1. Except as otherwise provided in subsection 5, a provider of health care may authorize a member of the direct support staff of a provider of supported living arrangement services who does not hold a professional license or certificate as a provider of health care to perform specific skilled care services for a person who is receiving supported living arrangement services if:(a) The skilled care services to be performed are usual and customary services that a person without an intellectual or developmental disability would personally perform without the assistance of a provider of health care;(b) The provider of health care determines that:(1) The member of the direct support staff has the knowledge, skill and ability to competently perform the skilled care services;(2) The skilled care services are simple and the performance of the skilled care services by the member of the direct support staff does not increase the risk of harm to the person receiving the skilled care services; and(3) The condition of the person receiving the skilled care services is stable and predictable;(c) The member of the direct support staff agrees to comply with subsection 2; and(d) A professional license or certificate is not required by law to perform the skilled care services.2. A member of the direct support staff of a provider of supported living arrangement services who is providing the skilled care services pursuant to subsection 1 to a person who is receiving supported living arrangement services shall refer the person to a provider of health care if:(a) The medical condition of the person changes or the person develops a new medical condition;(b) The skilled care services provided to the person do not accomplish the expected objectives of the skilled care services;(c) An emergency situation develops; or(d) Any other occurrence designated by the provider of health care who authorized the services as requiring such referral occurs.3. A provider of health care who authorizes a member of the direct support staff of a provider of supported living arrangement services to perform skilled care services in accordance with this section shall include in the medical records of the person to whom services are provided:(a) The specific skilled care services that the provider of health care has authorized the member of the direct support staff to perform; and(b) Notations evidencing compliance with the requirements of this section.4. After a provider of health care authorizes a member of the direct support staff of a provider of supported living arrangement services to perform skilled care services in accordance with this section, no further authorization or supervision by the provider of health care is required for the member of the direct support staff to continue providing those skilled care services.5. A member of the direct support staff of a provider of supported living arrangement services who performs skilled care services in accordance with this section shall not:(a) Perform any skilled care services for a person who resides in a medical facility; or(b) Perform any skilled care services that have not been specifically authorized by a provider of health care pursuant to this section.6. As used in this section:(a) "Provider of health care" means:(1) A physician licensed pursuant to chapter 630, 630A or 633 of NRS;(2) An advanced practice registered nurse certified pursuant to chapter 632 of NRS; or(3) A physician assistant licensed pursuant to chapter 630 or 633 of NRS.(b) "Skilled care services" include, without limitation, administering medication, wound care, gastronomy, jejunostomy tube feeding, ostomy care, catheter care and other similar services.Nev. Admin. Code § 435.Sec. 4
Added to NAC by Div. of Men. Health & Dev. Services by R026-24A, eff. 8/13/2024