2005 Nevada Revised Statutes - Chapter 450 — County Hospitals and Hospital Districts

CHAPTER 450 - COUNTY HOSPITALS AND HOSPITALDISTRICTS

GENERAL PROVISIONS

NRS 450.005 Definitions.

NRS 450.006 Alliedhealth profession defined.

NRS 450.008 Purchasinggroup defined.

COUNTY HOSPITALS

Definitions

NRS 450.010 Taxpayersdefined.

 

Establishment

NRS 450.020 Procedure.

NRS 450.030 Petitionsigned by at least 30 percent of taxpayers; submission of question at nextgeneral election.

NRS 450.040 Petitionsigned by at least 50 percent of taxpayers; submission of question at nextprimary or general election.

NRS 450.043 Motionof board of county commissioners; submission of question at special election ornext primary or general election.

NRS 450.045 Approvalof bond issue; appointment of board of hospital trustees; issuance and sale ofbonds.

NRS 450.050 Administration,control and government of county hospitals acquired by purchase or constructionunder provisions of certain legislative acts.

NRS 450.060 Acquisitionof additional building or site when board of hospital trustees assumes controlof existing hospital.

 

Board of Hospital Trustees

NRS 450.070 Number;election; terms of office.

NRS 450.080 Officeof hospital trustee nonpartisan.

NRS 450.090 Selectionof county commissioners for membership on board.

NRS 450.100 Oathand bond.

NRS 450.110 Vacancies.

NRS 450.120 Officersof board.

NRS 450.130 Compensationand expenses of trustees.

NRS 450.135 Interestin purchase of supplies prohibited; exception.

NRS 450.140 Meetingsof board; quorum.

NRS 450.150 Generalpowers and duties of board.

NRS 450.160 Rulesand regulations.

NRS 450.165 Boardauthorized to acquire building or other facility for provision of health carein county adjacent to county where hospital is established; board authorized toissue special obligations to finance facility.

NRS 450.170 Visitsand examinations of hospital; report to board of county commissioners.

NRS 450.175 Hospitaladvisory board in certain counties: Appointment; powers and duties;compensation of members.

NRS 450.180 Employmentor removal of employees or appointed persons; contract for medical services.

NRS 450.191 Contractfor management of hospital.

NRS 450.200 Condemnationof property for use by hospital.

NRS 450.210 Approvalof plans and specifications for construction of hospital; advertisement ofbids.

NRS 450.220 Giftsand bequests to hospital: Title vested in county; control by board of hospitaltrustees.

 

Finances

NRS 450.230 Budget.

NRS 450.240 Managementof county hospital by board; levy of tax for maintenance and operation.

NRS 450.250 Controlof expenditures by board; lease of buildings; deposit of money in hospital fundor separate account.

NRS 450.255 Mortgageor pledge of personal property of hospital; acquisition of real property forexpansion.

NRS 450.260 Collectionor settlement of claims.

 

Bonds

NRS 450.270 Maximumamount.

NRS 450.280 Purposesand procedure for issuance of general obligation bonds at request of board ofhospital trustees.

NRS 450.290 Issuanceof general and special obligation bonds by board of county commissioners.

NRS 450.300 Applicabilityof Local Government Securities Law.

NRS 450.310 Schedulesof fees, rates and charges for services, facilities and commodities.

 

Administration

NRS 450.390 Hospitalfor benefit of county; payment of charges; exclusion of persons from use ofhospital.

NRS 450.400 Extensionof privileges and use of hospital to certain nonresidents: Notice; removal ofperson to resident county; payment for temporary care; action for recovery ofcharges.

NRS 450.410 Admissionof paying patients; charges.

NRS 450.420 Boardof county commissioners to determine status of patient; charges fixed by boardof hospital trustees; costs chargeable to county; exceptions.

NRS 450.425 Boardof county commissioners may levy ad valorem tax to pay cost of servicesrendered at hospital to certain persons admitted for emergency treatment.

NRS 450.430 Equalprivileges of practitioners; rights of patients.

NRS 450.440 Staffof physicians: Organization; rotation of service; assistance.

NRS 450.450 Generaladministration of hospital subject to regulations of trustees.

NRS 450.455 Programfor training resident physicians.

NRS 450.460 Schoolfor training nurses.

NRS 450.470 Roomfor examination of mentally ill persons; room for custodial supervision of mentallyill or dangerous persons.

NRS 450.480 Useof advanced emergency medical technicians for emergency care authorized.

NRS 450.485 Contractfor use of facility for intermediate care or facility for skilled nursing.

 

Transfer

NRS 450.490 Conveyanceor lease of hospital to corporation.

NRS 450.500 Conveyanceor lease of hospital to nonprofit corporation.

NRS 450.510 Countywhose population is less than 100,000 may contract with community nonprofithospital for care of indigent patients; enlargement or alteration of hospital.

 

Miscellaneous Provisions

NRS 450.520 Determinationthat emergency exists before submission of certain questions at specialelection.

NRS 450.525 Membershipof hospital in purchasing group.

NRS 450.530 Purchaseof supplies, materials and equipment without complying with certainrequirements for competitive bidding.

COUNTY HOSPITAL DISTRICTS

NRS 450.550 Definitions.

NRS 450.560 Establishmentof district on motion of board of county commissioners.

NRS 450.570 Noticeof intent to establish district: Contents; publication.

NRS 450.580 Objectionsto formation of district; hearing.

NRS 450.590 Establishmentof district: Petition of owners of property; adoption, contents and publicationof resolution of intention to establish district; exception.

NRS 450.600 Hearingon petition.

NRS 450.610 Resolutioncreating district.

NRS 450.620 Enactmentof ordinance regarding number, terms and election of trustees; service of boardof county commissioners ex officio as board of trustees.

NRS 450.625 Trusteesof district that includes territory within more than one county.

NRS 450.630 Generalpowers and duties of board of trustees; rules and regulations.

NRS 450.640 Employeesand staff of hospital: Appointment to board of chief of staff of physicians fordistrict hospital; appointment by board of chief executive officer andnecessary assistants for hospital; compensation; removal; admission.

NRS 450.650 Budgets.

NRS 450.660 Taxlevies; disposition of proceeds.

NRS 450.665 Powersof board of trustees: Borrowing of money and incurrence or assumption ofindebtedness; limitations and conditions.

NRS 450.670 Powersof board of trustees: Issuance and sale of bonds for certain purposes.

NRS 450.675 Powersof board of trustees: Mortgage or pledge of personal property and acquisitionof real property.

NRS 450.680 Electionconcerning issuance of bonds; applicability of Local Government Securities Law.

NRS 450.690 Donations.

NRS 450.700 Boardof trustees to determine status of patient and fix charges.

NRS 450.710 Creationof district for sole purpose of contracting for services of hospital.

NRS 450.715 Authorityof board of trustees to contract for services of hospital.

NRS 450.720 Contractfor management of district hospital.

NRS 450.725 Membershipof district hospital in purchasing group.

NRS 450.730 Purchaseof supplies, materials and equipment without complying with certainrequirements for competitive bidding.

NRS 450.750 Boardof county commissioners in certain districts deemed local governmentresponsible for transferring certain payments of money.

NRS 450.751 Dissolutionof hospital district in county whose population is less than 400,000:Determination that dissolution is in best interest required; ordinance of boardof county commissioners; considerations; duties of county clerk.

NRS 450.753 Dissolutionof hospital district: Right of qualified electors to protest; dissolutionprohibited if majority of qualified electors protest; dissolution by finalordinance; recital of protests.

NRS 450.755 Dissolutionof hospital district: Hearing; full consideration of all protests required;adoption of final ordinance of dissolution or ordinance of nondissolution byboard of county commissioners.

NRS 450.757 Dissolutionof hospital district: County clerk must file final ordinance of dissolution;locations.

NRS 450.759 Dissolutionof hospital district in county whose population is less than 400,000: Unpaidtaxes, levies and assessments are lien on property; power of board of countycommissioners to collect.

NRS 450.760 Dissolutionof hospital district in county whose population is less than 400,000:Retirement of outstanding debt and other obligations; levy of property tax;disposition of property.

MISCELLANEOUS PROVISIONS

NRS 450.800 Countyor district hospital may contract for services.

_________

CHAPTER 450

 

GENERAL PROVISIONS

NRS 450.005 Definitions. As used in this chapter, unless the context otherwiserequires, the words and terms defined in NRS450.006 and 450.008 have themeanings ascribed to them in those sections.

(Added to NRS by 1975, 641; A 1977, 961; 1979, 150;1991, 1133; 1999, 191)

NRS 450.006 Alliedhealth profession defined. Allied healthprofession means:

1. Psychology as defined in chapter 641 of NRS; or

2. Oriental medicine or acupuncture as defined in chapter 634A of NRS.

(Added to NRS by 1999, 190; A 2001, 1830)

NRS 450.008 Purchasinggroup defined. Purchasing group means acooperative organization of hospitals and other health care organizations thataffiliate for the purpose of combining their purchasing power to secure a lowercost for their purchases of supplies, materials and equipment than would beavailable to the members of the purchasing group individually.

(Added to NRS by 1999, 191)

COUNTY HOSPITALS

Definitions

NRS 450.010 Taxpayersdefined. For the purposes of NRS 450.010 to 450.510, inclusive, taxpayers includeonly citizens of the United States of the age of 18 years and upward who, atthe time of filing their petition, are registered electors of the county inwhich an election is proposed to be held and whose names appear on the latestassessment roll of the county as owners of real or personal property.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,365](NRS A 1975, 79; 1987, 295; 1995, 332)

Establishment

NRS 450.020 Procedure. Any county or group of counties may establish a publichospital in the manner prescribed in NRS450.030 and 450.040.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]

NRS 450.030 Petitionsigned by at least 30 percent of taxpayers; submission of question at nextgeneral election. Whenever the board of countycommissioners of any county is presented with a petition signed by at least 30percent of the taxpayers in such county or in each of a group of countiesasking that an annual tax be levied for the establishing and maintenance of apublic hospital, at a place in the county or counties named therein, andspecifying the maximum amount of money proposed to be expended in purchasing orbuilding the hospital, including the acquisition of a site, the board of countycommissioners shall, after a compliance with and subject to the provisions of NRS 350.011 to 350.0165, inclusive, submit the questionof issuing bonds therefor to the qualified electors of the county at the next generalelection to be held in the county, as provided in NRS 350.020 to 350.070, inclusive.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]+ [Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165](NRS A 1965, 632; 1969,1603; 1981, 962)

NRS 450.040 Petitionsigned by at least 50 percent of taxpayers; submission of question at nextprimary or general election.

1. Whenever the board of county commissioners of anycounty is presented with a petition signed by at least 50 percent of thetaxpayers in the county or in each of a group of counties asking that an annualtax be levied for the establishment and maintenance of a public hospital, at aplace in the county or counties named therein, and specifying the maximumamount of money proposed to be expended in purchasing or building the hospital,including the acquisition of a site, the board of county commissioners shallforthwith comply with the provisions of NRS350.011 to 350.0165, inclusive, andshall submit the proposal to issue bonds for the project to the county debtmanagement commission for each of the counties.

2. Upon the receipt of the approval thereof of eachsuch commission, each board of county commissioners shall submit the questionof issuing bonds for the hospital project designated in the petition to thequalified electors of the county at the next primary or general election, asprovided in NRS 350.020 to 350.070, inclusive.

3. If the petition designated in subsection 1 indicatesthe hospital is to serve more than one county, each county designated shallsubmit to the commission and to the qualified electors of the county a bondquestion authorizing the issuance of the countys bonds for the project in amaximum principal amount at least sufficient to defray the countysproportional share of the maximum amount designated in the petition to beexpended for the project based upon the last assessed valuation of the taxableproperty in the county and the valuation of that property in all the countiesdesignated in the petition.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]+ [Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165](NRS A 1965, 633; 1969,1603; 1981, 962; 1993, 1078; 1995, 773)

NRS 450.043 Motionof board of county commissioners; submission of question at special election ornext primary or general election. Whenever theboard of county commissioners of any county on its own motion desires toestablish a county hospital, the board shall:

1. Specify the maximum amount of money proposed to beexpended in purchasing or building the hospital, including the acquisition of asite;

2. Comply with the provisions of NRS 350.011 to 350.0165, inclusive; and

3. Upon the receipt of the approval of the county debtmanagement commission of the proposal to issue the county hospital bonds,submit the question of issuing bonds for the project to the qualified electorsof the county at a special election or the next primary or general election, asprovided in NRS 350.020 to 350.070, inclusive.

(Added to NRS by 1965, 633; A 1969, 1604; 1981, 963;1993, 1078; 1995, 773)

NRS 450.045 Approvalof bond issue; appointment of board of hospital trustees; issuance and sale ofbonds. Whenever a question of issuing bonds submittedto the qualified electors of any county pursuant to NRS 450.030, 450.040 or 450.043 has been approved as provided in NRS 350.070, the board or boards of countycommissioners shall immediately proceed to appoint the board of hospitaltrustees and shall proceed to issue and sell the bonds as provided in NRS 450.010 to 450.510, inclusive, subject to theprovisions of the Local Government Securities Law.

(Added to NRS by 1965, 633; A 1969, 1604; 1985, 293)

NRS 450.050 Administration,control and government of county hospitals acquired by purchase or constructionunder provisions of certain legislative acts. Inall cases where any county hospital has been acquired by purchase, constructionor otherwise, in any of the several counties of this state under or by virtueof any act of the Legislature other than NRS450.010 to 450.510, inclusive, andhas been governed and administered thereunder by the board of countycommissioners, or otherwise, the board of county commissioners is authorizedand empowered forthwith to appoint a board of hospital trustees for such countyhospital. Thereafter, all the provisions of NRS450.010 to 450.510, inclusive,relative to the maintenance of hospitals, election of hospital trustees, maintenanceof a training school for nurses, provision for suitable care for such hospitalsand disabled persons, and the administration and government of county hospitaland patients therein shall be immediately applicable and controlling withrespect to the future administration, control and government of such hospitalin like manner and with the same force and effect as if an election had beenduly held in accordance with the provisions of NRS 450.010 to 450.510, inclusive, and a majority of allthe votes cast had been in favor of establishing such hospital.

[1.1:169:1929; added 1953, 126](NRS A 1965, 633)

NRS 450.060 Acquisitionof additional building or site when board of hospital trustees assumes controlof existing hospital. In all counties whereexisting hospitals are taken over by a board of hospital trustees, as providedin NRS 450.010 to 450.510, inclusive, additional necessarybuildings and sites may be acquired only if a bond issue is approved by thevoters at a primary, general or special election according to the terms of NRS 450.010 to 450.510, inclusive, as if no hospital thenexisted. In a county whose population is 100,000 or more, in cases wherebuildings or parts thereof have been constructed but remain unfinished andunequipped, the board of hospital trustees may complete the building orbuildings or part or parts thereof and furnish and equip them from the boardscurrent receipts, without a bond issue.

[16:169:1929; A 1937, 194; 1941, 14; 1931 NCL 2240](NRS A 1969, 1543; 1979, 548; 1993, 1079)

Board of Hospital Trustees

NRS 450.070 Number;election; terms of office.

1. Except in counties where the board of countycommissioners is the board of hospital trustees, the board of hospital trusteesfor the public hospital consists of five trustees, who must:

(a) Be residents of the county or counties concerned.

(b) Be elected as provided in subsection 2.

2. In any county:

(a) Whose population is less than 100,000, hospitaltrustees must be elected for terms of 4 years in the same manner as othercounty officers are elected.

(b) Whose population is 100,000 or more but less than400,000, hospital trustees must be elected from the county at large for termsof 4 years.

[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,165](NRS A 1959, 556; 1965, 634; 1967, 1255; 1969, 338, 1390, 1543; 1971,1537; 1973, 127; 1975, 1101; 1979, 548; 1989, 1927)

NRS 450.080 Officeof hospital trustee nonpartisan. Except incounties where the board of county commissioners is the board of hospitaltrustees:

1. The offices of hospital trustees are herebydeclared to be nonpartisan, and the names of candidates for such offices shallappear alike upon the ballots of all parties at all primary elections.

2. At the general election only the names of thosecandidates, not to exceed twice the number of hospital trustees to be elected,who received the highest numbers of votes at the primary election shall appearon the ballot.

[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,165](NRS A 1973, 274; 1975, 1102)

NRS 450.090 Selectionof county commissioners for membership on board.

1. In any county whose population is 400,000 or more,the board of county commissioners is, ex officio, the board of hospitaltrustees, and the county commissioners shall serve as hospital trustees duringtheir terms of office as county commissioners.

2. In any county whose population is less than400,000, the board of county commissioners may enact an ordinance providingthat the board of county commissioners is, ex officio, the board of hospitaltrustees. If such an ordinance is enacted in a county:

(a) The county commissioners shall serve as hospitaltrustees during their terms of office as county commissioners; and

(b) If hospital trustees have been elected pursuant to NRS 450.070 and 450.080, the term of office of eachhospital trustee who is serving in that capacity on the effective date of theordinance is terminated as of the effective date of the ordinance.

3. A board of county commissioners shall not enact anordinance pursuant to subsection 2 unless it determines that:

(a) The county has fully funded its indigent careaccount created pursuant to NRS 428.010;

(b) The county has fulfilled its duty to reimburse thehospital for indigent care provided to qualified indigent patients; and

(c) During the previous calendar year:

(1) At least one of the hospitals accountspayable was more than 90 days in arrears;

(2) The hospital failed to fulfill its statutoryfinancial obligations, such as the payment of taxes, premiums for industrialinsurance or contributions to the Public Employees Retirement System;

(3) One or more of the conditions relating tofinancial emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or

(4) The hospital received notice from theFederal Government or the State of Nevada that the certification or licensureof the hospital was in imminent jeopardy of being revoked because the hospitalhad not carried out a previously established plan of action to correctpreviously noted deficiencies found by the regulatory body.

4. Except in counties where the board of countycommissioners is the board of hospital trustees, in any county whose populationis 100,000 or more but less than 400,000, the board of hospital trustees forthe public hospital must be composed of the five regularly elected or appointedmembers, and, in addition, three county commissioners selected by the chairmanof the board of county commissioners shall serve as voting members of the boardof hospital trustees during their terms of office as county commissioners.

5. Except in counties where the board of countycommissioners is the board of hospital trustees, in any county whose populationis less than 100,000, the board of hospital trustees for the public hospitalmust be composed of the five regularly elected or appointed members, and, inaddition, the board of county commissioners may, by resolution, provide that:

(a) One county commissioner selected by the chairman ofthe board of county commissioners shall serve as a voting member of the boardof hospital trustees during his term of office as county commissioner;

(b) A physician who is the chief of the staff ofphysicians for the public hospital shall serve as a voting member of the boardof hospital trustees; or

(c) Both a county commissioner appointed pursuant tothe provisions of paragraph (a) and a physician appointed pursuant to theprovisions of paragraph (b) shall serve as voting members of the board ofhospital trustees.

The term ofoffice of a member appointed pursuant to the provisions of paragraph (b) is 2years and begins on the date the board of county commissioners appoints themember.

[Part 2:169:1929; A 1937, 194; 1949, 83; 1955,165](NRS A 1960, 407; 1967, 1255; 1969, 1544; 1975, 1102; 1979, 549; 1989,1928; 1995, 791; 1997, 571; 2001, 467)

NRS 450.100 Oathand bond. Within 10 days after theirappointment or election, trustees shall qualify by taking the oath of office.No bond shall be required of them.

[Part 3:169:1929; A 1955, 244]

NRS 450.110 Vacancies. Except in counties where the board of county commissionersis the board of hospital trustees, a vacancy in the board of hospital trusteesoccasioned by a resignation, removal or otherwise must be reported to the boardor boards of county commissioners and must be filled in the same manner as theoriginal appointment. An appointee shall hold office:

1. Until the next following general election in theusual manner; or

2. If the appointee is a physician appointed to fillthe vacancy of a member appointed pursuant to the provisions of paragraph (b)of subsection 5 of NRS 450.090, for theunexpired term of that member.

[5:169:1929; NCL 2229](NRS A 1975, 1103; 2001, 468)

NRS 450.120 Officersof board. Except as provided in subsection 3:

1. Within 10 days after their appointment or election,the trustees shall organize as a board of hospital trustees by the election ofone of their number as chairman, one as secretary, and by the election of suchother officers as they may deem necessary.

2. The county treasurer of the county in which thehospital is located shall be the treasurer of the board of hospital trustees.The treasurer shall receive and pay out all the moneys under the control of theboard, as ordered by it, but shall receive no compensation from the board ofhospital trustees.

3. In counties where the board of county commissionersis the board of hospital trustees, the chairman of the board of countycommissioners may be chairman of the board of hospital trustees or the board ofcounty commissioners may, at its first meeting in January of each year,designate another of its members to serve as chairman of the board of hospitaltrustees for a term of 1 year. The vice chairman of the board of countycommissioners may be vice chairman of the board of hospital trustees, or theboard of county commissioners may, at its first meeting in January of eachyear, designate another of its members to serve as vice chairman of the boardof hospital trustees for a term of 1 year. The county clerk shall be thesecretary of the board of hospital trustees. The county clerk shall receive nocompensation from the board of hospital trustees.

[Part 3:169:1929; A 1955, 244](NRS A 1975, 1103;1977, 931)

NRS 450.130 Compensationand expenses of trustees.

1. Except in counties where the board of countycommissioners is the board of hospital trustees, in any county whose populationis less than 100,000:

(a) A hospital trustee is entitled to receive a salaryas follows:

(1) The chairman and secretary of the board ofhospital trustees are entitled to receive $85 for each meeting of the board ora committee appointed by the board that they attend, not to exceed $510 permonth.

(2) The other trustees are entitled to receive$80 for each meeting of the board or a committee appointed by the board thatthey attend, not to exceed $480 per month.

(b) In additionto the salary required by paragraph (a), the board of hospital trustees mayprovide to each member of the board the same health insurance coverage as theboard provides to its employees.

2. Except in counties where the board of countycommissioners is the board of hospital trustees, in any county whose populationis 100,000 or more, a hospital trustee, subject to the provisions of subsection3, is entitled to receive a salary of $100 per month and the chairman of theboard of hospital trustees is entitled to receive a salary of $200 per month.

3. Before any hospital trustee is entitled to anycompensation as provided in subsection 2, he must first have devoted a minimumof 1 day during the month exclusively to the business and affairs of thehospital, exclusive of regular meetings of the board of hospital trustees.

4. Any trustee of any county hospital is entitled toreceive reimbursement for any cash expenditures actually made for personalexpenses incurred as a trustee. An itemized statement of all those expenses andmoney paid out must be made under oath by each of the trustees and filed withthe secretary. An itemized statement may be allowed only by an affirmative voteof all trustees present at a meeting of the board.

5. In counties where the county commissioners are theboard of hospital trustees, they shall serve without compensation, but areallowed the per diem allowance and traveling expenses fixed by law.

[Part 3:169:1929; A 1955, 244](NRS A 1973, 319;1975, 1103; 1979, 549; 1993, 921; 1995, 792; 2001, 364)

NRS 450.135 Interestin purchase of supplies prohibited; exception. Atrustee shall not have a personal pecuniary interest, either directly orindirectly, in the purchase of any supplies for the hospital unless thesupplies are purchased by competitive bidding.

(Added to NRS by 1977, 1114)

NRS 450.140 Meetingsof board; quorum.

1. The board of hospital trustees shall hold meetingsat least once each month, and shall keep a complete record of all itstransactions.

2. Except as otherwise provided in NRS 241.0355:

(a) In counties where three county commissioners arenot members of the board, three members of the board constitute a quorum forthe transaction of business.

(b) And except as otherwise provided in paragraph (c),in counties where three county commissioners are members of the board, any fiveof the members constitute a quorum for the transaction of business.

(c) In counties where the board of county commissionersis the board of hospital trustees, a majority of the board constitutes a quorumfor the transaction of business.

[Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165] +[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194](NRS A 1960, 93, 407; 1991,288; 2001, 1129)

NRS 450.150 Generalpowers and duties of board. The board ofhospital trustees, in general, shall carry out the spirit and intent of NRS 450.010 to 450.510, inclusive, in establishing andmaintaining a county public hospital.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]

NRS 450.160 Rulesand regulations. The board of hospitaltrustees shall make and adopt such bylaws, rules and regulations for its ownguidance and for the government of the hospital, and such rules and regulationsgoverning the admission of physicians to the staff, as may be deemed expedientfor the economic and equitable conduct thereof, not inconsistent with NRS 450.010 to 450.510, inclusive, or the ordinances ofthe city or town wherein such hospital is located.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194](NRSA 1963, 346)

NRS 450.165 Boardauthorized to acquire building or other facility for provision of health carein county adjacent to county where hospital is established; board authorized toissue special obligations to finance facility.

1. A board of hospital trustees may acquire a buildingor other facility for the provision of health care in a county adjacent to thecounty or one of the counties where the county hospital is established, mayoperate such a facility, and may, but need not, enter into a contract with aprivate hospital or other person to operate such a facility, but only if no taxis levied or appropriation made from the county general fund in the county orcounties where the county hospital is established for the maintenance and operationof the county hospital. The board of hospital trustees may use money in thehospital fund or in any separate account established by the board for thispurpose.

2. To finance the acquisition of the additionalfacility, the board of hospital trustees may issue, without any election,special obligations payable only from revenues of the additional facility orfrom those revenues and the revenues of the county hospital and any relatedfacilities. These obligations are not an indebtedness of the county or countieswhere the county hospital is established or of the county in which theadditional facility is located.

3. As used in this section, acquire andacquisition have the meaning attributed to them in NRS 350.506.

(Added to NRS by 1995, 332)

NRS 450.170 Visitsand examinations of hospital; report to board of county commissioners.

1. One of the hospital trustees shall visit andexamine the hospital twice each month.

2. During the first week in February of each year, theboard shall file with the board of county commissioners a report of the proceedingsof the board of hospital trustees with reference to the hospital.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]

NRS 450.175 Hospitaladvisory board in certain counties: Appointment; powers and duties;compensation of members.

1. In counties where the board of county commissionersis the board of hospital trustees, the board of hospital trustees may appoint ahospital advisory board which shall exercise powers and duties delegated to theadvisory board by the board of hospital trustees.

2. Members of a hospital advisory board must beappointed by a majority vote of the board of hospital trustees and shall serveat the pleasure of the board.

3. Members of the hospital advisory board may receivecompensation for their services of no more than $100 per month.

(Added to NRS by 1975, 1101; A 1995, 793)

NRS 450.180 Employmentor removal of employees or appointed persons; contract for medical services. The board of hospital trustees may:

1. Appoint a chief executive officer and necessary assistants,and fix their compensations.

2. Employ physicians and interns, either full-time orpart-time, as the board determines necessary, and fix their compensations.

3. Remove those appointees and employees.

4. Control the admission of physicians and interns tothe staff by promulgating appropriate rules, regulations and standardsgoverning those appointments.

5. Contract with individual physicians or privatemedical associations for the provision of certain medical services as may berequired by the hospital.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,194](NRS A 1963, 346; 1979, 444; 1987, 387; 2005, 2557)

NRS 450.191 Contractfor management of hospital.

1. The governing body of a county hospital maycontract with a company which manages hospitals for the rendering of managementservices in a county hospital under the ultimate authority of the governingbody.

2. The agreement may provide:

(a) That the administrator of the hospital must be anemployee of the company which manages the hospital; and

(b) That the hospital may, in accordance with therequirements of NRS 450.530, purchasesupplies, materials and equipment through the purchasing contracts of thecompany which manages the hospital, or through a purchasing group, without complyingwith the requirements for competitive bidding set forth in chapter 332 of NRS.

(Added to NRS by 1975, 1101; A 1979, 444; 1987, 295; 1999, 191)

NRS 450.200 Condemnationof property for use by hospital. If the boardof hospital trustees and the owners of any property desired by the board ofhospital trustees for hospital purposes in the county or counties where thecounty hospital is established cannot agree as to the price to be paidtherefor, the board of hospital trustees shall report the facts to the board orboards of county commissioners. Condemnation proceedings shall be instituted bythe board or boards of county commissioners and prosecuted in the name of thecounty or counties by the district attorney for such county as may beconcerned.

[7:169:1929; NCL 2231](NRS A 1995, 333)

NRS 450.210 Approvalof plans and specifications for construction of hospital; advertisement ofbids. No hospital buildings shall be erectedor constructed until the plans and specifications have been made therefor andadopted by the board of hospital trustees, and bids advertised for according tolaw for other county public buildings.

[8:169:1929; NCL 2232]

NRS 450.220 Giftsand bequests to hospital: Title vested in county; control by board of hospitaltrustees. Any person, firm, organization,corporation or society desiring to make donations of money, personal propertyor real property for the benefit of a county public hospital shall have theright to vest title of the money, personal property or real property so donatedin the county or counties where the county hospital is established to becontrolled, when accepted, by the board of hospital trustees according to theterms of the deed, gift, devise or bequest of such property.

[15:169:1929; NCL 2239](NRS A 1995, 333)

Finances

NRS 450.230 Budget. The board of hospital trustees shall file with the boardof county commissioners a budget as required of all governmental agencies ofthis state by chapter 354 of NRS, and in thefiscal management of the affairs of the public hospital and all otherinstitutions under the supervision, government and control of the board ofhospital trustees, the board of hospital trustees are governed by the provisionsof chapter 354 of NRS.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,194](NRS A 1963, 455; 1965, 747; 1975, 13; 1987, 296)

NRS 450.240 Managementof county hospital by board; levy of tax for maintenance and operation.

1. In all counties where a tax for the establishmentand maintenance of a public hospital has been authorized by a majority of thevoters voting for a bond issue in accordance with law, the supervision,management, government and control of the county hospital vests in and must beexercised by the board of hospital trustees for the county public hospital, andthe institution must thereafter be operated by the board of hospital trustees.

2. Annually, upon the request of the board of hospitaltrustees, the board of county commissioners may levy a tax for the maintenanceand operation of the county public hospital, excluding the establishment,maintenance or operation of any facility located outside the county or countieswhere the county hospital is established.

3. The resolution adopted by the board of countycommissioners imposing a tax levy for a county public hospital must state:

(a) The portion of the levy which is necessary toretire hospital bonds and any other outstanding hospital securities, and to payinterest thereon;

(b) The portion of the levy which is necessary to payfor the care of indigent patients; and

(c) The portion of the levy which is necessary to payfor the cost of new equipment, replacement of old equipment and otherimprovements to the hospital not covered by specific bond issues or othersecurities and not included in the cost of care of indigent patients asprovided in paragraph (b). The cost must be prorated to the county inaccordance with the number of patient days of care of county patients.

4. The board of county commissioners may not levy atax for the care of indigents in the county public hospital as a hospitalexpense unless the levy and its justification are included in the budget forthe hospital fund submitted to the Department of Taxation as provided by law.

[1:67:1931; 1931 NCL 2243] + [2:67:1931; A 1937,167; 1941, 15; 1943, 39; 1943 NCL 2243.01](NRS A 1957, 239; 1965, 945; 1969,1605; 1975, 1745; 1987, 387; 1995, 333)

NRS 450.250 Controlof expenditures by board; lease of buildings; deposit of money in hospital fundor separate account.

1. The board of hospital trustees has the exclusivecontrol of:

(a) The expenditures of all money collected to thecredit of the hospital fund.

(b) The purchase of the site or sites.

(c) The purchase or construction of any hospitalbuilding or buildings.

(d) The supervision, care and custody of the grounds,rooms or buildings purchased, constructed, leased or set apart for thatpurpose.

2. With the approval of the board of county commissionersof the county or counties where the county hospital is established, the boardof hospital trustees may lease buildings in that county or those counties formedical purposes or for purposes of related health care activities.

3. All money received for the hospital must bedeposited in the county treasury of the county in which the hospital issituated to the credit of the hospital fund, and paid out only upon warrantsdrawn by the board of hospital trustees of the county or counties upon properlyauthenticated vouchers of the board of hospital trustees, after their approvalby the county auditor, except that all money received for a hospital may bedeposited in a separate account established and administered by the board ofhospital trustees under the provisions of NRS354.603.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,194](NRS A 1971, 1349; 1975, 1811; 1979, 550, 1407, 1408; 1981, 686, 1771;1993, 1974; 1995, 333)

NRS 450.255 Mortgageor pledge of personal property of hospital; acquisition of real property forexpansion. The board of trustees of a countyhospital, with the approval of the board of county commissioners, if the boardof county commissioners is not the board of hospital trustees, may, byresolution:

1. Mortgage or pledge the personal property of thehospital, including accounts receivable, and enter into agreements for the saleand leasing back to the hospital of its personal property to provide securityfor acquiring money for the operation of the hospital; and

2. Acquire real property for the expansion of thehospital by entering into a contract for purchase of a type and duration and onsuch terms as the governing body determines, including a contract secured by amortgage or other security interest in the real property.

(Added to NRS by 1987, 295; A 1997, 3100)

NRS 450.260 Collectionor settlement of claims. The board of hospitaltrustees may:

1. By proper legal action, collect claims due to thepublic hospital.

2. Accept as settlement of a claim due an amount lessthan that of the claim.

3. Pay from the hospital fund all fees and expensesnecessarily incurred by the board in connection with the collection of claims.

[Part 4:169:1929; A 1937, 194; 1943, 17; 1955,194](NRS A 1987, 296)

Bonds

NRS 450.270 Maximumamount. Whenever any county or counties inthis state shall have provided for the appointment and election of hospitaltrustees, and have voted for the issuance of bonds for hospital purposes, asauthorized by law, each such county shall issue bonds in such sums and amountsas the board of hospital trustees shall certify to the board of countycommissioners to be necessary for the purpose stated in the bond questionapproved at the election, but such bonds in the aggregate shall not exceed themaximum amount authorized by the bond question.

[Part 6:169:1929; NCL 2230](NRS A 1965, 634)

NRS 450.280 Purposesand procedure for issuance of general obligation bonds at request of board ofhospital trustees.

1. Whenever the board of hospital trustees of anycounty deems it advisable that bonds be issued for the enlargement,maintenance, repair, improvement or reconstruction of a public hospital,including, without limitation, the construction, installation and otheracquisition of additional fixtures, structures, and buildings for the publichospital, equipment and furnishings therefor, and additional sites therefor, orany combination thereof, the board shall, by resolution, request the board ofcounty commissioners of the county to issue general obligation bonds thereforand shall specify in the resolution the maximum amount of money proposed to beexpended for any of those purposes.

2. Thereupon the board of county commissioners shall:

(a) Comply with the provisions of NRS 350.011 to 350.0165, inclusive; and

(b) Upon the receipt of the approval of the county debtmanagement commission of the proposal to issue the county hospital bonds,submit the question of issuing the bonds to the qualified electors of the countyat a special election or the next primary or general election, as provided in NRS 350.020 to 350.070, inclusive.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,365](NRS A 1965, 634; 1969, 1605; 1981, 963; 1993, 1079; 1995, 773)

NRS 450.290 Issuanceof general and special obligation bonds by board of county commissioners.

1. Subject to the provisions of NRS 450.010 to 450.510, inclusive, for any hospitalproject stated in a bond question approved as provided in NRS 350.070, the board of countycommissioners, at any time, in the name and on the behalf of the county, mayissue:

(a) General obligation bonds, payable from taxes; and

(b) General obligation bonds, payable from taxes, whichpayment is additionally secured by a pledge of gross or net revenues derivedfrom the operation of the hospital facilities, and, if so determined by theboard of county commissioners, further secured by a pledge of gross or netrevenues derived from any other income-producing project of the county or fromany license or other excise taxes levied by the county for revenue, as may belegally made available for their payment.

2. The board of county commissioners of any county, inthe name and on behalf of the county, may issue, for any hospital project,without the securities being authorized at any election, special obligationmunicipal securities payable solely from net revenues or gross revenues derivedfrom the operation of hospital facilities.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,365](NRS A 1965, 635; 1969, 1606; 1975, 1158; 1977, 777; 1979, 550; 1981, 510;1983, 1670)

NRS 450.300 Applicabilityof Local Government Securities Law. Subject tothe provisions of NRS 450.290, for anyhospital facilities authorized by NRS450.010 to 450.510, inclusive, theboard of county commissioners may, on the behalf and in the name of the county,borrow money, otherwise become obligated, and evidence obligations by theissuance of bonds and other county securities, and in connection with theundertaking or facilities, the board may otherwise proceed as provided in theLocal Government Securities Law.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,365](NRS A 1965, 635; 1969, 1606; 1985, 293)

NRS 450.310 Schedulesof fees, rates and charges for services, facilities and commodities. In order to insure the payment of the general obligationbonds of the county, the payment of which is additionally secured by a pledgeof revenues of such hospital facilities, of any such other income-producingproject and of any such excise taxes, as provided in NRS 450.290, or other such additionallysecured general obligation securities of the county, there may be establishedand maintained, and from time to time revised, a schedule or schedules of fees,rates and charges for services, facilities and commodities rendered by orthrough such facilities and any such other income-producing project and aschedule or schedules of any such excise taxes, as the case may be, by theboard of hospital trustees for such hospital facilities and otherwise by theboard of county commissioners, in an amount sufficient for that purpose andalso sufficient to discharge any covenant in the proceedings authorizing theissuance of any of the bonds or other securities, including any covenant forthe establishment of reasonable reserve funds.

[Part 1:169:1929; A 1931, 231; 1943, 213; 1953,365](NRS A 1965, 636; 1969, 1607)

Administration

NRS 450.390 Hospitalfor benefit of county; payment of charges; exclusion of persons from use ofhospital.

1. Every county hospital in this State being supportedby public money, and every hospital established under NRS 450.010 to 450.510, inclusive, must be for the benefitof that county or counties and of any person falling sick or being injured ormaimed within its limits, but the governing body of the hospital may extend theprivileges and use of the hospital to persons residing outside of the county orcounties upon such terms and conditions as the governing body may by its rulesand regulations prescribe.

2. Every inhabitant or person who is not a pauper andevery relative required by the laws of this State to support an inhabitant orperson who is a pauper shall pay to the governing body, or an officer itdesignates, a reasonable compensation for occupancy, nursing, care, medicineand attendance, other than medical or surgical attendance, according to therules and regulations prescribed by the governing body. If after demand by thegoverning body, or its designated officer, the inhabitant, person or relativefails, refuses or neglects to pay the compensation, it may be recovered in asuit at law brought by the governing body.

3. The hospital is subject to such reasonable rulesand regulations as the governing body may adopt in order to render the use ofthe hospital of the greatest benefit to the greatest number of people.

4. The governing body may exclude from the use of the hospitalany and all inhabitants and persons who willfully violate those rules andregulations.

5. The provisions of this section do not prohibit thehospital from exercising other powers granted to it by the provisions of thischapter.

[9:169:1929; NCL 2233] + [1:132:1941; 1931 NCL 2245](NRS A 1987, 388)

NRS 450.400 Extensionof privileges and use of hospital to certain nonresidents: Notice; removal ofperson to resident county; payment for temporary care; action for recovery ofcharges.

1. When the privileges and use of the hospital areextended to a resident of another county who is reasonably believed to beindigent, as defined in NRS 439B.310,and who is:

(a) Entitled under the laws of this state to relief,support, care, nursing, medicine or medical or surgical aid from the othercounty; or

(b) Injured, maimed or falls sick in the other county,

thegoverning head shall notify the board of county commissioners of that countywithin 3 working days after the person is admitted to that hospital.

2. The notice must be in writing and addressed to theboard of county commissioners of that county.

3. Except in the case of an injury suffered in a motorvehicle accident, the board of county commissioners receiving the notice shallcause the person to be removed immediately to that county, and shall pay areasonable sum to the hospital for the temporary occupancy, care, nursing,medicine, and attendance, other than medical or surgical attendance, furnishedto him.

4. If the board of county commissioners neglects orrefuses to remove the person, or if in the opinion of the attending physicianit is not advisable to remove the person, the governing head has a legal claimagainst the county for all charges for occupancy, nursing, care, medicine, andattendance, other than medical or surgical attendance, necessarily furnished,and may recover those charges in a suit at law.

[2:132:1941; A 1949, 588; 1943 NCL 2245.01](NRS A1983, 1943; 1991, 1000; 1993, 1974)

NRS 450.410 Admissionof paying patients; charges.

1. Supervising boards of county hospitals may:

(a) Provide for treatment to sick or injured personsand require the payment of reasonable charges therefor.

(b) Contract for the provision of such treatment on aperiodic prepaid basis with any person authorized by the Commissioner ofInsurance pursuant to title 57 of NRS to arrange for or provide health careservices on a periodic prepaid basis.

Thetreatment of such persons must not be permitted to interfere with the treatmentof purely charitable cases.

2. Every person treated by a county hospital andrequired to pay charges for hospitalization, shall pay the charges fixed by thesupervising board therefor, which charges, when paid, must be paid forthwithinto the county treasury and deposited to the credit of the hospital fund.

3. Every person treated by a county hospital andrequired to pay charges to the hospital has the right to the services of aphysician or surgeon of his own choice, and has the right to employ suchspecial nurses as may be necessary, but the cost of the physician, surgeon ornurses must not become a claim against the county.

4. Supervising boards shall fix and determinereasonable charges to be paid by sick and injured persons treated by countyhospitals, which charges must include the board and lodging of the person andthe customary use of hospital facilities by the person admitted.

[1:124:1941; 1931 NCL 2244] + [2:124:1941; 1931 NCL 2244.01] + [3:124:1941; 1931 NCL 2244.02] + [4:124:1941; 1931 NCL 2244.03](NRS A 1987, 389; 1997, 907)

NRS 450.420 Boardof county commissioners to determine status of patient; charges fixed by boardof hospital trustees; costs chargeable to county; exceptions.

1. The board of county commissioners of the county inwhich a public hospital is located may determine whether patients presented tothe public hospital for treatment are subjects of charity. Except as otherwiseprovided in NRS 439B.330, the board ofcounty commissioners shall establish by ordinance criteria and procedures to beused in the determination of eligibility for medical care as medical indigentsor subjects of charity.

2. The board of hospital trustees shall fix thecharges for treatment of those persons able to pay for the charges, as theboard deems just and proper. The board of hospital trustees may impose aninterest charge of not more than 12 percent per annum on unpaid accounts. Thereceipts must be paid to the county treasurer and credited by him to thehospital fund. In fixing charges pursuant to this subsection the board ofhospital trustees shall not include, or seek to recover from paying patients,any portion of the expense of the hospital which is properly attributable tothe care of indigent patients.

3. Except as provided in subsection 4 of this sectionand subsection 3 of NRS 439B.320, thecounty is chargeable with the entire cost of services rendered by the hospitaland any salaried staff physician or employee to any person admitted foremergency treatment, including all reasonably necessary recovery, convalescentand follow-up inpatient care required for any such person as determined by theboard of trustees of the hospital, but the hospital shall use reasonablediligence to collect the charges from the emergency patient or any other personresponsible for his support. Any amount collected must be reimbursed orcredited to the county.

4. The county is not chargeable with the cost ofservices rendered by the hospital or any attending staff physician or surgeonto the extent the hospital is reimbursed for those services pursuant to NRS 428.115 to 428.255, inclusive.

[14:169:1929; NCL 2238](NRS A 1969, 875; 1975,1305; 1977, 480; 1983, 1943; 1985, 1463; 1987, 389, 878; 1993, 1975)

NRS 450.425 Boardof county commissioners may levy ad valorem tax to pay cost of servicesrendered at hospital to certain persons admitted for emergency treatment.

1. The board of county commissioners of a county inwhich a county hospital is established may, upon approval by a majority of thevoters voting on the question in an election held throughout the county, levyan ad valorem tax of not more than 2.5 cents on each $100 of assessed valuationupon all taxable property in the county, to pay the cost of services renderedin the county by the hospital pursuant to subsection 3 of NRS 450.420. The approval required by thissubsection may be requested at any primary or general election.

2. Any tax imposed pursuant to this section is inaddition to the taxes imposed pursuant to NRS428.050, 428.185 and 428.285. The proceeds of any tax levied pursuantto this section are exempt from the limitations imposed by NRS 354.59811, 428.050 and 428.285 and must be excluded in determiningthe maximum rate of tax authorized by those sections.

(Added to NRS by 1987, 878; A 1989, 2086; 1991, 482;1993, 1079; 1995, 334)

NRS 450.430 Equalprivileges of practitioners; rights of patients.

1. In the management of the public hospital, nodiscrimination may be made against physicians, podiatric physicians or dentistslicensed under the laws of this state or licensed practitioners of the alliedhealth professions, and all such physicians, dentists, podiatric physicians andpractitioners have privileges in treating patients in the hospital inaccordance with their training and ability, except that practitioners of theallied health professions may not be members of the staff of physiciansdescribed in NRS 450.440. Practitionersof the allied health professions are subject to the bylaws and regulationsestablished by the board of hospital trustees.

2. The patient has the right to employ, at his ownexpense, his own physician, if that physician is a member of the hospitalstaff, or his own nurse, and when acting for any patient in the hospital, thephysician employed by the patient has charge of the care and treatment of thepatient, and the nurses in the hospital shall comply with the directions of thephysician concerning that patient, subject to the regulations established bythe board of hospital trustees.

[Part 11:169:1929; A 1955, 194](NRS A 1957, 780;1975, 641; 1979, 150; 2001,1830)

NRS 450.440 Staffof physicians: Organization; rotation of service; assistance.

1. The board of hospital trustees shall organize astaff of physicians composed of each regular practicing physician, podiatricphysician and dentist in the county in which the hospital is located whorequests staff membership and meets the standards set forth in the regulationsprescribed by the board of hospital trustees.

2. The staff shall organize in a manner prescribed bythe board so that there is a rotation of service among the members of the staffto give proper medical and surgical attention and service to the indigent sick,injured or maimed who may be admitted to the hospital for treatment.

3. The board of hospital trustees or the board ofcounty commissioners may offer the following assistance to members of the staffto attract and retain them:

(a) Establishment of clinic or group practice;

(b) Malpractice insurance coverage under the hospitalspolicy of professional liability insurance;

(c) Professional fee billing; and

(d) The opportunity to rent office space in facilitiesowned or operated by the hospital, as the space is available, if thisopportunity is offered to all members of the staff on the same terms andconditions.

[Part 11:169:1929; A 1955, 194](NRS A 1963, 346;1967, 996; 1979, 150, 1408, 1409; 2001, 1830; 2005, 2557)

NRS 450.450 Generaladministration of hospital subject to regulations of trustees. When a county hospital is established, the physicians,nurses, attendants, the persons sick therein, and all persons approaching orcoming within the limits of the same, and all furniture and other articles usedor brought there shall be subject to such rules and regulations as the board ofhospital trustees may prescribe.

[10:169:1929; NCL 2234]

NRS 450.455 Programfor training resident physicians. A board ofhospital trustees may institute and maintain training programs in the countyhospital for resident physicians, including interns and postgraduates. Suchprograms must meet the standards for recognition by the American MedicalAssociation and for accreditation by the Liaison Committee on Graduate MedicalEducation.

(Added to NRS by 1963, 455; A 1979, 676)

NRS 450.460 Schoolfor training nurses. The board of hospitaltrustees may establish and maintain in connection with a county hospital and asa part thereof a training school for nurses. Upon completion of the prescribedcourse of training the board of hospital trustees shall give diplomas to suchnurses as complete the course satisfactorily.

[12:169:1929; NCL 2236]

NRS 450.470 Roomfor examination of mentally ill persons; room for custodial supervision ofmentally ill or dangerous persons.

1. If the county hospital is located at the countyseat, the board of hospital trustees shall, at all times, provide a suitableroom that may be used for the examination of persons who are alleged to bementally ill and who are to be brought before the judge of the district courtfor proceedings to determine the issue of involuntary court-ordered admissionas provided in chapter 433A of NRS. Thissection does not prohibit or limit the examination of persons alleged to bementally ill at a private hospital as provided in chapter433A of NRS.

2. The board of trustees of such a county hospital, incooperation with the local law enforcement agencies, may provide a suitableroom that may be used for the custodial supervision of persons who are allegedto be:

(a) Mentally ill; or

(b) Dangerous to themselves or others.

[13:169:1929; NCL 2237](NRS A 1967, 1679; 1975,1634; 1993, 834)

NRS 450.480 Useof advanced emergency medical technicians for emergency care authorized. A hospital or rescue unit which meets minimum requirementsestablished by the State Board of Health, or an ambulance service which meetsminimum requirements established by the State Board of Health in a county whosepopulation is less than 100,000, or a county or district board of health in acounty whose population is 100,000 or more, may use advanced emergency medicaltechnicians, as defined in NRS 450B.025,for the rendering of emergency medical care to the sick or injured:

1. At the scene of an emergency and during transportto a hospital;

2. While in a hospital emergency department; and

3. Until responsibility for care is assumed by theregular staff of the hospital.

(Added to NRS by 1973, 610; A 1975, 37; 1987, 2206; 1993,2827)

NRS 450.485 Contractfor use of facility for intermediate care or facility for skilled nursing. The board of hospital trustees may contract for the use ofa facility for intermediate care or a facility for skilled nursing for thetreatment of patients who may safely be discharged to such a facility.

(Added to NRS by 1987, 295)

Transfer

NRS 450.490 Conveyanceor lease of hospital to corporation.

1. The board of county commissioners of any county forwhich a public hospital has been established or is administered pursuant to NRS 450.010 to 450.510, inclusive, and whose publichospital is the only hospital in the county, may convey the hospital for anamount not less than its appraised value or lease it for a term of not morethan 50 years to any corporation if all of the following conditions are met:

(a) The corporation must provide in its articles ofincorporation for an advisory board for the hospital. The advisory board mustconsist of persons who represent a broad section of the people to be served bythe hospital.

(b) The corporation must contract to:

(1) Care for indigent patients at a charge tothe county which does not exceed the actual cost of providing that care, or inaccordance with NRS 439B.300 to 439B.340, inclusive, if applicable; and

(2) Receive any person falling sick or maimedwithin the county.

(c) The corporation must agree to accept all thecurrent assets, including accounts receivable, to assume all the currentliabilities, and to take over and maintain the records of the existing publichospital.

(d) The agreement must provide for the transfer ofpatients, staff and employees, and for the continuing administration of anytrusts or bequests pertaining to the existing public hospital.

(e) The agreement must provide for the assumption bythe corporation of all indebtedness of the county which is attributable to thehospital, and:

(1) If the hospital is conveyed, for payment tothe county of an amount which is not less than the appraised value of thehospital, after deducting any indebtedness so assumed, immediately or bydeferred installments over a period of not more than 30 years.

(2) If the hospital is leased, for a rentalwhich will, over the term of the lease, reimburse the county for its actualcapital investment in the hospital, after deducting depreciation and anyindebtedness so assumed. The lease may provide a credit against the rental sorequired for the value of any capital improvements made by the corporation.

2. If any hospital which has been conveyed pursuant tothis section ceases to be used as a hospital, unless the premises so conveyedare sold and the proceeds used to erect or enlarge another hospital for thecounty, the hospital so conveyed reverts to the ownership of the county. If anyhospital which has been leased pursuant to this section ceases to be used as ahospital, the lease is terminated.

(Added to NRS by 1981, 1186; A 1987, 879)

NRS 450.500 Conveyanceor lease of hospital to nonprofit corporation.

1. Except as otherwise provided in NRS 450.490, the board of county commissionersof any county for which a public hospital has been established pursuant to NRS 450.010 to 450.510, inclusive, or establishedotherwise but administered pursuant to NRS450.010 to 450.510, inclusive, mayconvey the hospital, or lease it for a term of not more than 50 years, to anonprofit corporation if all of the following conditions are met:

(a) The governing body of the nonprofit corporationmust be composed initially of the incumbent members of the board of hospitaltrustees, as individuals. The articles of incorporation must provide for:

(1) A membership of the corporation which isbroadly representative of the public and includes residents of eachincorporated city in the county and of the unincorporated area of the county ora single member which is a nonprofit corporation whose articles ofincorporation provide for a membership which is broadly representative of thepublic and includes residents of each incorporated city in the county and ofthe unincorporated area of the county;

(2) The selection of the governing body by themembership of the corporation or, if the corporation has a single member, bythe single member;

(3) The governing body to select its membersonly to fill a vacancy for an unexpired term; and

(4) The terms of office of members of thegoverning body, not to exceed 6 years.

(b) The nonprofit corporation must contract to:

(1) Care for indigent patients at a charge tothe county which does not exceed the actual cost of providing such care, or inaccordance with NRS 439B.300 to 439B.340, inclusive, if applicable; and

(2) Receive any person falling sick or maimedwithin the county.

(c) The nonprofit corporation must agree to accept allthe current assets, including accounts receivable, to assume all the currentliabilities, and to take over and maintain the records of the existing publichospital.

(d) The agreement must provide for the transfer ofpatients, staff and employees, and for the continuing administration of anytrusts or bequests pertaining to the existing public hospital.

(e) The agreement must provide for the assumption bythe corporation of all indebtedness of the county which is attributable to thehospital, and:

(1) If the hospital is conveyed, for payment tothe county of its actual capital investment in the hospital, after deductingdepreciation and any indebtedness so assumed, immediately or by deferred installmentsover a period of not more than 30 years.

(2) If the hospital is leased, for a rentalwhich will over the term of the lease reimburse the county for its actualcapital investment in the hospital, after deducting depreciation and anyindebtedness so assumed. The lease may provide a credit against the rental sorequired for the value of any capital improvements made by the corporation.

2. Boards of county commissioners which have jointresponsibility for a public hospital may jointly exercise the power conferredby subsection 1, and are subject jointly to the related duties.

3. If any hospital which has been conveyed pursuant tothis section ceases to be used as a nonprofit hospital, unless the premises soconveyed are sold and the proceeds used to erect or enlarge another nonprofithospital for the county, the hospital so conveyed reverts to the ownership ofthe county. If any hospital which has been leased pursuant to this sectionceases to be used as a nonprofit hospital, the lease is terminated.

(Added to NRS by 1969, 215; A 1975, 575; 1981, 1186;1985, 597; 1987, 880)

NRS 450.510 Countywhose population is less than 100,000 may contract with community nonprofithospital for care of indigent patients; enlargement or alteration of hospital.

1. The board of county commissioners of any countywhose population is less than 100,000 may contract with any nonprofitcorporation to which a public hospital has been conveyed or leased, for thecare of indigent patients from the contracting county and the receiving ofother persons falling sick or being maimed or injured within the contractingcounty. The contract must be consistent with the provisions of NRS 439B.300 to 439B.340, inclusive, if applicable.

2. The contracting county may participate in theenlargement or alteration of the hospital.

(Added to NRS by 1969, 216; A 1969, 1545; 1979, 551;1987, 881; 1993, 2661)

Miscellaneous Provisions

NRS 450.520 Determinationthat emergency exists before submission of certain questions at specialelection.

1. For the purposes of NRS 450.043, 450.060 and 450.280, a special election may be heldonly if the board of county commissioners determines, by a unanimous vote, thatan emergency exists.

2. The determination made by the board is conclusiveunless it is shown that the board acted with fraud or a gross abuse ofdiscretion. An action to challenge the determination made by the board must becommenced within 15 days after the boards determination is final.

3. As used in this section, emergency means anyunexpected occurrence or combination of occurrences which requires immediateaction by the board to prevent or mitigate a substantial financial loss to thecounty or to enable the board to provide an essential service to the residentsof the county.

(Added to NRS by 1993, 1078; A 1995, 334)

NRS 450.525 Membershipof hospital in purchasing group.

1. A county hospital may, with the approval of thegoverning body of the hospital, become a member of a purchasing group for thepurpose of purchasing supplies, materials and equipment used by the countyhospital.

2. A county hospital that becomes a member of apurchasing group may, in accordance with the requirements of NRS 450.530, purchase supplies, materialsand equipment through the purchasing group without complying with therequirements for competitive bidding set forth in chapter332 of NRS.

(Added to NRS by 1999, 190)

NRS 450.530 Purchaseof supplies, materials and equipment without complying with certainrequirements for competitive bidding. A countyhospital that is authorized pursuant to NRS450.191 or 450.525 to purchasesupplies, materials and equipment in accordance with this section through thepurchasing contracts of the company that manages the hospital or through apurchasing group may purchase the supplies, materials and equipment withoutcomplying with the requirements for competitive bidding set forth in chapter 332 of NRS if:

1. The documents pertaining to the proposed purchase,including, without limitation, the prices available to the company orpurchasing group, are summarized in writing and, together with a swornstatement by an officer or agent of the company or purchasing group that theprices were obtained by the company or purchasing group through a process ofcompetitive bidding, are presented to the governing body of the county hospitalat its next regularly scheduled meeting; and

2. The governing body, after reviewing the summary andstatement, finds that the proposed purchase will be made at a lower price thanthe lowest price reasonably obtainable by the hospital through competitivebidding pursuant to chapter 332 of NRS oravailable to the hospital pursuant to NRS333.470 and approves the proposed purchase.

(Added to NRS by 1999, 190)

COUNTY HOSPITAL DISTRICTS

NRS 450.550 Definitions. As used in NRS 450.550to 450.760, inclusive, unless thecontext otherwise requires:

1. Board of trustees means:

(a) A board of hospital trustees:

(1) Elected pursuant to NRS 450.620 and a physician who isappointed pursuant to subsection 1 of NRS450.640, if applicable; or

(2) Appointed pursuant to NRS 450.625 and a physician who isappointed pursuant to subsection 1 of NRS450.640, if applicable; or

(b) A board of county commissioners, if that boardenacts an ordinance which provides that the board of county commissioners is,ex officio, the board of hospital trustees, and a physician who is appointedpursuant to subsection 1 of NRS 450.640,if applicable.

2. District hospital means a hospital constructed,maintained and governed pursuant to NRS450.550 to 450.760, inclusive.

(Added to NRS by 1969, 1387; A 1989, 1011; 1993,1975; 1995, 793; 1997, 3100, 3135; 1999, 639, 2076; 2001, 468; 2005, 1448)

NRS 450.560 Establishmentof district on motion of board of county commissioners.

1. The board of county commissioners of any county mayof its own motion establish a hospital district in the manner prescribed in NRS 450.550 to 450.750, inclusive. The establishment of ahospital district is in addition to any other powers granted to a board ofcounty commissioners pursuant to NRS 450.010to 450.510, inclusive.

2. Except as otherwise provided in this subsection, ahospital district specified in subsection 1 may include territory within morethan one county. If the establishment of such a district is proposed by a boardof county commissioners, the district may be established only if the board ofcounty commissioners of each county included within the district, other thanthe county of the board of county commissioners that proposes to establish thedistrict, adopts a resolution approving the establishment of the district.

(Added to NRS by 1969, 1387; A 1997, 3100, 3135; 1999, 639)

NRS 450.570 Noticeof intent to establish district: Contents; publication. The notice of intent to establish a hospital districtmust:

1. State the name of the proposed district and thename of the county or counties in which the proposed district is located.

2. State the time and place fixed by the board of countycommissioners for a hearing on the proposed establishment of the district.

3. Describe the territory or specify the exteriorboundaries of the territory proposed to be included within the district, whichboundaries, so far as practicable, must be the centerlines of highways.

4. Be published once a week for 2 successive weeksbefore the time fixed for the hearing in a newspaper designated by the board ofcounty commissioners.

(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639)

NRS 450.580 Objectionsto formation of district; hearing.

1. At or before the time fixed for the hearing of theproposed establishment of a hospital district, any person interested may filewritten objections to the establishment of the district with the clerk of theboard of county commissioners that proposes to establish the district.

2. At the hearing, the board of county commissionersshall hear and consider any objections filed pursuant to subsection 1.

3. The board may:

(a) Sustain any objections filed pursuant to subsection1;

(b) Change or alter the boundaries of the proposeddistrict to conform to the requirements of the district; and

(c) Exclude from the district any land that will not bebenefited by the establishment of the district.

(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639)

NRS 450.590 Establishmentof district: Petition of owners of property; adoption, contents and publicationof resolution of intention to establish district; exception.

1. Except as otherwise provided in subsection 3, if 25percent or more of the holders of title or evidence of title to lands lyingwithin the proposed district, whose names appear as such upon the last countyassessment roll, present a petition to the board of county commissioners of thecounty in which the land lies, setting forth the exterior boundaries of theproposed district and asking that the district so described be establishedwithin a county hospital district pursuant to the provisions of NRS 450.550 to 450.750, inclusive, the board of countycommissioners shall adopt a resolution declaring the intention of the board toinclude the territory within a county hospital district, naming the districtand describing its exterior boundaries.

2. The resolution must:

(a) Fix a time and place for the hearing of theproposed establishment of the district not less than 30 days after itsadoption.

(b) Direct the clerk of the board of countycommissioners to publish:

(1) The notice of intention of the board ofcounty commissioners to establish the county hospital district; and

(2) The time and place fixed for the hearing.

(c) Designate that the notice must be published in anewspaper of general circulation published in the county and circulated in theproposed county hospital district, or if there is no newspaper so published andcirculated, then in a newspaper of general circulation circulated in theproposed district.

3. The provisions of this section do not apply to aproposed hospital district if it includes territory within more than onecounty.

(Added to NRS by 1969, 1388; A 1997, 3101, 3136; 1999, 639)

NRS 450.600 Hearingon petition. Upon the hearing of the petition,the board of county commissioners shall determine whether or not the petitioncomplies with the requirements and purposes of NRS 450.550 to 450.750, inclusive, and must hear allcompetent and relevant testimony offered in support or in objection thereto.

(Added to NRS by 1969, 1388)

NRS 450.610 Resolutioncreating district. If after a hearing, theboard of county commissioners determines that the creation of the proposedhospital district is desirable, the board shall by resolution provide for thecreation of such district, designating the name of the district andestablishing the boundaries of the district.

(Added to NRS by 1969, 1388)

NRS 450.620 Enactmentof ordinance regarding number, terms and election of trustees; service of boardof county commissioners ex officio as board of trustees.

1. Except as otherwise provided in subsection 2 and NRS 450.625, if a hospital district iscreated pursuant to NRS 450.550 to 450.750, inclusive, the board of countycommissioners shall provide by ordinance for:

(a) The number of members of the board of trustees;

(b) The term of office of the trustees, which must notexceed 4 years; and

(c) The times and manner of the election of thetrustees, which must be nonpartisan.

2. If a hospital district specified in subsection 1does not include territory within more than one county, the board of countycommissioners may enact an ordinance providing that the board of countycommissioners is, ex officio, the board of hospital trustees of the districthospital. If such an ordinance is enacted in a county:

(a) The county commissioners shall serve as thehospital trustees of the district hospital during their terms of office ascounty commissioners; and

(b) If hospital trustees have been elected pursuant tosubsection 1, the term of office of each hospital trustee of the districthospital who is serving in that capacity on the effective date of the ordinanceis terminated as of the effective date of the ordinance.

3. Except as otherwise provided in NRS 450.710, a board of county commissionersshall not enact an ordinance pursuant to subsection 2 unless it determinesthat:

(a) The county has fully funded its indigent careaccount created pursuant to NRS 428.010;

(b) The county has fulfilled its duty to reimburse thehospital for indigent care provided to qualified indigent patients; and

(c) During the previous calendar year:

(1) At least one of the hospitals accountspayable was more than 90 days in arrears;

(2) The hospital failed to fulfill its statutoryfinancial obligations, including the payment of taxes, premiums for industrialinsurance or contributions to the Public Employees Retirement System;

(3) One or more of the conditions relating tofinancial emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or

(4) The hospital received notice from theFederal Government or the State of Nevada that the certification or license ofthe hospital was in imminent jeopardy of being revoked because the hospital hadnot carried out a previously established plan of action to correct previouslynoted deficiencies found by the regulatory body.

(Added to NRS by 1969, 1388; A 1995, 793; 1997, 572,3102, 3137; 1999, 639,2077)

NRS 450.625 Trusteesof district that includes territory within more than one county.

1. If a hospital district created pursuant to NRS 450.550 to 450.750, inclusive, includes territorywithin more than one county, the board of trustees of the hospital district mustconsist of three members of the board of county commissioners that created thedistrict and:

(a) Three members of the board of county commissionersof each county other than the county of the board of county commissioners thatcreated the district, if the portion of the county included in the district istwo-thirds or more of the total area of the county;

(b) Two members of the board of county commissioners ofeach county other than the county of the board of county commissioners thatcreated the district, if the portion of the county included in the district ismore than one-third of the total area of the county but less than two-thirds ofthe total area of the county; or

(c) One member of the board of county commissioners ofeach county other than the county of the board of county commissioners thatcreated the district, if the portion of the county included in the district isone-third or less of the total amount of the area of the county.

2. Each member of the board of trustees appointedpursuant to this section must be appointed by the board of county commissionersof which he is a member.

3. The term of office of the members of the board oftrustees is 3 years.

4. A member who ceases to be a member of the board ofcounty commissioners that appointed him ceases to be a member of the board oftrustees.

5. Any vacancy must be filled for the unexpired termby the board of county commissioners that appointed the member who created thevacancy.

(Added to NRS by 1997, 3099; A 1997, 3134; 1999, 639)

NRS 450.630 Generalpowers and duties of board of trustees; rules and regulations. The board of trustees shall:

1. Carry out the spirit and intent of NRS 450.550 to 450.750, inclusive, in establishing andmaintaining a hospital in each district created pursuant to NRS 450.550 to 450.750, inclusive.

2. Make and adopt bylaws, rules and regulations:

(a) For its own guidance and the government of any suchhospital; and

(b) Fixing the charges for treatment of patients.

(Added to NRS by 1969, 1388; A 1987, 390)

NRS 450.640 Employeesand staff of hospital: Appointment to board of chief of staff of physicians fordistrict hospital; appointment by board of chief executive officer andnecessary assistants for hospital; compensation; removal; admission. The board of trustees may:

1. After the board is formed pursuant to theprovisions of NRS 450.620 or 450.625, increase the number of members whoserve on the board by appointing, as a voting member of the board, onephysician who is the chief of staff of physicians for a district hospital. Theterm of office of a member who is appointed pursuant to this subsection is 2years, commencing on the date of appointment by the board of trustees. Avacancy in the term of a member appointed pursuant to this subsection must befilled in the same manner as the original appointment for the remainder of theunexpired term.

2. Appoint a chief executive officer and necessaryassistants for each hospital, and fix the compensations of such persons.

3. Employ physicians, surgeons and interns, as theboard determines necessary, and fix their compensation.

4. Remove such appointees and employees.

5. Remove persons who are appointed or employedpursuant to this section.

6. Control the admission of physicians, surgeons andinterns to the staff by promulgating rules, regulations and standards governingsuch appointments.

(Added to NRS by 1969, 1389; A 1987, 390; 2001, 469)

NRS 450.650 Budgets. The board of trustees of each county hospital districtshall prepare annual budgets in accordance with NRS 354.470 to 354.626, inclusive.

(Added to NRS by 1969, 1389)

NRS 450.660 Taxlevies; disposition of proceeds.

1. At the time of making the levy of county taxes forthat year, each board of trustees shall levy a tax sufficient, together withthe revenue which will result from application of the rate to the net proceedsof minerals, to raise the amount so budgeted upon any real and personalproperty that is subject to taxation within the boundaries of the district. Anytax levied on interstate or intercounty telephone lines, power lines and otherpublic utility lines pursuant to this section must be based upon valuations asestablished by the Nevada Tax Commission pursuant to the provisions of NRS 361.315 to 361.330, inclusive.

2. When levied, the tax must be:

(a) Entered upon the assessment rolls of each countythat is included within the district; and

(b) Collected in the same manner as state and countytaxes.

3. When the tax is collected it must be:

(a) Placed in the treasury of the county in which thedistrict hospital is located;

(b) Credited to the current expense fund of thedistrict; and

(c) Used only for the purpose for which it was raised.

(Added to NRS by 1969, 1389; A 1989, 49; 1993, 1976;1997, 3103, 3138; 1999,639)

NRS 450.665 Powersof board of trustees: Borrowing of money and incurrence or assumption ofindebtedness; limitations and conditions.

1. The board of trustees may borrow money and incur orassume indebtedness on behalf of the county hospital district if the totalamount of the indebtedness, excluding revenue bonds and other securitiesconstituting special obligations which are not debts, does not exceed an amountequal to 10 percent of the total of the last assessed valuation of taxableproperty, excluding motor vehicles, located within the district.

2. The board of trustees shall not borrow money orissue securities to evidence such borrowing until the board has obtained theapproval of the:

(a) Debt management commission; and

(b) Board of county commissioners,

of eachcounty in which the hospital district is located.

(Added to NRS by 1989, 1011; A 1995, 774; 1997, 3103,3138; 1999, 639)

NRS 450.670 Powersof board of trustees: Issuance and sale of bonds for certain purposes. The board of trustees may issue and sell, for eachdistrict in its jurisdiction:

1. General obligation bonds, payable from taxes;

2. General obligation bonds, payment of which isadditionally secured by a pledge of gross or net revenues derived from theoperation of hospital facilities; and

3. Special obligation bonds, payable solely from grossor net revenues derived from the operation of hospital facilities,

for thepurpose of providing funds for the purchase of hospital equipment, theacquisition of property, the construction of buildings and improvement ofproperty owned by the district for use in any one county hospital district.

(Added to NRS by 1969, 1389; A 1989, 1011)

NRS 450.675 Powersof board of trustees: Mortgage or pledge of personal property and acquisitionof real property. The board of trustees, withthe approval of the board of county commissioners, if the board of countycommissioners is not the board of hospital trustees, or, if the district inwhich the hospital is located includes territory within more than one county,with the approval of the board of county commissioners of each of thosecounties, may, by resolution:

1. Mortgage or pledge the personal property of thehospital, including accounts receivable, and enter into agreements for the saleand leasing back to the hospital of its personal property to provide securityfor acquiring money for the operation of the hospital; and

2. Acquire real property for the expansion of thehospital by entering into a contract for purchase of a type and duration and onsuch terms as the governing body determines, including a contract secured by amortgage or other security interest in the real property.

(Added to NRS by 1997, 3100)

NRS 450.680 Electionconcerning issuance of bonds; applicability of Local Government Securities Law.

1. If a board of trustees desires to avail itself ofthe power conferred by NRS 450.670 andsubmission to the voters is required by the provisions of NRS 350.020 to 350.070, inclusive, the board shall submitthe question of issuing the bonds to the registered voters of the district inaccordance with those provisions.

2. The provisions of the Local Government SecuritiesLaw apply to any bonds authorized to be issued pursuant to NRS 450.670, except to the extent thoseprovisions are inconsistent with the provisions of NRS 450.550 to 450.750, inclusive.

(Added to NRS by 1969, 1389; A 1981, 964; 1989, 1012)

NRS 450.690 Donations. Any person, firm, organization, corporation or societydesiring to make donations of money, personal property or real property for thebenefit of any district hospital may make such donations to the district. Anysuch donation is effective when accepted by the board of trustees according tothe terms of the deed, gift, devise or bequest of such property.

(Added to NRS by 1969, 1389)

NRS 450.700 Boardof trustees to determine status of patient and fix charges.

1. The board of trustees may determine whetherpatients presented to the district hospital for treatment are subjects ofcharity. Except as otherwise provided in NRS439B.330, the board of trustees shall establish the criteria and proceduresto be used in the determination of eligibility for medical care as medicalindigents or subjects of charity.

2. The board of trustees shall fix the charges fortreatment of those persons who are able to pay for the treatment. The receiptsfor those charges must be paid to the county treasurer of the county in whichthe district hospital is located and credited by him to the fund for thedistrict.

(Added to NRS by 1969, 1389; A 1987, 390, 881; 1997,3104, 3138; 1999, 639)

NRS 450.710 Creationof district for sole purpose of contracting for services of hospital.

1. A board of county commissioners may create ahospital district in an area where no hospital district exists for the solepurpose of contracting with a public agency or a privately owned hospital toprovide the services of a hospital to the residents of the district. If such acontract is executed, the board of trustees:

(a) Shall prepare a budget pursuant to NRS 450.650;

(b) Shall levy a tax pursuant to NRS 450.660;

(c) May accept donations pursuant to NRS 450.690;

(d) May determine medical indigency pursuant to NRS 450.700; and

(e) May borrow money and incur or assume indebtednesspursuant to NRS 450.665.

2. A board of county commissioners shall not create ahospital district pursuant to this section unless it determines that:

(a) The proposed hospital district constitutes ageographic area of the county that is not served by adequate medical services;

(b) There is no county hospital or the county hospitalis not capable of providing the necessary services; and

(c) The proposal is approved by a majority of the votescast on the issue by persons in the proposed hospital district.

3. If a hospital district is created pursuant to thissection, the board of county commissioners may be designated by ordinance as,ex officio, the board of trustees of the hospital district, notwithstanding theprovisions of subsection 3 of NRS 450.620.

(Added to NRS by 1999, 2075)

NRS 450.715 Authorityof board of trustees to contract for services of hospital. The board of trustees may contract with a public agency ora privately owned hospital to provide the services of a hospital to theresidents of the hospital district if it determines that:

1. There is a need to provide medical services to theresidents of the district which are not being provided by the district; or

2. It is less costly or more efficient to provide theservices of a hospital to the residents of the district by contracting with apublic agency or a privately owned hospital.

(Added to NRS by 1999, 2075)

NRS 450.720 Contractfor management of district hospital.

1. The board of trustees may contract with a companywhich manages hospitals for the rendering of management services in a districthospital.

2. The agreement may provide:

(a) That the chief executive officer of the hospitalmust be an employee of the company which manages the hospital; and

(b) That the hospital may, in accordance with therequirements of NRS 450.730, purchasesupplies, materials and equipment through the purchasing contracts of thecompany which manages the hospital, or through a purchasing group, without complyingwith the requirements for competitive bidding set forth in chapter 332 of NRS.

(Added to NRS by 1999, 2076)

NRS 450.725 Membershipof district hospital in purchasing group.

1. A districthospital may, with the approval of the board of trustees, become a member of apurchasing group for the purpose of purchasing supplies, materials andequipment used by the district hospital.

2. A district hospital that becomes a member of apurchasing group may, in accordance with the requirements of NRS 450.730, purchase supplies, materialsand equipment through the purchasing group without complying with therequirements for competitive bidding set forth in chapter332 of NRS.

(Added to NRS by 1999, 2076)

NRS 450.730 Purchaseof supplies, materials and equipment without complying with certainrequirements for competitive bidding. A districthospital that is authorized pursuant to NRS450.720 or 450.725 to purchasesupplies, materials and equipment in accordance with this section through thepurchasing contracts of the company that manages the hospital or through apurchasing group may purchase the supplies, materials and equipment withoutcomplying with the requirements for competitive bidding set forth in chapter 332 of NRS if:

1. The documents pertaining to the proposed purchase,including, without limitation, the prices available to the company orpurchasing group, are summarized in writing and, together with a swornstatement by an officer or agent of the company or purchasing group that theprices were obtained by the company or purchasing group through a process ofcompetitive bidding, are presented to the board of trustees at its next regularlyscheduled meeting; and

2. The board of trustees, after reviewing the summaryand statement, finds that the proposed purchase will be made at a lower pricethan the lowest price reasonably obtainable by the hospital through competitivebidding pursuant to chapter 332 of NRS oravailable to the hospital pursuant to NRS333.470 and approves the proposed purchase.

(Added to NRS by 1999, 2076)

NRS 450.750 Boardof county commissioners in certain districts deemed local governmentresponsible for transferring certain payments of money. For the purposes of NRS422.382, if a hospital district created pursuant to NRS 450.550 to 450.750, inclusive, includes territorywithin more than one county, the board of county commissioners of the county inwhich the hospital is located shall be deemed to be the local governmentresponsible for transferring payments of money to the Department of Health andHuman Services for treatment of medically indigent patients pursuant to theprovisions of that section.

(Added to NRS by 1997, 3099)

NRS 450.751 Dissolutionof hospital district in county whose population is less than 400,000:Determination that dissolution is in best interest required; ordinance of boardof county commissioners; considerations; duties of county clerk. In a county whose population is less than 400,000:

1. Except as otherwise provided in subsection 2, if amajority of the members of the board of county commissioners determine that itis in the best interests of the county and of the hospital district that thehospital district be dissolved, the board of county commissioners shall sodetermine by ordinance, after there is first found, determined and recited inthe ordinance that:

(a) All outstanding indebtedness and bonds of all kindsof the hospital district have been paid; and

(b) The services of the hospital district are no longerneeded or can be more effectively performed by an existing unit of government.

2. If the hospital district includes territory withinmore than one county, the hospital district may be dissolved only if a majorityof the members of the board of county commissioners of each county includedwithin the district take the actions described in subsection 1.

3. In determining pursuant to subsection 1 whether thedissolution of a hospital district is in the best interests of the county andof the hospital district, a board of county commissioners must consider,without limitation, whether:

(a) The hospital district is capable of providingsufficient health care services to the residents of the county or countieswithin the territory of the hospital district in an economical manner;

(b) The basic health care needs of the residents of thecounty or counties within the territory of the hospital district will be met ifthe hospital district is dissolved;

(c) There have been substantial changes in thefinancial status of the hospital district during the immediately preceding 2years; and

(d) There has been an increased tax burden on theresidents of the county or counties within the territory of the hospitaldistrict during the immediately preceding 2 years.

4. The county clerk of each county within which anyterritory of the hospital district is located shall thereupon certify a copy ofthe ordinance to the board of trustees of the hospital district and shall mailwritten notice to all qualified electors who reside within the hospitaldistrict in his county, containing:

(a) The adoption of the ordinance;

(b) The determination of the board of countycommissioners of that county that the district should be dissolved; and

(c) The time and place for the hearing on thedissolution.

(Added to NRS by 2005, 1446)

NRS 450.753 Dissolutionof hospital district: Right of qualified electors to protest; dissolutionprohibited if majority of qualified electors protest; dissolution by finalordinance; recital of protests.

1. On or before the date fixed for the hearing on thedissolution of a hospital district, any qualified elector who resides withinthe hospital district may protest against the dissolution of the hospitaldistrict by filing a written protest with the county clerk of the county inwhich he resides.

2. If, at or before the time fixed by the ordinanceand notice, written protest is filed pursuant to subsection 1 by a majority ofthe qualified electors who reside within the hospital district, the hospitaldistrict must not be dissolved. If any written protests are filed and:

(a) If the hospital district does not include territorywithin more than one county, the board of county commissioners determines thatthe protests so filed represent less than a majority of the qualified electorswho reside within the hospital district, the board may complete the dissolutionby the adoption of a final ordinance of dissolution, which ordinance mustcontain a recital of the protests, and the recital is binding and conclusivefor all purposes; or

(b) If the hospital district includes territory withinmore than one county, the board of county commissioners of each county includedwithin the hospital district determines that the protests so filed representless than a majority of the qualified electors who reside within the hospitaldistrict, the dissolution may be completed by the adoption of a final ordinanceof dissolution by the board of county commissioners of each county includedwithin the hospital district, which ordinance must contain a recital of theprotests, and the recital is binding and conclusive for all purposes.

(Added to NRS by 2005, 1446)

NRS 450.755 Dissolutionof hospital district: Hearing; full consideration of all protests required;adoption of final ordinance of dissolution or ordinance of nondissolution byboard of county commissioners. Except asotherwise provided in subsection 2 of NRS450.753, at the place, date and hour specified for the hearing on thedissolution of a hospital district in the notice mailed pursuant to NRS 450.751 or at any subsequent time towhich the hearing may be adjourned, the board of county commissioners of eachcounty within which any territory of the hospital district is located shallgive full consideration to all protests which have been filed pursuant to NRS 450.753 and shall hear all personsdesiring to be heard and shall thereafter adopt either the final ordinance ofdissolution or an ordinance determining that the hospital district must not bedissolved. The dissolution may be completed by the adoption of a finalordinance of dissolution by the board of county commissioners of each countyincluded within the hospital district.

(Added to NRS by 2005, 1447)

NRS 450.757 Dissolutionof hospital district: County clerk must file final ordinance of dissolution;locations. Within 30 days after the effective dateof each ordinance which is required for the dissolution of a hospital districtpursuant to NRS 450.753 or 450.755, each county clerk shall file acopy of the ordinance in his office and shall cause to be filed an additionalcopy of the ordinance in the Office of the Secretary of State, which filingsmust be without fee and must otherwise be filed in the same manner as articlesof incorporation are required to be filed under chapter78 of NRS.

(Added to NRS by 2005, 1447)

NRS 450.759 Dissolutionof hospital district in county whose population is less than 400,000: Unpaidtaxes, levies and assessments are lien on property; power of board of countycommissioners to collect. In a county whosepopulation is less than 400,000:

1. All outstanding and unpaid tax sales and levies andall special assessment liens of a dissolved hospital district are valid andremain a lien against the property against which they are assessed or levieduntil paid, subject to the limitations of liens provided by general law. Taxesand special assessments paid after the dissolution of a hospital district mustbe placed in the general fund of the county in which the district hospital waslocated.

2. The board of county commissioners of the county inwhich the district hospital was located has the same power to enforce thecollection of all special assessments and outstanding tax sales of the hospitaldistrict as the hospital district had if it had not been dissolved.

(Added to NRS by 2005, 1447)

NRS 450.760 Dissolutionof hospital district in county whose population is less than 400,000:Retirement of outstanding debt and other obligations; levy of property tax;disposition of property. In a county whosepopulation is less than 400,000:

1. Before dissolving a hospital district pursuant to NRS 450.751 to 450.760, inclusive, the board of countycommissioners of the county in which the district hospital is located shalldetermine whether the proceeds from the taxes currently being levied in thehospital district, if any, for the operation of the hospital and the repaymentof debt are sufficient to repay any outstanding obligations of the hospital districtwithin a reasonable period after the dissolution of the hospital district. Ifthere are no taxes currently being levied for the hospital district or thetaxes being levied are not sufficient to repay the outstanding obligations ofthe hospital district within a reasonable period after the dissolution of thehospital district, before dissolving the hospital district pursuant to NRS 450.751 to 450.760, inclusive:

(a) If the hospital district does not include territorywithin more than one county, the board of county commissioners may levy aproperty tax on all of the taxable property in the hospital district that issufficient, when combined with any revenue from taxes currently being levied inthe hospital district, to repay the outstanding obligations of the hospitaldistrict within a reasonable period after the dissolution of the hospitaldistrict; or

(b) If the hospital district includes territory withinmore than one county, the board of county commissioners of each county withinwhich any territory of the hospital district is located may levy a property taxon all of the taxable property in the county that is within the hospitaldistrict that is sufficient, when combined with any revenue from taxescurrently being levied in the hospital district, to repay the outstandingobligations of the hospital district within a reasonable period after the dissolutionof the hospital district.

2. The allowed revenue from taxes ad valoremdetermined pursuant to NRS 354.59811does not apply to any additional property tax levied pursuant to subsection 1.If the hospital district is being managed by the Department of Taxation pursuantto NRS 354.685 to 354.725, inclusive, at the time ofdissolution, the rate levied pursuant to subsection 1 must not be included inthe total ad valorem tax levy for the purposes of the application of thelimitation in NRS 361.453, but the ratelevied when combined with all other overlapping rates levied in the State mustnot exceed $4.50 on each $100 of assessed valuation. A board of county commissionersshall discontinue any rate levied pursuant to subsection 1 on a date that willensure that no taxes are collected for this purpose after the outstandingobligations of the hospital district have been paid in full.

3. If, at the time of the dissolution of the hospitaldistrict pursuant to NRS 450.751 to 450.760, inclusive, there are anyoutstanding loans, bonded indebtedness or other obligations of the hospitaldistrict, including, without limitation, unpaid obligations to organizationssuch as the Public Employees Retirement System, unpaid salaries or unpaidloans made to the hospital district by the county, the taxes being levied inthe hospital district at the time of dissolution must continue to be levied andcollected in the same manner as if the hospital district had not been dissolveduntil all outstanding obligations of the hospital district have been paid in full,but for all other purposes, the hospital district shall be considered dissolvedfrom the date on which each board of county commissioners of each countyincluded within the hospital district has adopted a final ordinance ofdissolution pursuant to NRS 450.753 or 450.755.

4. If the hospital district is being managed by theDepartment of Taxation pursuant to NRS354.685 to 354.725, inclusive, atthe time of dissolution, the management ceases upon dissolution, but the boardof county commissioners of the county in which the district hospital waslocated shall continue to make such financial reports to the Department ofTaxation as the Department deems necessary until all outstanding obligations ofthe hospital district have been paid in full.

5. The property of the dissolved hospital district maybe retained by the board of county commissioners of the county in which thedistrict hospital was located for use as a hospital or disposed of in anymanner the board deems appropriate.

6. Any proceeds of the sale or other transfer of theproperty of the dissolved hospital district and any proceeds from taxes whichhad been levied and received by the hospital district before dissolution,whether levied for operating purposes or for the repayment of debt, must beused by the board of county commissioners of the county in which the districthospital was located to repay any indebtedness of the hospital district.

(Added to NRS by 1999, 86; A 2005, 1448)

MISCELLANEOUS PROVISIONS

NRS 450.800 Countyor district hospital may contract for services.

1. In addition to having the powers conferred under chapter 277 of NRS, a county or district hospitalmay contract with a private hospital or other organization for emergencymedical services, including the transportation of patients, or any other servicesperformed in connection with or related to the operation of a hospital. Theservices may be performed by the parties to the contract or the parties mayestablish a separate organization for that purpose.

2. A county or district hospital may enter into acontract to provide services:

(a) For persons, whether or not admitted to thehospital, if those services are performed in connection with or related to theoperation of the hospital.

(b) Necessary for the health and welfare of the generalpublic.

(Added to NRS by 1981, 511; A 1987, 391)

 

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