Assisted Living in Nevada

Agency: Division of Health, Bureau of Health Care Quality and Compliance
Phone: (775) 684-1030
Website: www.health.nv.gov/HCQC.htm

A residential facility for groups furnishes food, shelter, assistance, and limited supervision to an aged, infirm, mentally retarded, or disabled person on a 24-hour basis. The term includes an assisted living facility.

Facility Scope of Care:
Facilities must provide residents with assistance with activities of daily living (ADLs) and protective supervision as needed. Facilities must also provide nutritious meals and snacks, laundry and housekeeping, and meet the needs of the residents. Facilities must provide 24-hour supervision.

Move-In/Move-Out Requirements:
A resident must be at least 18 years of age. Facilities may not admit or retain persons who: (1) Are bedfast; (2) Require chemical or physical restraints; (3) Require confinement in locked quarters; (4) Require skilled nursing or other medical supervision on a 24- hour basis; (5) Require gastrostomy care; (6) Suffer from a staphylococcus infection or other serious infection; or (7) Suffer from any other serious medical condition. There are other medical conditions that are specified in the regulations that, unless a resident is able to self-manage the condition, require the resident move out of the facility. A resident may be discharged without his/her approval if: (1) He/she fails to pay his bill within five days after it is due; (2) He/she fails to comply with the rules or policies of the facility; or (3) The administrator of the facility or the Bureau determines that the facility is unable to provide the necessary care for the resident.

Resident Assessment:
An assessment of tuberculosis signs and symptoms and need for assistance with ADLs must be completed upon admission.

Medication Management:
If a caregiver assists in the administration of medication, the caregiver must complete an initial medication course from an approved medication training provider. The caregiver also must complete three hours of additional training every three years and pass an approved examination.

Physical Plant Requirements:
Private resident units must be a minimum of 80 square feet and shared resident units must provide a minimum of 60 square feet of floor space per resident.

Residents Allowed Per Room:
A maximum of three residents is allowed per resident unit.

Life Safety:
Under Nevada law, the state fire marshal, on behalf of the Health Division, is responsible for approval and inspection of assisted living facilities with regard to fire safety standards. The state fire marshal uses Uniform Fire Codes. Fire safety requirements include an evacuation plan, fire drills, portable fire extinguishers, smoke detectors, and maintenance of proper exits. All new facilities must be equipped with an automatic sprinkler system. Some older facilities may not be equipped with a sprinkler system because sprinkler systems were not required when they were originally licensed. If anyone purchases one of these older facilities, they must install an automatic sprinkler system.

Alzheimer's Unit Requirements:
Eight hours of training is required for staff supervising residents with Alzheimer's disease. Locked quarters are allowed in Alzheimer's units. In addition, alarms, buzzers, horns, or other audible devices activated when a door is opened are to be installed on all exit doors. There will be not more than six residents for each caregiver during those hours when the residents are awake. At least one member of the staff must be awake and on duty at all times.

Staff Training for Alzheimer's Care:
Each employee of the facility that provides care to individuals with any form of dementia must successfully complete, within the first 40 hours of beginning employment, at least two hours of training in providing care, including emergency care, to a resident with any form of dementia. In addition, within three months of initial employment, he/she must receive at least eight hours of training in providing care to a resident with any form of dementia. If an employee is licensed or certified by an occupational licensing board, at least three hours of required continuing education must be in providing care to a resident with dementia and must be completed on or before the first anniversary of employment. If an employee is a direct caregiver, the individual must complete at least three hours of training in providing care to a resident with dementia on or before the first anniversary of employment.

Staffing Requirements:
An administrator and a sufficient number of caregivers must be employed by the facility. Facilities with more than 20 residents shall ensure that at least one employee is awake and on duty at all times. For Alzheimer's units, one caregiver must be present for every six residents during awake hours and one caregiver must be awake at all times

Staff Education Training:
Caregivers must be at least 18 years of age; have personal qualities enabling them to understand the problems of the aged and disabled; be able to read, write, speak, and understand English; and possess knowledge, skills, and abilities to meet residents' needs. Within 30 days of beginning employment, a caregiver must be trained in first aid and CPR. Within 60 days of beginning employment, a caregiver must receive no less than four hours of training related to the care of residents.

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver covers personal care services in group residential settings.