Nev. Admin. Code § 450B.505

Current through April 30, 2024

Section 450B.505 - Permit required; appointment, powers and duties of medical director

1. Each service providing emergency care must:

(a) Apply for and receive a permit from the Division; and

(b) Have a medical director who is responsible for developing, carrying out and evaluating standards for the provision of emergency care by the service.

2. The medical director of a service shall:

(a) Establish medical standards which:

(1) Are consistent with the national standard which is prepared by the National Highway Traffic Safety Administration of the United States Department of Transportation as a national standard for the level of service for which a permit is issued to the service or an equivalent standard approved by the Administrator of the Division and which are approved by the board;

(2) Are equal to or more restrictive than the national standard prepared by the National Highway Traffic Safety Administration of the United States Department of Transportation or an equivalent standard approved by the Administrator of the Division and adopted by the state emergency medical system; and

(3) Must be reviewed and maintained on file by the Division or a physician active in providing emergency care who is designated by the Division to review and make recommendations to the Division.

(b) Direct the emergency care provided by any licensed attendant who is actively employed by the service.

3. The appointment of a medical director must be approved by the Division or a physician with experience in emergency care who is designated by the Division to approve those appointments. The medical director must:

(a) Be a physician;

(b) Have experience in and current knowledge of the emergency care of patients who are acutely ill or injured;

(c) Have knowledge of and access to local plans for responding to emergencies;

(d) Be familiar with the operations of a base hospital, including communication with, and direction of, personnel who provide emergency care;

(e) Be actively involved in the training of personnel who provide emergency care;

(f) Be actively involved in the audit, review and critique of emergency care provided by personnel;

(g) Have knowledge of administrative and legislative processes affecting local, regional and state systems that provide emergency medical services;

(h) Have knowledge of laws and regulations affecting local, regional and state systems that provide emergency medical services; and

(i) Have knowledge of procedures and treatment for adult, pediatric and trauma resuscitation.

4. The medical director of a service which is licensed by another state who meets the requirements of that state to serve as a medical director shall be deemed to satisfy the requirements of subsection 3 if he or she submits proof to the Division that he or she has satisfied the requirements of that state.

5. A medical director of a service may:

(a) In consultation with appropriate specialists and consistent with the national standard prepared by the National Highway Traffic Safety Administration of the United States Department of Transportation or an equivalent standard approved by the Administrator of the Division, establish medical protocols and policies for the service;

(b) Recommend to the Division the revocation of licensure of personnel who provide emergency care;

(c) Approve educational requirements that meet the requirements of the national standard prepared by the National Highway Traffic Safety Administration of the United States Department of Transportation or an equivalent standard approved by the Administrator of the Division and proficiency levels for instructors and personnel of the service;

(d) Approve educational programs within the service that are consistent with the national standard prepared by the National Highway Traffic Safety Administration of the United States Department of Transportation or an equivalent standard approved by the Administrator of the Division;

(e) Suspend a licensed attendant within that service pending review and evaluation by the Division;

(f) Establish medical standards for dispatch procedures to ensure that the appropriate response units are dispatched to the scene of a medical emergency and appropriate emergency medical dispatch care is provided before the arrival of the dispatched response units;

(g) Establish criteria and procedures to be used when a patient refuses transportation;

(h) Establish medical criteria for the level of care and type of transportation to be used for emergency care;

(i) Establish medical criteria for the level of care provided for a situation in which a person on the scene is treated and released;

(j) Establish standing orders and procedures and the criteria under which the providers of emergency care may operate before initiating contact with a physician at a base station; and

(k) Conduct an audit to ensure the quality of the medical system of the service in conjunction with the activities of the designated base hospital or health facility.

6. The medical director of the service may delegate his or her duties to any other qualified physician. If the medical director of the service wishes to delegate his or her duties pursuant to this subsection, he or she shall provide written notification to the Division before delegating his or her duties.

7. If a medical director of a service wishes to resign, he or she:

(a) Shall provide written notification of such intentions to the Division and the service not less than 30 days before the effective date of the resignation; and

(b) May provide recommendations for an interim replacement.

8. If the medical director of a service is unable to carry out his or her responsibilities, he or she shall designate an alternate physician to assume the duties of the medical director.

9. The Division shall impose against a service that provides emergency care without a permit an administrative penalty of:

(a) For services provided on or after January 27, 2017, and before July 1, 2018, $200 per day;

(b) For services provided on or after July 1, 2018, and before July 1, 2019, $300 per day; and

(c) For services provided on or after July 1, 2019, $500 per day.

Nev. Admin. Code § 450B.505

Added to NAC by Bd. of Health, eff. 8-1-91; A by R045-97, 10-30-97; R182-01, 3-5-2002; A by R024-14, eff. 10/24/2014; A by R068-16A, eff. 1/27/2017

NRS 450B.120, 450B.200 and 450B.900