hereby amended to read as follows:
159A.053 1. A petitioner may request that the court appoint a temporary guardian for the person or the estate, or both, of a proposed protected minor by filing a verified petition.
2. [The petition] To support the request, the petitioner must [state] set forth in the petition and present under oath facts which :
(a) Establish that the proposed protected minor would be exposed to an immediate risk of physical, emotional, educational or financial harm if the court did not appoint a temporary guardian or otherwise establish good cause for the appointment of a temporary guardian ; and [which show that:
(a)] (b) Show that:
(1) The petitioner has tried in good faith to notify the persons entitled to notice pursuant to NRS 159A.047 by telephone or in writing before the filing of the petition;
[(b)] (2) The proposed protected minor would be exposed to an immediate risk of physical, emotional , educational or financial harm if the petitioner were to provide notice to the persons entitled to notice pursuant to NRS 159A.047 before the court determines whether to appoint a temporary guardian; or
κ2025 Statutes of Nevada, Page 1701 (CHAPTER 253, AB 387)κ
[(c)] (3) Giving notice to the persons entitled to notice pursuant to NRS 159A.047 is not feasible under the circumstances.
3. A petition which seeks an ex parte appointment of a temporary guardian must be accompanied by an affidavit which explains the emergency that requires a temporary guardian to be appointed before a hearing.
4. If no parent of the proposed protected minor has had the care, custody and control of the minor for the 6 months immediately preceding the petition, temporary guardianship of the person of the minor is presumed to be in the best interest of the minor.
5. The court may require a hearing on the petition for the purpose of receiving additional evidence, including, without limitation, testimony, to determine the need for the appointment of a temporary guardian pursuant to this section and shall establish requirements for the provision of notice for any such hearing.
6. The court may, upon that petition or other showing as it may require, appoint a temporary guardian of the person or the estate, or both, of the proposed protected minor.
[6.] 7. Except as otherwise provided in [subsection 7,] subsections 5 and 8, after the appointment of a temporary guardian, the petitioner shall attempt in good faith to notify the persons entitled to notice pursuant to NRS 159A.047, including, without limitation, notice of any hearing to extend the temporary guardianship. If the petitioner fails to make such an effort, the court may terminate the temporary guardianship.
[7. If,]
8. Except as otherwise provided in subsection 5, if, before the appointment of a temporary guardian, the court was satisfied that giving notice to the persons entitled to notice pursuant to NRS 159A.047 was not feasible under the circumstances or determined that such notice was not required pursuant to subparagraph (2) or (3) of paragraph (b) [or (c)] of subsection 2, the petitioner shall notify the persons entitled to notice pursuant to NRS 159A.047 without undue delay, but not later than 48 hours after the appointment of the temporary guardian or not later than 48 hours after the petitioner discovers the existence, identity and location of the persons entitled to notice pursuant to that section. If the petitioner fails to provide such notice, the court may terminate the temporary guardianship.
[8.] 9. Not later than 10 days after the date of an ex parte appointment of a temporary guardian pursuant to subsection [5,] 6, the court shall hold a hearing to determine the need to extend the temporary guardianship. Except as otherwise provided in subsection [9,] 10, if the court finds by clear and convincing evidence that the protected minor continues to be in need of a temporary guardian, the court may, pursuant to subsection [10,] 11, extend the temporary guardianship until a general guardian is appointed.
[9.] 10. The court may not extend a temporary guardianship pursuant to subsection [8] 9 beyond the initial period of 10 days unless the petitioner demonstrates that:
(a) The provisions of NRS 159A.0475 have been satisfied; or
(b) Notice [by publication pursuant to] in any manner prescribed by the Nevada Rules of Civil Procedure is currently being undertaken.
[10.] 11. The court may extend the temporary guardianship, for good cause shown, for not more than two successive 60-day periods, unless extraordinary circumstances necessitate a longer duration for the temporary guardianship.
κ2025 Statutes of Nevada, Page 1702 (CHAPTER 253, AB 387)κ
[11.] 12. If for any reason a guardian who is appointed for a protected minor cannot perform the duties of a guardian, the court may, upon a petition filed to request temporary guardianship for the minor, appoint a temporary guardian to exercise the powers of a guardian until another guardian is appointed for the minor.
Sec. 15. NRS 159A.0535 is hereby amended to read as follows:
159A.0535 1. [A] Unless waived by the court for good cause shown, a proposed protected minor who is found in this State must physically attend the hearing for the appointment of a guardian [unless:
(a) A certificate signed by a physician or psychiatrist who is licensed to practice in this State specifically states the condition of the proposed protected minor, the reasons why the proposed protected minor is unable to appear in court and whether the proposed protected minors attendance at the hearing would be detrimental to the physical or mental health of the proposed protected minor; or
(b) A certificate signed by any other person the court finds qualified to execute a certificate states the condition of the proposed protected minor, the reasons why the proposed protected minor is unable to appear in court and whether the proposed protected minors attendance at the hearing would be detrimental to the physical or mental health of the proposed protected minor.
2. A proposed protected minor found in this State who cannot attend the hearing for the appointment of a guardian as set forth in a certificate pursuant to subsection 1 may] or appear at the hearing by telephone or by videoconference or any other means that uses audio-video communication [.
3. The court may prescribe the form in which a certificate required by this section must be filed. If the certificate consists of separate parts, each part must be signed by the person who is required to sign the certificate.
4.] , if so authorized by the court.
2. If the proposed protected minor is not in this State, the proposed protected minor must attend or appear at the hearing as described in subsection 1 only if the court determines that the attendance of the proposed protected minor is necessary in the interests of justice.
[5.] 3. As used in this section, audio-video communication means communication by which a person is able to see, hear and communicate with another person in real time using electronic means.
Sec. 16. NRS 159A.055 is hereby amended to read as follows:
159A.055 1. The petitioner has the burden of proving by clear and convincing evidence that the appointment of a guardian of the person, of the estate, or of the person and estate is necessary [.] and in the best interests of the proposed protected minor.
2. In determining the best interests of the proposed protected minor pursuant to subsection 1, the court shall consider:
(a) The wishes of the proposed protected minor;
(b) The extent to which the parent poses a safety risk of either physical or emotional danger to the proposed protected minor;
(c) The nature and quality of the parent-child relationship;
(d) The length of time that the proposed protected minor has been out of the care, custody and control of either parent;
(e) The ability of the parent to meet the needs of the proposed protected minor;
(f) The recommendation of the guardian ad litem, if applicable; and
(g) Any other factor deemed relevant by the court.
κ2025 Statutes of Nevada, Page 1703 (CHAPTER 253, AB 387)κ
3. If [it appears to] the court [that the allegations of the petition are sufficient and] finds by clear and convincing evidence that the appointment of a guardian [should be appointed for] is necessary and in the best interests of the proposed protected minor, the court shall enter an order appointing a guardian. [The]
4. An order appointing a guardian must:
(a) Set forth with specificity the findings of fact upon which the order is based;
(b) Specify whether the guardian appointed is guardian of the person, of the estate, or of the person and estate;
[(b)] (c) Specify whether the proposed protected minor is a resident or nonresident of this State;
[(c)] (d) Specify the amount of the bond to be executed and filed by the guardian; and
[(d)] (e) Designate the names and addresses, so far as may be determined, of [:
(1) The] the relatives of the proposed protected minor upon whom notice must be served pursuant to NRS 159A.047 . [; and
(2) Any other interested person; and
(e) Specify whether the proposed protected minor will require a guardianship after reaching 18 years of age.
3.] 5. A notice of entry of the court order must be sent to [:
(a) The] the relatives of the proposed protected minor upon whom notice must be served pursuant to NRS 159A.047 . [; and
(b) Any other interested person.]
Sec. 17. NRS 159A.0565 is hereby amended to read as follows:
159A.0565 [In]
1. Subject to subsection 2, in an order appointing a guardian or in any order thereafter, the court may award rights of visitation between a protected minor and his or her parents , [or] relatives who are within the fourth degree of consanguinity [.] or fictive kin.
2. If an order described in subsection 1 limits the visitation between the protected minor and a parent, the order must set forth with specificity findings of fact as to why the limitation is necessary to protect the physical and emotional well-being of the child.
3. As used in this section, fictive kin means a person who is not related by blood to a protected minor but who has a significant emotional and positive relationship with the protected minor.
Sec. 18. NRS 159A.061 is hereby amended to read as follows:
159A.061 1. The parents of a proposed protected minor, or either parent, [if qualified and] are presumed suitable [, are preferred over all others for appointment as guardian] to care for [the person or estate or person and estate of] the proposed protected minor [. The appointment of a parent as guardian for the person or estate of a proposed protected minor must not conflict with a valid order for custody of the proposed protected minor.] and it is presumed to be in the best interest of the proposed protected minor to be cared for by a qualified and suitable parent.
2. Except as otherwise provided in subsection [4, if a parent of a proposed protected minor files a petition seeking appointment as guardian for the proposed protected minor, the] 3, a parent is presumed to be suitable to serve as guardian for the proposed protected minor [.] unless:
κ2025 Statutes of Nevada, Page 1704 (CHAPTER 253, AB 387)κ
(a) The parent is unable to provide for any or all of the basic needs of the proposed protected minor, including, without limitation:
(1) Food;
(2) Shelter;
(3) Clothing;
(4) Medical care; and
(5) Education;
(b) Because of action or inaction, the parent poses a significant safety risk of either physical or emotional danger to the proposed protected minor; or
(c) The proposed protected minor has not been in the care, custody and control of the parent for the 6 months immediately preceding the filing of the petition.
3. [In determining whether the parents of a proposed protected minor, or either] If a proposed protected minor has been in the care, custody and control of a person who is not a parent for the 6 months immediately preceding the filing of a petition for the appointment of a guardian, a parent must prove that the provisions of paragraph (a) or (b) of subsection 2 do not apply to the parent.
4. In evaluating a petition for the appointment of a guardian, the court shall determine the suitability of each parent [, or any other person who seeks appointment as] of the proposed protected minor and the proposed guardian for the proposed protected minor [is qualified and suitable, the court shall consider,] by considering, if applicable and without limitation:
(a) [Which parent has physical custody of the proposed protected minor;] With whom the proposed protected minor lives and how long the proposed protected minor has lived with that person;
(b) The ability of the parents, parent or other person to provide for the basic needs of the proposed protected minor, including, without limitation, food, shelter, clothing and medical care, taking into consideration any special needs of the proposed protected minor;
(c) Whether the parents, parent or other person has engaged in the habitual use of alcohol or any controlled substance during the previous 6 months, except the use of cannabis in accordance with the provisions of chapter 678C of NRS;
(d) Whether the parents, parent or other person has been convicted of a crime of moral turpitude, a crime involving domestic violence or a crime involving the abuse, neglect, exploitation, isolation or abandonment of a child, his or her spouse, his or her parent or any other adult;
(e) Whether the parents, parent or other person has been convicted in this State or any other jurisdiction of a felony; and
(f) Whether the parents, parent or other person has engaged in one or more acts of domestic violence against the proposed protected minor, a parent of the proposed protected minor or any other person who resides with the proposed protected minor.
[4. A parent of a proposed protected minor is presumed to be unsuitable to care for the proposed protected minor if:
(a) The parent is unable to provide for any or all of the basic needs of the proposed protected minor, including, without limitation:
(1) Food;
(2) Shelter;
κ2025 Statutes of Nevada, Page 1705 (CHAPTER 253, AB 387)κ
(3) Clothing;
(4) Medical care; and
(5) Education;
(b) Because of action or inaction, the parent poses a significant safety risk of either physical or emotional danger to the proposed protected minor; or
(c) The proposed protected minor has not been in the care, custody and control of the parent for the 6 months immediately preceding the filing of the petition. The presumption created by this paragraph is a rebuttable presumption.]
5. Subject to the [preference] presumptions set forth in subsection 1 and except as otherwise provided in subsection [7,] 9, the court shall appoint as guardian the qualified person who is most suitable and is willing to serve.
6. Except as otherwise provided in subsection 7, the court may not appoint a guardian for a proposed protected minor without the consent of the proposed protected minor if the proposed protected minor is 14 years of age or older.
7. If the minor will not consent to the appointment of a guardian and the proposed guardian is otherwise found qualified and suitable pursuant to this section, the petitioner must show by clear and convincing evidence that the award of the guardianship to the person who is the most suitable and willing to serve is necessary and in the best interests of the proposed protected minor.
8. In determining which qualified person is most suitable, the court shall, in addition to considering any applicable factors set forth in subsections 2 [, 3] and 4, give consideration, among other factors, to:
(a) Any nomination of a guardian for the proposed protected minor contained in a will or other written instrument executed by a parent of the proposed protected minor.
(b) [Any] Subject to subsections 6 and 7, any request made by the proposed protected minor . [, if he or she is 14 years of age or older, for the appointment of a person as guardian for the proposed protected minor.]
(c) The relationship by blood or adoption of the proposed guardian to the proposed protected minor. [In considering preferences of appointment, the court may consider relatives of the half blood equally with those of the whole blood. The court may consider relatives in the following order of preference:
(1) Parent.
(2) Adult sibling.
(3) Grandparent.
(4) Uncle or aunt.]
(d) Any recommendation made by a master of the court or special master pursuant to NRS 159A.0615.
(e) Any recommendation made by:
(1) An agency which provides child welfare services, an agency which provides child protective services or a similar agency; or
(2) A guardian ad litem or court appointed special advocate who represents the proposed protected minor.
(f) Any request for the appointment of any other interested person that the court deems appropriate.
[7.] 9. The court may award temporary guardianship pursuant to this section, supported by findings of suitability, pending a trial or evidentiary hearing if that appointment is supported by findings.
κ2025 Statutes of Nevada, Page 1706 (CHAPTER 253, AB 387)κ
[8.] 10. Notwithstanding the presumption set forth in subsection [4,] 2, in the event of competing petitions for the appointment of guardianship of a proposed protected minor, any finding of unsuitability of a parent of the proposed protected minor must be found by clear and convincing evidence after a hearing on the merits or an evidentiary hearing.
[9.] 11. In determining whether to appoint a guardian of the person or estate of a proposed protected minor and who should be appointed, the court must always act in the best interests of the proposed protected minor.
[10.] 12. A court shall not refuse to appoint a person as a guardian of the person or estate of a proposed protected minor solely because the person:
(a) Is deaf, is blind or has another physical disability; or
(b) Is the holder of a valid registry identification card.
[11.] 13. As used in this section:
(a) [Agency which provides child welfare services has the meaning ascribed to it in NRS 432B.030.
(b)] Blind has the meaning ascribed to it in NRS 426.082.
[(c)] (b) Holder of a valid registry identification card means a person who holds a valid registry identification card as defined in NRS 678C.080 that identifies the person as:
(1) Exempt from state prosecution for engaging in the medical use of cannabis; or
(2) A designated primary caregiver as defined in NRS 678C.040.
Sec. 19. NRS 159A.076 is hereby amended to read as follows:
159A.076 1. The court may grant a summary administration if, at any time, it appears to the court that after payment of all claims and expenses of the guardianship the value of the protected minors property does not exceed $10,000.
2. If the court grants a summary administration, the court may:
(a) Authorize the guardian of the estate who is authorized to manage the protected minors property to convert the property to cash and sell any of the property, with or without notice, as the court may direct. After the payment of all claims and the expenses of the guardianship, the guardian shall [deposit the money in savings accounts or] invest the money as provided in NRS 159A.117, and hold the investment and all interest, issues, dividends and profits for the benefit of the protected minor. The court may dispense with annual accountings and all other proceedings required by this chapter.
(b) Terminate the guardianship of the estate and direct the guardian to deliver the protected minors property to the custodial parent or parents, guardian or custodian of the protected minor to hold, invest or use as the court may order.
3. Whether the court grants a summary administration at the time the guardianship is established or at any other time, the guardian shall file an inventory and record of value with the court.
4. If, at any time, the net value of the estate of the protected minor exceeds $10,000:
(a) The guardian shall file an amended inventory and accounting with the court;
(b) The guardian shall file annual accountings; and
(c) The court [may] shall require the guardian to place the entire value of the estate in a blocked account, unless the guardian is a private professional guardian or a public guardian, in which case the court may require the guardian to post a bond.
κ2025 Statutes of Nevada, Page 1707 (CHAPTER 253, AB 387)κ
5. As used in this section, blocked account means a restricted account that requires a court order before a distribution or transfer is made from the account.
Sec. 20. NRS 159A.079 is hereby amended to read as follows:
159A.079 1. Except as otherwise ordered by the court, a guardian of the person has the care, custody and control of the person of the protected minor, and has the authority and, subject to subsection 2, shall perform the duties necessary for the proper care, maintenance, education and support of the protected minor, including, without limitation, the following:
(a) Supplying the protected minor with food, clothing, shelter and all incidental necessaries, including locating an appropriate residence for the protected minor based on the financial situation and needs of the protected minor, including, without limitation, any medical needs or needs relating to his or her care.
(b) Taking reasonable care of any clothing, furniture, vehicles and other personal effects of the protected minor and commencing a proceeding if any property of the protected minor is in need of protection.
(c) Authorizing medical, surgical, dental, psychiatric, psychological, hygienic or other remedial care and treatment for the protected minor.
(d) Seeing that the protected minor is properly trained and educated and that the protected minor has the opportunity to learn a trade, occupation or profession.
(e) Facilitating appropriate contact between the protected minor and each parent of the protected minor if the contact:
(1) Is in the best interest of the protected minor; and
(2) Complies with an order for visitation, if applicable.
2. In the performance of the duties enumerated in subsection 1 by a guardian of the person, due regard must be given to the extent of the estate of the protected minor. A guardian of the person may be required to incur expenses on behalf of the protected minor if the estate of the protected minor is insufficient to reimburse the guardian.
3. A guardian of the person is the protected minors personal representative for purposes of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any applicable regulations. The guardian of the person has authority to obtain information from any government agency, medical provider, business, creditor or third party who may have information pertaining to the protected minors health care or health insurance.
4. A guardian of the person may, subject to the provisions of subsection 6 and NRS 159A.0807, establish and change the residence of the protected minor at any place within this State. The guardian shall select the least restrictive appropriate residence which is available and necessary to meet the needs of the protected minor and which is financially feasible.
5. A guardian of the person shall petition the court for an order authorizing the guardian to change the residence of the protected minor to a location outside of this State. The guardian must show that changing the residence of the protected minor to a location outside of this State is in the best interest of the protected minor or that there is no appropriate residence available for the protected minor in this State. The court shall retain jurisdiction over the guardianship unless the guardian files for termination of the guardianship pursuant to NRS 159A.1905 or 159A.191 or the jurisdiction of the guardianship is transferred to the other state. Not later than 6 months after changing the residence of a protected minor to a location outside of this State, the guardian shall file a petition for guardianship in the state of the protected minors residence.
κ2025 Statutes of Nevada, Page 1708 (CHAPTER 253, AB 387)κ
after changing the residence of a protected minor to a location outside of this State, the guardian shall file a petition for guardianship in the state of the protected minors residence.
6. A guardian of the person must file a notice with the court of his or her intent to move a protected minor to or place a protected minor in a facility that provides residential treatment, including, without limitation, a secured residential long-term care facility , pursuant to subsection 4 of NRS 159A.0807 unless : [the secured residential long-term care facility is in this State and:]
(a) An emergency condition exists pursuant to subsection 5 of NRS 159A.0807;
(b) The court has previously granted the guardian authority to move the protected minor to or place the protected minor in such a facility based on findings made when the court appointed the guardian; or
(c) The move or placement is made pursuant to a written recommendation by a licensed physician, [a physician employed by the Department of Veterans Affairs,] a licensed social worker or an employee of a county or state office for protective services.
7. This section does not relieve a parent or other person of any duty required by law to provide for the care, support and maintenance of any dependent.
Sec. 21. NRS 159A.0807 is hereby amended to read as follows:
159A.0807 1. Every protected minor has the right, if possible, to:
(a) Have his or her preferences followed; and
(b) Age in his or her own surroundings or, if not possible, in the least restrictive environment suitable to his or her unique needs and abilities.
2. Except as otherwise provided in subsection 5, a proposed protected minor must not be moved until a guardian is appointed.
3. Except as otherwise provided in this section and subsections 5 and 6 of NRS 159A.079, the guardian shall notify all interested persons in accordance with subsection 4 before the protected minor:
(a) Is admitted to a facility that provides residential treatment, including, without limitation, a secured residential long-term care facility;
(b) Changes his or her residence, including, without limitation, to or from one [secured] facility that provides residential [long-term care facility] treatment to another; or
(c) Will reside at a location other than his or her residence for more than 3 days.
4. Except as otherwise provided in this section and subsections 5 and 6 of NRS 159A.079, a guardian shall file with the court a notice of his or her intent to move the protected minor and shall serve notice upon all interested persons not less than 10 days before moving the protected minor. If no objection to the move is received from any interested person within 10 days after receiving the notice, the guardian may move the protected minor without court permission.
5. If an emergency condition exists, including, without limitation, the health or safety of the protected minor is at risk of imminent harm or the protected minor has been hospitalized and will be unable to return to his or her residence for a period of more than 24 hours, the guardian may take any temporary action needed without the permission of the court and shall file notice with the court and serve notice upon all interested persons as soon as practicable after taking such action.
κ2025 Statutes of Nevada, Page 1709 (CHAPTER 253, AB 387)κ
6. Except as otherwise provided in this subsection, any notice provided to a court, an interested person or person of natural affection pursuant to this section or NRS 159A.0809 must include the current location of the protected minor. The guardian shall not provide any contact information to an interested person or person of natural affection if an order of protection has been issued against the interested person or person of natural affection on behalf of the protected minor.
7. A guardian is not required to provide notice to an interested person or person of natural affection in accordance with this section or NRS 159A.0809 if:
(a) The interested person or person of natural affection informs the guardian in writing that the person does not wish to receive such notice; or
(b) The protected minor or a court order has expressly prohibited the guardian from providing notice to the interested person or person of natural affection.
Sec. 22. NRS 159A.0809 is hereby amended to read as follows:
159A.0809 1. Except as otherwise provided in NRS 159A.0807, a guardian shall immediately notify all interested persons and persons of natural affection:
(a) If the guardian reasonably believes that the death of the protected minor is likely to occur within the next 30 days and such belief is based on information from a psychologist, physician or other health care provider of the protected minor or a person otherwise qualified to provide such a medical opinion, including, without limitation, a health care provider employed by a hospice or by a hospital . [of the Department of Veterans Affairs.]
(b) Upon the death of the protected minor.
(c) Upon obtaining any information relating to the burial or cremation of the protected minor.
2. The guardian shall provide notification pursuant to paragraph (b) of subsection 1:
(a) In person or by telephone to the family members of the protected minor or, if the protected minor does not have any family members or does not have a relationship with any family members, the person of natural affection designated to receive such notification;
(b) By electronic communication to any family member of the protected minor or person of natural affection who has opted to receive notification by electronic communication; and
(c) In writing to all other interested persons and persons of natural affection not given notice pursuant to paragraph (a) or (b).
Sec. 23. NRS 159A.081 is hereby amended to read as follows:
159A.081 1. A guardian of the person shall make and file in the guardianship proceeding for review of the court a written report on the condition of the protected minor and the exercise of authority and performance of duties by the guardian:
(a) Annually, not later than 60 days after the anniversary date of the appointment of the guardian;
(b) Within 10 days after changing the residence of a protected minor; and
(c) At such other times as the court may order.
2. A report filed pursuant to paragraph (b) of subsection 1 must:
(a) Include a copy of the written recommendation upon which the transfer was made; and
κ2025 Statutes of Nevada, Page 1710 (CHAPTER 253, AB 387)κ
(b) Be served, without limitation, on the protected minor and any attorney for the protected minor.
3. The court may prescribe the form and contents for filing a report described in subsection 1. Such a report must include, without limitation:
(a) The physical condition of the protected minor;
(b) The place of residence of the protected minor;
(c) The name of all other persons living with the protected minor unless the protected minor is residing at a secured residential long-term care facility, group home, supportive living facility, assisted living facility or other facility for long-term care; [and]
(d) The frequency of visitation between the protected minor and any parent of the protected minor; and
(e) Any other information required by the court.
4. The guardian of the person shall give to the guardian of the estate, if any, a copy of each report not later than 30 days after the date the report is filed with the court.
5. The court is not required to hold a hearing or enter an order regarding the report.
6. As used in this section, facility for long-term care has the meaning ascribed to it in NRS 427A.028.
Sec. 24. NRS 159A.083 is hereby amended to read as follows:
159A.083 1. A guardian of the estate shall:
[1.] (a) Protect, preserve, manage and dispose of the estate of the protected minor according to law and for the best interests of the protected minor [.] ;
(b) Responsibly invest the property of the protected minor pursuant to NRS 159A.117;
(c) File an annual accounting pursuant to NRS 159A.176 to 159A.184, inclusive; and
(d) Take any other action authorized or required by law.
2. [Apply] Upon approval of the court, a guardian of the estate may:
(a) Expend money from the estate of the protected minor [for the proper care, maintenance, education and support of the protected minor having due regard for other income or property available to support] if it is necessary to meet any extraordinary needs of the protected minor [.
3. Have such other authority and perform such other duties as are provided by law.] , considering the routines and needs of the protected minor before the establishment of the guardianship of the estate and the expenditures prescribed in an annual budget approved by the court pursuant to NRS 159A.0445;
(b) Manage any property right on behalf of the protected minor;
(c) Establish:
(1) A special needs trust;
(2) A trust for the benefit of the protected minor which is payable over the lifetime of the minor or over a reasonable shorter period; and
(3) A structured settlement which is payable over the lifetime of the protected minor or over a reasonable shorter period of time; and
(d) Invest money, including, without limitation, with the assistance of a financial advisor, for the purposes of growing the estate of the protected minor, as appropriate given the age and needs of the minor and the size of the estate.
κ2025 Statutes of Nevada, Page 1711 (CHAPTER 253, AB 387)κ
3. As used in this section:
(a) Estate of the protected minor does not include any payment assigned to a guardian for the support of the protected minor, including, without limitation, child support payments that are processed pursuant to Part D of Title IV of the Social Security Act, 42 U.S.C. §§ 651 et seq., and any supplemental security income benefit.
(b) Special needs trust has the meaning ascribed to it in NRS 163.556.
(c) Structured settlement has the meaning ascribed to it in NRS 42.275.
Sec. 25. NRS 159A.085 is hereby amended to read as follows:
159A.085 1. Not later than 60 days after the date of the appointment of a guardian of the estate or, if necessary, such further time as the court may allow, the guardian shall make and file in the guardianship proceeding a verified inventory of all of the property of the protected minor which comes to the possession or knowledge of the guardian, including, without limitation, the existence of any trust of which the protected minor is currently a beneficiary who is receiving or is entitled to receive distributions.
2. A temporary guardian of the estate shall file an inventory with the court by not later than the date on which the temporary guardian files a final accounting as required pursuant to NRS 159A.177.
3. The guardian shall take and subscribe an oath, which must be endorsed or attached to the inventory, before any person authorized to administer oaths, that the inventory contains a true statement of:
(a) All of the estate of the protected minor which has come into the possession of the guardian;
(b) All of the money that belongs to the protected minor; and
(c) All of the just claims of the protected minor against the guardian.
4. A copy of the inventory filed with the court and a notice of the filing must be served on the protected minor, his or her attorney and any guardian ad litem representing the protected minor.
5. Whenever any property of the protected minor not mentioned in the inventory comes to the possession or knowledge of a guardian of the estate, the guardian shall:
(a) Make and file in the proceeding a verified supplemental inventory not later than 30 days after the date the property comes to the possession or knowledge of the guardian; or
(b) Include the property in the next accounting.
6. The court may order which of the two methods described in subsection 5 the guardian shall follow.
7. [The court may order all or any part of the property of the protected minor appraised as provided in NRS 159A.0865 and 159A.305.
8.] If the guardian neglects or refuses to file the inventory within the time required pursuant to subsection 1, the court may, for good cause shown and upon such notice as the court deems appropriate:
(a) Revoke the letters of guardianship and the guardian is liable [on the bond] for any loss or injury to the estate caused by the neglect of the guardian; or
(b) Enter a judgment for any loss or injury to the estate caused by the neglect of the guardian.
κ2025 Statutes of Nevada, Page 1712 (CHAPTER 253, AB 387)κ
Sec. 26. NRS 159A.103 is hereby amended to read as follows:
159A.103 A guardian of the estate shall pay from the guardianship estate [pursuant to NRS 159A.105, 159A.107 and 159A.109] all just claims against the protected minor, the estate or the guardian as such, [whether accruing before or after the appointment of the guardian and whether arising in contract, in tort or otherwise.] in the same manner as prescribed by chapter 159 of NRS for the payment of claims by the guardian of the estate of a protected person.
Sec. 27. NRS 159A.112 is hereby amended to read as follows:
159A.112 1. If a guardian of the estate has not been appointed, a guardian of the person may:
(a) Institute proceedings to compel any person under a duty to support the protected minor or to pay for the welfare of the protected minor to perform that duty; and
(b) Receive money and tangible property deliverable to the protected minor . [and apply such money and property for the support, care and education of the protected minor. The]
2. A guardian shall not use any money from the estate of the protected minor to cover the cost of any [room] :
(a) Room and board that the guardian or the spouse, parent or child of the guardian furnishes to the protected minor [unless a charge for the service is approved by a court order, after notice to at least one adult relative in the nearest degree of consanguinity to the protected minor in which there is an adult.] ; or
(b) Any care, maintenance, education or support for the protected minor, unless approved by the court upon a showing that the expenditure is necessary to meet an extraordinary need of the protected minor.
3. The guardian shall exercise care to conserve any [excess] money [for the needs] of the protected minor.
[2. If a guardian of the estate has been appointed, any money received by the guardian of the person that is in excess of the money expended to pay for the support, care and education of the protected minor must be paid to the guardian of the estate for management of the estate. The guardian of the person shall account to the guardian of the estate for any money expended.
3. A guardian of the person of a protected minor for whom a guardian of the estate also has been appointed may receive reasonable sums for any room and board furnished to the protected minor if the guardian of the person presents a claim to the guardian of the estate pursuant to NRS 159A.107 and 159A.109.
4. A guardian of the person may request the guardian of the estate to make a payment from the estate of the protected minor to another person or entity for the care and maintenance of the protected minor in accordance with NRS 159A.107 and 159A.109.]
Sec. 28. NRS 159A.113 is hereby amended to read as follows:
159A.113 1. Before taking any of the following actions, the guardian of the estate shall petition the court for an order authorizing the guardian to:
(a) Invest the property of the protected minor pursuant to NRS 159A.117.
(b) [Borrow money for the protected minor pursuant to NRS 159A.121.
(c) Except as otherwise provided in NRS 159A.079, enter into contracts for the protected minor or complete the performance of contracts of the protected minor pursuant to NRS 159A.123.
κ2025 Statutes of Nevada, Page 1713 (CHAPTER 253, AB 387)κ
(d) Make gifts from the protected minors estate pursuant to NRS 159A.125.
(e)] Sell, lease or place in trust any property of the protected minor pursuant to NRS 159A.127.
[(f)] (c) Exchange or partition the protected minors property pursuant to NRS 159A.175.
[(g)] (d) Exercise or release the power of the protected minor as a donee of a power of appointment.
[(h)] (e) Exercise the right of the protected minor to take under or against a will.
[(i)] (f) Transfer to a trust created by the protected minor any property unintentionally omitted from the trust.
[(j)] (g) Submit a revocable trust or an irrevocable trust to the jurisdiction of the court if:
(1) The protected minor is the grantor and sole beneficiary of the income of the trust; or
(2) The trust was created by the court.
[(k)] (h) Pay any claim by the Department of Health and Human Services to recover benefits for Medicaid correctly paid to or on behalf of the protected minor.
[(l)] (i) Transfer money in a protected minors blocked account to the Nevada Higher Education Prepaid Tuition Trust Fund created pursuant to NRS 353B.140.
2. Before taking any of the following actions, unless the guardian has been otherwise ordered by the court to petition the court for permission to take specified actions or make specified decisions in addition to those described in subsection 1, the guardian may petition the court for an order authorizing the guardian to:
(a) Obtain advice, instructions and approval of any other proposed act of the guardian relating to the protected minors property.
(b) Take any other action which the guardian deems would be in the best interests of the protected minor.
3. The petition must be signed by the guardian and contain:
(a) The name, age, residence and address of the protected minor.
(b) A concise statement as to the condition of the protected minors estate.
(c) A concise statement as to the advantage to the protected minor of or the necessity for the proposed action.
(d) The terms and conditions of any proposed sale, lease, partition, trust, exchange or investment, and a specific description of any property involved.
4. Any of the matters set forth in subsection 1 may be consolidated in one petition, and the court may enter one order authorizing or directing the guardian to do one or more of those acts.
[5. A petition filed pursuant to paragraph (c) of subsection 1 may be consolidated in and filed with the petition for the appointment of the guardian, and if the guardian is appointed, the court may enter additional orders authorizing the guardian to enter contracts for the protected minor or complete contracts of the protected minor.]
Sec. 29. NRS 159A.117 is hereby amended to read as follows:
159A.117 1. Upon approval of the court by order, a guardian of the estate may:
κ2025 Statutes of Nevada, Page 1714 (CHAPTER 253, AB 387)κ
(a) Invest the property of the protected minor, make loans and accept security therefor, in the manner and to the extent authorized by the court.
(b) Exercise options of the protected minor to purchase or exchange securities or other property.
2. [A guardian of the estate may, without securing the prior approval of the court, invest the property of the protected minor in the following:
(a) Savings accounts in any bank, credit union, savings and loan association or savings bank in this State, to the extent that the deposits are insured by the Federal Deposit Insurance Corporation, the National Credit Union Share Insurance Fund or a private insurer approved pursuant to NRS 672.755.
(b) Interest-bearing obligations of or fully guaranteed by the United States.
(c) Interest-bearing obligations of the United States Postal Service.
(d) Interest-bearing obligations of the Federal National Mortgage Association.
(e) Interest-bearing general obligations of this State.
(f) Interest-bearing general obligations of any county, city or school district of this State.
(g) Money market mutual funds which are invested only in those instruments listed in paragraphs (a) to (f), inclusive.
3. A guardian of the estate for two or more protected persons may invest the property of two or more of the protected persons in property in which each protected person whose property is so invested has an undivided interest. The guardian shall keep a separate record showing the interest of each protected person in the investment and in the income, profits or proceeds therefrom.
4.] A guardian of the estate may access or manage a guardianship account via the Internet on a secured website established by the bank, credit union or broker holding the account.
Sec. 30. NRS 159A.127 is hereby amended to read as follows:
159A.127 A guardian of the estate, with prior approval of the court by order, may sell, lease or place in trust any of the property of the protected minor:
1. For the purpose of paying claims against the protected minor [,] or the [guardianship] estate . [or the guardian of the estate.]
2. For the purpose of providing for the proper care, maintenance, education and support of the protected minor.
3. For the purpose of investing the proceeds.
4. To obtain income through rentals or royalties.
5. For any other purpose that is in the best interests of the protected minor.
Sec. 31. NRS 159A.183 is hereby amended to read as follows:
159A.183 [1.] Subject to the discretion and approval of the court , [and except as otherwise provided in subsection 5,] a guardian must be allowed:
[(a) Reasonable]
1. If the guardian is a private professional guardian of the estate, reasonable compensation for the guardians services; and
[(b) Necessary and reasonable expenses]
2. Reimbursement for:
(a) Expenses incurred in exercising the authority and performing the duties of a guardian; and
κ2025 Statutes of Nevada, Page 1715 (CHAPTER 253, AB 387)κ
[(c) Reasonable expenses incurred in retaining accountants, attorneys, appraisers or other professional services.
2. Reasonable compensation and services must be based upon similar services performed for persons who are not under a legal disability. In determining whether compensation is reasonable, the court may consider:
(a) The nature of the guardianship;
(b) The type, duration and complexity of the services required; and
(c) Any other relevant factors.
3. In the absence of an order of the court pursuant to this chapter shifting the responsibility of the payment of compensation and expenses, the payment of compensation and expenses must be paid from the estate of the protected minor. In evaluating the ability of a protected minor to pay such compensation and expenses, the court may consider:
(a) The nature, extent and liquidity of the protected minors assets;
(b) The disposable net income of the protected minor;
(c) Any foreseeable expenses; and
(d) Any other factors that are relevant to the duties of the guardian pursuant to NRS 159A.079 or 159A.083.
4. Any compensation or expenses, including, without limitation, attorneys fees, must not be paid from the estate of the protected minor unless and until the payment of such fees is approved by the court pursuant to this section or NRS 159A.344, as applicable.
5. A guardian is not allowed compensation or expenses, including, without limitation, attorneys fees, for services incurred by the guardian as a result of a petition to have him or her removed as guardian if the court removes the guardian.]
(b) Other actual costs of preserving and growing the estate if the expenses are necessary to meet an extraordinary need of the protected minor.
Sec. 32. NRS 159A.1852 is hereby amended to read as follows:
159A.1852 A guardian who, after appointment:
1. Is convicted of a gross misdemeanor or felony in any state;
2. Files for or receives protection as an individual or as a principal of any entity under the federal bankruptcy laws [;] , if appointed guardian of the estate or guardian of the person and estate;
3. [Has a drivers license suspended, revoked or cancelled for nonpayment of child support;
4.] Is suspended for misconduct or disbarred from [:
(a) The practice of law;
(b) The practice of accounting; or
(c) Any other profession] any professional practice which [:
(1) Involves or] may involve the management or sale of money, investments, securities or real property [; or
(2) Requires licensure in this State or any other state; or
5. Has a judgment entered against him or her for misappropriation of funds or assets from any person or entity in any state,] , if appointed guardian of the estate or guardian of the person and estate; or
4. Is being investigated for child abuse or neglect by an agency which provides child welfare services,
κ2025 Statutes of Nevada, Page 1716 (CHAPTER 253, AB 387)κ
Κ shall immediately inform the court of the circumstances of those events. The court may remove the guardian and appoint a successor guardian, unless the court finds that it is in the best interest of the protected minor to allow the guardian to continue in his or her appointment.
Sec. 33. NRS 159A.1853 is hereby amended to read as follows:
159A.1853 1. The following persons may petition the court to have a guardian removed:
(a) The protected minor;
(b) Any relative who is within the second degree of consanguinity to the protected minor;
(c) [A public guardian; or] Any attorney of the protected minor;
(d) An agency which provides child welfare services; or
(e) Any other interested person.
2. The petition must:
(a) State with particularity the reasons for removing the guardian; and
(b) Show cause for the removal.
3. If the court denies the petition for removal, the petitioner shall not file a subsequent petition unless a material change of circumstances warrants a subsequent petition.
4. If the court finds that the petitioner did not file a petition for removal in good faith or in furtherance of the best interests of the protected minor, the court may [:
(a) Disallow the petitioner from petitioning the court for attorneys fees from the estate of the protected minor; and
(b) Impose] impose sanctions on the petitioner . [in an amount sufficient to reimburse the estate of the protected minor for all or part of the expenses incurred by the estate of the protected minor in responding to the petition and for any other pecuniary losses which are associated with the petition.]
Sec. 34. NRS 159A.187 is hereby amended to read as follows:
159A.187 1. When a guardian dies or is removed by order of the court, the court, upon the courts own motion or upon a petition filed by any interested person, may appoint another guardian in the same manner and subject to the same requirements as are provided by law for an original appointment of a guardian.
2. If a guardian of the person is appointed for a protected minor pursuant to this section, the protected minor must be served with the petition. If the protected minor does not object to the appointment, the protected minor is not required to attend the hearing.
3. If a guardian dies or is removed by order of the court and there is not a legally qualified guardian or temporary substitute guardian who is willing to serve, the court shall notify an agency which provides child welfare services concerning the matter.
Sec. 35. NRS 159A.1905 is hereby amended to read as follows:
159A.1905 1. A protected minor, the guardian or another person may petition the court for the termination or modification of a guardianship. The petition must state or contain:
(a) The name and address of the petitioner.
(b) The relationship of the petitioner to the protected minor.
(c) The name, age and address of the protected minor, if the protected minor is not the petitioner, or the date of death of the protected minor if the protected minor is deceased.
κ2025 Statutes of Nevada, Page 1717 (CHAPTER 253, AB 387)κ
(d) The name and address of the guardian, if the guardian is not the petitioner.
(e) The reason for termination or modification.
(f) Whether the termination or modification is sought for a guardianship of the person, of the estate, or of the person and estate.
(g) A general description and the value of the remaining property of the protected minor and the proposed disposition of that property.
2. Upon the filing of the petition, the court shall appoint an attorney to represent the protected minor if [:
(a) The protected minor is unable to retain an attorney; or
(b) The] the court determines that the appointment is necessary to protect the interests of the protected minor.
3. [The] Except as otherwise provided in NRS 159A.1915, the petitioner has the burden of proof to show by clear and convincing evidence that the termination or modification of the guardianship of the person, of the estate, or of the person and estate is in the best interests of the protected minor.
4. The court shall issue a citation requiring all interested persons to appear and show cause why termination or modification of the guardianship should not be granted. The court shall serve the citation on the guardian and the petitioner. The petitioner shall serve the citation on all interested persons.
5. If the court finds that the petitioner did not file a petition for termination or modification in good faith or in furtherance of the best interests of the protected minor, the court may [:
(a) Disallow the petitioner from petitioning the court for attorneys fees from the estate of the protected minor; and
(b) Impose] impose sanctions on the petitioner in an amount sufficient to reimburse the estate of the protected minor for all or part of the expenses and for any other pecuniary losses which are incurred by the estate of the protected minor and associated with the petition.
Sec. 36. NRS 159A.191 is hereby amended to read as follows:
159A.191 1. A guardianship of the person, of the estate, or of the person and estate is terminated:
(a) By the death of the protected minor;
(b) Upon the protected minors change of domicile to a place outside this State and the transfer of jurisdiction to the court having jurisdiction in the new domicile;
(c) Upon order of the court, if the court determines that the guardianship no longer is necessary;
(d) On the date on which the protected minor reaches 18 years of age; or
(e) On the date on which the protected minor graduates from high school or becomes 19 years of age, whichever occurs sooner, if:
(1) The protected minor will be older than 18 years of age upon graduation from high school; and
(2) The protected minor and the guardian consent to continue the guardianship and the consent is filed with the court at least 14 days before the date on which the protected minor will become 18 years of age.
2. A guardianship of the estate is terminated:
(a) If the court removes the guardian or accepts the resignation of the guardian and does not appoint a successor guardian;
(b) If the court determines that the guardianship is not necessary and orders the guardianship terminated; or
κ2025 Statutes of Nevada, Page 1718 (CHAPTER 253, AB 387)κ
(c) By the death of the protected minor, subject to the provisions of NRS 159A.193.
3. If the guardianship is of the person and estate, the court may order the guardianship terminated as to the person, the estate, or the person and estate.
4. The guardian shall notify the court, all interested parties, the trustee, and the named executor or appointed personal representative of the estate of the protected minor of the death of the protected minor within 30 days after the death.
5. Immediately upon the death or emancipation of the protected minor:
(a) The guardian of the estate shall have no authority to act for the protected minor except to wind up the affairs of the guardianship pursuant to NRS 159A.193 ; [, and to distribute the property of the protected minor as provided in NRS 159A.195 and 159A.197;] and
(b) No person has standing to file a petition pursuant to NRS 159A.078.
6. A hearing may be held not later than 90 days before a protected minor reaches the age of majority to determine whether:
(a) Guardianship is needed beyond the age of majority;
(b) The protected minor desires an additional year of guardianship beyond the age of majority; and
(c) The guardian should be notified of any requirements of the guardianship which require compliance before termination of the guardianship.
7. If, at a hearing conducted pursuant to subsection 6, a court makes a determination that, upon reaching the age of majority, a protected minor would be deemed incapacitated, as defined in NRS 159.019, a petition may be filed in accordance with the provisions of chapter 159 of NRS to seek guardianship for the protected minor pursuant to that chapter to take effect when the protected minor reaches the age of majority. The protected minor has the right to be represented by counsel if guardianship is sought pursuant to this subsection.
Sec. 37. NRS 159A.1915 is hereby amended to read as follows:
159A.1915 1. If, before a protected minor is emancipated, a parent of the protected minor petitions the court for the termination of a guardianship of the protected minor, the [parent has the burden of proof to show by clear and convincing evidence that:] court shall consider whether:
(a) There has been a material change of circumstances since the time the guardianship was created [. The parent must show that, as part of the change of circumstances, the] ;
(b) The parent has been restored to suitability as described in NRS 159A.061 [.
(b) Except as otherwise provided in subsection 2, the welfare of the protected minor would be substantially enhanced by the] ; and
(c) The termination of the guardianship [and the placement of] is in the best interests of the protected minor . [with the parent.]
2. [If the parent consented to the guardianship when it was created, the parent is required to make only that showing set forth in paragraph (a) of subsection 1.] In determining the best interests of the protected minor, the court shall consider:
(a) Whether the parent has abandoned or persistently neglected the protected minor;
κ2025 Statutes of Nevada, Page 1719 (CHAPTER 253, AB 387)κ
(b) Whether the parent has demonstrated continued neglect or abdication of parental responsibilities;
(c) The likelihood of physical or emotional harm to the protected minor if the protected minor is placed in the custody of the parent;
(d) The level and nature of parental involvement since the appointment of the guardian;
(e) The quality of commitment demonstrated by the parent to raising the protected minor;
(f) The likelihood that the parent could provide stability and security for the protected minor;
(g) The age of the protected minor during the guardianship;
(h) The length of time that the protected minor has been in the care of the person appointed as guardian, including any time before the appointment;
(i) Whether the protected minor and the guardian have a bonded relationship such that significant emotional harm to the protected minor would result from the termination of the guardianship;
(j) The impact that terminating the guardianship would have on the right of the protected minor to education, including, without limitation, receiving special education;
(k) The wishes of the protected minor relating to the termination of the guardianship, including, without limitation, any request for a graduated visitation schedule or therapeutic reunification; and
(l) Any other circumstance that would substantially and adversely impact the welfare of the protected minor.
Sec. 38. NRS 159A.315 is hereby amended to read as follows:
159A.315 1. If the court finds, after examination of a person cited pursuant to NRS 159A.305, that the person has committed an act:
(a) Set forth in paragraph (a) of subsection 1 of NRS 159A.305, the court may order the person to return the asset or the value of the asset to the guardian of the estate; or
(b) Set forth in paragraph (b) of subsection 1 of NRS 159A.305, the court may order the person to return the asset or provide information concerning the location of the asset to the guardian of the estate.
2. The court may hold a person who is cited pursuant to NRS 159A.305 in contempt of court and deal with the person accordingly if the person:
(a) Refuses to appear and submit to examination or to testify regarding the matter complained of in the petition; or
(b) Fails to comply with an order of the court issued pursuant to subsection 1.
3. An order of the court pursuant to subsection 1 is prima facie evidence of the right of the proposed protected minor or the estate of the protected minor to the asset described in the order in any action that may be brought for the recovery thereof, and any judgment recovered therein must be double the value of the asset, and damages in addition thereof equal to the value of such property.
4. If the person who is cited pursuant to NRS 159A.305 appears and, upon consideration of the petition, the court finds that the person is not liable or responsible to the proposed protected minor or the estate of the protected minor, the court may order [:
(a) The proposed protected minor or the estate of the protected minor to pay the attorneys fees and costs of the respondent; or
κ2025 Statutes of Nevada, Page 1720 (CHAPTER 253, AB 387)κ
(b) If the court finds that the petitioner unnecessarily or unreasonably filed the petition,] the petitioner personally to pay the attorneys fees and costs of the respondent.
Sec. 39. NRS 159A.344 is hereby amended to read as follows:
159A.344 1. Any person, including, without limitation, a guardian or proposed guardian, who retains an attorney for the purposes of representing a party in a guardianship proceeding is personally liable for any attorneys fees and costs incurred as a result of such representation.
2. Notwithstanding the provisions of subsection 1 , [and except as otherwise provided in subsection 5 of NRS 159A.183,] a person who is personally liable for attorneys fees and costs may petition the court for an order authorizing such attorneys fees and costs to be paid from the estate of the protected minor in accordance with this section. Any such attorneys fees and costs must not be paid from the guardianship estate unless and until the court authorizes the payment pursuant to this section.
3. When a person who intends to petition the court for payment of attorneys fees and costs from the guardianship estate first appears in the guardianship proceeding, the person must file written notice of his or her intent to seek payment of attorneys fees and costs from the guardianship estate. The written notice:
(a) Must provide a general explanation of the compensation arrangement and how compensation will be computed;
(b) Must include the hourly billing rates of all timekeepers, including, without limitation, attorneys, law clerks and paralegals;
(c) Must provide a general explanation of the reasons why the services of the attorney are necessary to further the best interests of the protected minor;
(d) Must be served by the person on all persons entitled to notice pursuant to NRS 159A.034 and 159A.047; and
(e) Is subject to approval by the court after a hearing.
4. If written notice was filed and approved by the court pursuant to subsection 3, a person may file with the court a petition requesting payment of attorneys fees and costs from the guardianship estate. Such a petition must include the following information:
(a) A detailed statement as to the nature and extent of the services performed by the attorney;
(b) An itemization of each task performed by the attorney, with reference to the time spent on each task in an increment to the nearest one-tenth of an hour and with no minimum billing unit in excess of one-tenth of an hour;
(c) An indication of whether any time billed, including, without limitation, any time spent traveling or waiting, benefited any clients of the attorney other than the protected minor and, if so, how many other clients benefited from such time; and
(d) Any other information considered relevant to a determination of whether attorneys fees are just, reasonable and necessary.
Κ Absent approval from all parties who have appeared in the proceeding, any supplemental requests for the payment of attorneys fees and costs cannot be augmented in open court and must be properly noticed in the same manner as the underlying petition requesting payment.
5. In determining whether attorneys fees are just, reasonable and necessary, the court may consider all the following factors:
κ2025 Statutes of Nevada, Page 1721 (CHAPTER 253, AB 387)κ
(a) The written notice approved by the court pursuant to subsection 3.
(b) Whether the services conferred any actual benefit upon the protected minor or attempted to advance the best interests of the protected minor.
(c) The qualities of the attorney, including, without limitation, his or her ability, training, education, experience, professional standing and skill.
(d) The character of the work performed, including, without limitation, the difficulty, intricacy and importance of the work, the time and skill required to complete the work, the responsibility imposed and the nature of the proceedings.
(e) The work actually performed by the attorney, including, without limitation, the skill, time and attention given to the work.
(f) The result of the work, including, without limitation, whether the attorney was successful and any benefits that were derived.
(g) The usual and customary fees charged in the relevant professional communities for each task performed, regardless of who actually performed the task. The court may only award:
(1) Compensation at an attorney rate for time spent performing services that require an attorney;
(2) Compensation at a paralegal rate for time spent performing paralegal services;
(3) Compensation at a fiduciary rate for time spent performing fiduciary services; and
(4) No compensation for time spent performing secretarial or clerical services.
(h) The appropriate apportionment among multiple clients of any billed time that benefited multiple clients of the attorney.
(i) The extent to which the services were provided in a reasonable, efficient and cost-effective manner, including, without limitation, whether there was appropriate and prudent delegation of services to others.
(j) The ability of the estate of the protected minor to pay, including, without limitation:
(1) The value of the estate;
(2) The nature, extent and liquidity of the assets of the estate;
(3) The disposable net income of the estate;
(4) The anticipated future needs of the protected minor; and
(5) Any other foreseeable expenses.
(k) The efforts made by the person and attorney to reduce and minimize any issues.
(l) Any actions by the person or attorney that unnecessarily expanded issues or delayed or hindered the efficient administration of the estate.
(m) Whether any actions taken by the person or attorney were taken for the purpose of advancing or protecting the interests of the person as opposed to the interests of the protected minor.
(n) Any other factor that is relevant in determining whether attorneys fees are just, reasonable and necessary, including, without limitation, any other factor that is relevant in determining whether the person was acting in good faith and was actually pursuing the best interests of the protected minor.
6. The court shall not approve compensation for an attorney for:
(a) Time spent on internal business activities of the attorney, including, without limitation, clerical or secretarial support; or
κ2025 Statutes of Nevada, Page 1722 (CHAPTER 253, AB 387)κ
(b) Time reported as a total amount of time spent on multiple tasks, rather than an itemization of the time spent on each task.
7. Any fees paid by a third party, including, without limitation, a trust of which the estate is a beneficiary, must be disclosed to and approved by the court.
8. In addition to any payment provided to a person pursuant to this section for the services of an attorney, a person may receive payment for ordinary costs and expenses incurred in the scope of the attorneys representation.
9. If two or more parties in a guardianship proceeding file competing petitions for the appointment of a guardian or otherwise litigate any contested issue in the guardianship proceeding, only the prevailing party may petition the court for payment of attorneys fees and costs from the guardianship estate pursuant to this section. If the court determines that there is no prevailing party, the court may authorize a portion of each partys attorneys fees and costs to be paid from the guardianship estate if the court determines that such fees and costs are just, reasonable and necessary given the nature of any issues in dispute.
10. If an attorney is appointed by the court in a guardianship proceeding, he or she may petition the court for compensation for his or her services from the guardianship estate in accordance with the procedure set forth in this section.
Sec. 40. NRS 159A.346 is hereby amended to read as follows:
159A.346 1. If a guardian violates any right of a protected minor that is set forth in this chapter, a court may take any appropriate action, including, without limitation:
(a) Issuing an order that certain actions be taken or discontinued;
(b) [Disallowing any fees payable to the guardian;
(c)] After notice and a hearing, issuing an order compensating a protected minor or the estate of a protected minor for any injury, death or loss of money or property caused by the actions of the guardian or the failure of the guardian to take appropriate action;
[(d)] (c) Removing the guardian pursuant to NRS 159A.185; or
[(e)] (d) Taking any other action that is proper under the circumstances.
2. If any action by a guardian is deemed to be deliberately harmful or fraudulent or to have been committed with malice, the court may also impose:
(a) Twice the actual damages incurred by the protected minor; and
(b) Attorneys fees and costs.
Sec. 41. (Deleted by amendment.)
Sec. 42. NRS 159A.014, 159A.0345, 159A.049 and 159A.0755 are hereby repealed.
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