USA Statutes : nevada
Title : Title 40 - PUBLIC HEALTH AND SAFETY
Chapter : CHAPTER 450 - COUNTY HOSPITALS AND HOSPITAL DISTRICTS
As used in this chapter, unless the
context otherwise requires, the words and terms defined in NRS 450.006
and 450.008 have the meanings ascribed to them in those
sections.
(Added to NRS by 1975, 641; A 1977, 961; 1979, 150; 1991, 1133;
1999, 191 )
“Allied health
profession” 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 )
“Purchasing group” means
a cooperative organization of hospitals and other health care
organizations that affiliate for the purpose of combining their
purchasing power to secure a lower cost for their purchases of supplies,
materials and equipment than would be available to the members of the
purchasing group individually.
(Added to NRS by 1999, 191 )
COUNTY HOSPITALS
Definitions
For the purposes of NRS 450.010
to 450.510 , inclusive, “taxpayers” include only citizens
of the United States of the age of 18 years and upward who, at the time
of filing their petition, are registered electors of the county in which
an election is proposed to be held and whose names appear on the latest
assessment 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
Any county or group of counties may
establish a public hospital in the manner prescribed in NRS 450.030
and 450.040 .
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]
Whenever the board of
county commissioners of any county is presented with a petition signed by
at least 30 percent of the taxpayers in such county or in each of a group
of counties asking that an annual tax be levied for the establishing and
maintenance of a public hospital, at a place in the county or counties
named therein, and specifying the maximum amount of money proposed to be
expended in purchasing or building the hospital, including the
acquisition of a site, the board of county commissioners shall, after a
compliance with and subject to the provisions of NRS 350.011 to 350.0165 , inclusive, submit the question of issuing
bonds therefor to the qualified electors of the county at the next
general election 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)
1. Whenever the board of county commissioners of any county is
presented with a petition signed by at least 50 percent of the taxpayers
in the county or in each of a group of counties asking that an annual tax
be levied for the establishment and maintenance of a public hospital, at
a place in the county or counties named therein, and specifying the
maximum amount of money proposed to be expended in purchasing or building
the hospital, including the acquisition of a site, the board of county
commissioners shall forthwith comply with the provisions of NRS 350.011
to 350.0165 , inclusive, and shall submit the proposal to
issue bonds for the project to the county debt management commission for
each of the counties.
2. Upon the receipt of the approval thereof of each such
commission, each board of county commissioners shall submit the question
of issuing bonds for the hospital project designated in the petition to
the qualified electors of the county at the next primary or general
election, as provided in NRS 350.020 to
350.070 , inclusive.
3. If the petition designated in subsection 1 indicates the
hospital is to serve more than one county, each county designated shall
submit to the commission and to the qualified electors of the county a
bond question authorizing the issuance of the county’s bonds for the
project in a maximum principal amount at least sufficient to defray the
county’s proportional share of the maximum amount designated in the
petition to be expended for the project based upon the last assessed
valuation of the taxable property in the county and the valuation of that
property in all the counties designated 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)
Whenever the board of county commissioners of any county on its own
motion desires to establish a county hospital, the board shall:
1. Specify the maximum amount of money proposed to be expended in
purchasing or building the hospital, including the acquisition of a site;
2. Comply with the provisions of NRS 350.011 to 350.0165 , inclusive; and
3. Upon the receipt of the approval of the county debt management
commission of the proposal to issue the county hospital bonds, submit the
question of issuing bonds for the project to the qualified electors of
the county at a special election or the next primary or general election,
as provided in NRS 350.020 to 350.070
, inclusive.
(Added to NRS by 1965, 633; A 1969, 1604; 1981, 963; 1993, 1078;
1995, 773)
Whenever a question of
issuing bonds submitted to 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 county commissioners
shall immediately proceed to appoint the board of hospital trustees and
shall proceed to issue and sell the bonds as provided in NRS 450.010
to 450.510 , inclusive, subject to the provisions of the
Local Government Securities Law.
(Added to NRS by 1965, 633; A 1969, 1604; 1985, 293)
In all cases where any county hospital has
been acquired by purchase, construction or otherwise, in any of the
several counties of this state under or by virtue of any act of the
Legislature other than NRS 450.010 to
450.510 , inclusive, and has been
governed and administered thereunder by the board of county
commissioners, or otherwise, the board of county commissioners is
authorized and empowered forthwith to appoint a board of hospital
trustees for such county hospital. Thereafter, all the provisions of NRS
450.010 to 450.510 , inclusive, relative to the maintenance of
hospitals, election of hospital trustees, maintenance of a training
school for nurses, provision for suitable care for such hospitals and
disabled persons, and the administration and government of county
hospital and patients therein shall be immediately applicable and
controlling with respect to the future administration, control and
government of such hospital in like manner and with the same force and
effect as if an election had been duly held in accordance with the
provisions of NRS 450.010 to 450.510
, inclusive, and a majority of all the
votes cast had been in favor of establishing such hospital.
[1.1:169:1929; added 1953, 126]—(NRS A 1965, 633)
In all
counties where existing hospitals are taken over by a board of hospital
trustees, as provided in NRS 450.010 to
450.510 , inclusive, additional
necessary buildings and sites may be acquired only if a bond issue is
approved by the voters at a primary, general or special election
according to the terms of NRS 450.010
to 450.510 , inclusive, as if no
hospital then existed. In a county whose population is 100,000 or more,
in cases where buildings or parts thereof have been constructed but
remain unfinished and unequipped, the board of hospital trustees may
complete the building or buildings or part or parts thereof and furnish
and equip them from the board’s current 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
1. Except in counties where the board of county commissioners is
the board of hospital trustees, the board of hospital trustees for 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, hospital trustees must
be elected for terms of 4 years in the same manner as other county
officers are elected.
(b) Whose population is 100,000 or more but less than 400,000,
hospital trustees must be elected from the county at large for terms of 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)
Except in
counties where the board of county commissioners is the board of hospital
trustees:
1. The offices of hospital trustees are hereby declared to be
nonpartisan, and the names of candidates for such offices shall appear
alike upon the ballots of all parties at all primary elections.
2. At the general election only the names of those candidates, not
to exceed twice the number of hospital trustees to be elected, who
received the highest numbers of votes at the primary election shall
appear on the ballot.
[Part 2:169:1929; A 1937, 194; 1949, 83; 1955, 165]—(NRS A 1973,
274; 1975, 1102)
1. In any county whose population is 400,000 or more, the board of
county commissioners is, ex officio, the board of hospital trustees, and
the county commissioners shall serve as hospital trustees during their
terms of office as county commissioners.
2. In any county whose population is less than 400,000, the board
of county commissioners may enact an ordinance providing that the board
of county commissioners is, ex officio, the board of hospital trustees.
If such an ordinance is enacted in a county:
(a) The county commissioners shall serve as hospital trustees
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 each hospital trustee
who is serving in that capacity on the effective date of the ordinance is
terminated as of the effective date of the ordinance.
3. A board of county commissioners shall not enact an ordinance
pursuant to subsection 2 unless it determines that:
(a) The county has fully funded its indigent care account created
pursuant to NRS 428.010 ;
(b) The county has fulfilled its duty to reimburse the hospital for
indigent care provided to qualified indigent patients; and
(c) During the previous calendar year:
(1) At least one of the hospital’s accounts payable was more
than 90 days in arrears;
(2) The hospital failed to fulfill its statutory financial
obligations, such as the payment of taxes, premiums for industrial
insurance or contributions to the Public Employees’ Retirement System;
(3) One or more of the conditions relating to financial
emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or
(4) The hospital received notice from the Federal Government
or the State of Nevada that the certification or licensure of the
hospital was in imminent jeopardy of being revoked because the hospital
had not carried out a previously established plan of action to correct
previously noted deficiencies found by the regulatory body.
4. Except in counties where the board of county commissioners is
the board of hospital trustees, in any county whose population is 100,000
or more but less than 400,000, the board of hospital trustees for the
public hospital must be composed of the five regularly elected or
appointed members, and, in addition, three county commissioners selected
by the chairman of the board of county commissioners shall serve as
voting members of the board of hospital trustees during their terms of
office as county commissioners.
5. Except in counties where the board of county commissioners is
the board of hospital trustees, in any county whose population is less
than 100,000, the board of hospital trustees for the public hospital must
be composed of the five regularly elected or appointed members, and, in
addition, the board of county commissioners may, by resolution, provide
that:
(a) One county commissioner selected by the chairman of the board
of county commissioners shall serve as a voting member of the board of
hospital trustees during his term of office as county commissioner;
(b) A physician who is the chief of the staff of physicians for the
public hospital shall serve as a voting member of the board of hospital
trustees; or
(c) Both a county commissioner appointed pursuant to the provisions
of paragraph (a) and a physician appointed pursuant to the provisions of
paragraph (b) shall serve as voting members of the board of hospital
trustees.
Ê The term of office of a member appointed pursuant to the provisions of
paragraph (b) is 2 years and begins on the date the board of county
commissioners appoints the member.
[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 )
Within 10 days after their appointment
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]
Except in counties where the board of
county commissioners is the board of hospital trustees, a vacancy in the
board of hospital trustees occasioned by a resignation, removal or
otherwise must be reported to the board or boards of county commissioners
and must be filled in the same manner as the original appointment. An
appointee shall hold office:
1. Until the next following general election in the usual manner;
or
2. If the appointee is a physician appointed to fill the vacancy
of a member appointed pursuant to the provisions of paragraph (b) of
subsection 5 of NRS 450.090 , for the
unexpired term of that member.
[5:169:1929; NCL § 2229]—(NRS A 1975, 1103; 2001, 468 )
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
of one of their number as chairman, one as secretary, and by the election
of such other officers as they may deem necessary.
2. The county treasurer of the county in which the hospital 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
the board, as ordered by it, but shall receive no compensation from the
board of hospital trustees.
3. In counties where the board of county commissioners is the
board of hospital trustees, the chairman of the board of county
commissioners may be chairman of the board of hospital trustees or the
board of county commissioners may, at its first meeting in January of
each year, designate another of its members to serve as chairman of the
board of hospital trustees for a term of 1 year. The vice chairman of the
board of county commissioners may be vice chairman of the board of
hospital trustees, or the board of county commissioners may, at its first
meeting in January of each year, designate another of its members to
serve as vice chairman of the board of hospital trustees for a term of 1
year. The county clerk shall be the secretary of the board of hospital
trustees. The county clerk shall receive no compensation from the board
of hospital trustees.
[Part 3:169:1929; A 1955, 244]—(NRS A 1975, 1103; 1977, 931)
1. Except in counties where the board of county commissioners is
the board of hospital trustees, in any county whose population is less
than 100,000:
(a) A hospital trustee is entitled to receive a salary as follows:
(1) The chairman and secretary of the board of hospital
trustees are entitled to receive $85 for each meeting of the board or a
committee appointed by the board that they attend, not to exceed $510 per
month.
(2) The other trustees are entitled to receive $80 for each
meeting of the board or a committee appointed by the board that they
attend, not to exceed $480 per month.
(b) In addition to the salary required by paragraph (a), the board of
hospital trustees may provide to each member of the board the same health
insurance coverage as the board provides to its employees.
2. Except in counties where the board of county commissioners is
the board of hospital trustees, in any county whose population is 100,000
or more, a hospital trustee, subject to the provisions of subsection 3,
is entitled to receive a salary of $100 per month and the chairman of the
board of hospital trustees is entitled to receive a salary of $200 per
month.
3. Before any hospital trustee is entitled to any compensation as
provided in subsection 2, he must first have devoted a minimum of 1 day
during the month exclusively to the business and affairs of the hospital,
exclusive of regular meetings of the board of hospital trustees.
4. Any trustee of any county hospital is entitled to receive
reimbursement for any cash expenditures actually made for personal
expenses incurred as a trustee. An itemized statement of all those
expenses and money paid out must be made under oath by each of the
trustees and filed with the secretary. An itemized statement may be
allowed only by an affirmative vote of all trustees present at a meeting
of the board.
5. In counties where the county commissioners are the board of
hospital trustees, they shall serve without compensation, but are allowed
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 )
A trustee shall not have a personal pecuniary interest,
either directly or indirectly, in the purchase of any supplies for the
hospital unless the supplies are purchased by competitive bidding.
(Added to NRS by 1977, 1114)
1. The board of hospital trustees shall hold meetings at least
once each month, and shall keep a complete record of all its transactions.
2. Except as otherwise provided in NRS 241.0355 :
(a) In counties where three county commissioners are not members of
the board, three members of the board constitute a quorum for the
transaction of business.
(b) And except as otherwise provided in paragraph (c), in counties
where three county commissioners are members of the board, any five of
the members constitute a quorum for the transaction of business.
(c) In counties where the board of county commissioners is the
board of hospital trustees, a majority of the board constitutes a quorum
for 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 )
The board of
hospital trustees, in general, shall carry out the spirit and intent of
NRS 450.010 to 450.510 , inclusive, in establishing and maintaining a
county public hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]
The board of hospital trustees
shall make and adopt such bylaws, rules and regulations for its own
guidance and for the government of the hospital, and such rules and
regulations governing the admission of physicians to the staff, as may be
deemed expedient for the economic and equitable conduct thereof, not
inconsistent with NRS 450.010 to
450.510 , inclusive, or the ordinances
of the city or town wherein such hospital is located.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]—(NRS A 1963,
346)
1. A board of hospital trustees may acquire a building or other
facility for the provision of health care in a county adjacent to the
county or one of the counties where the county hospital is established,
may operate such a facility, and may, but need not, enter into a contract
with a private hospital or other person to operate such a facility, but
only if no tax is levied or appropriation made from the county general
fund in the county or counties where the county hospital is established
for the maintenance and operation of the county hospital. The board of
hospital trustees may use money in the hospital fund or in any separate
account established by the board for this purpose.
2. To finance the acquisition of the additional facility, the
board of hospital trustees may issue, without any election, special
obligations payable only from revenues of the additional facility or from
those revenues and the revenues of the county hospital and any related
facilities. These obligations are not an indebtedness of the county or
counties where the county hospital is established or of the county in
which the additional facility is located.
3. As used in this section, “acquire” and “acquisition” have the
meaning attributed to them in NRS 350.506 .
(Added to NRS by 1995, 332)
1. One of the hospital trustees shall visit and examine the
hospital twice each month.
2. During the first week in February of each year, the board shall
file with the board of county commissioners a report of the proceedings
of the board of hospital trustees with reference to the hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]
1. In counties where the board of county commissioners is the
board of hospital trustees, the board of hospital trustees may appoint a
hospital advisory board which shall exercise powers and duties delegated
to the advisory board by the board of hospital trustees.
2. Members of a hospital advisory board must be appointed by a
majority vote of the board of hospital trustees and shall serve at the
pleasure of the board.
3. Members of the hospital advisory board may receive compensation
for their services of no more than $100 per month.
(Added to NRS by 1975, 1101; A 1995, 793)
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 or part-time,
as the board determines necessary, and fix their compensations.
3. Remove those appointees and employees.
4. Control the admission of physicians and interns to the staff by
promulgating appropriate rules, regulations and standards governing those
appointments.
5. Contract with individual physicians or private medical
associations for the provision of certain medical services as may be
required by the hospital.
[Part 4:169:1929; A 1937, 194; 1943, 17; 1955, 194]—(NRS A 1963,
346; 1979, 444; 1987, 387; 2005, 2557 )
1. The governing body of a county hospital may contract with a
company which manages hospitals for the rendering of management services
in a county hospital under the ultimate authority of the governing body.
2. The agreement may provide:
(a) That the administrator of the hospital must be an employee of
the company which manages the hospital; and
(b) That the hospital may, in accordance with the requirements of
NRS 450.530 , purchase supplies,
materials and equipment through the purchasing contracts of the company
which manages the hospital, or through a purchasing group, without
complying with 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
)
If the
board of hospital trustees and the owners of any property desired by the
board of hospital trustees for hospital purposes in the county or
counties where the county hospital is established cannot agree as to the
price to be paid therefor, the board of hospital trustees shall report
the facts to the board or boards of county commissioners. Condemnation
proceedings shall be instituted by the board or boards of county
commissioners and prosecuted in the name of the county or counties by the
district attorney for such county as may be concerned.
[7:169:1929; NCL § 2231]—(NRS A 1995, 333)
No hospital buildings shall be
erected or constructed until the plans and specifications have been made
therefor and adopted by the board of hospital trustees, and bids
advertised for according to law for other county public buildings.
[8:169:1929; NCL § 2232]
Any person, firm,
organization, corporation or society desiring to make donations of money,
personal property or real property for the benefit of a county public
hospital shall have the right to vest title of the money, personal
property or real property so donated in the county or counties where the
county hospital is established to be controlled, when accepted, by the
board of hospital trustees according to the terms of the deed, gift,
devise or bequest of such property.
[15:169:1929; NCL § 2239]—(NRS A 1995, 333)
Finances
The board of hospital trustees shall file
with the board of county commissioners a budget as required of all
governmental agencies of this state by chapter 354 of NRS, and in the fiscal management of the affairs
of the public hospital and all other institutions under the supervision,
government and control of the board of hospital trustees, the board of
hospital trustees are governed by the provisions of 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)
1. In all counties where a tax for the establishment and
maintenance of a public hospital has been authorized by a majority of the
voters voting for a bond issue in accordance with law, the supervision,
management, government and control of the county hospital vests in and
must be exercised by the board of hospital trustees for the county public
hospital, and the institution must thereafter be operated by the board of
hospital trustees.
2. Annually, upon the request of the board of hospital trustees,
the board of county commissioners may levy a tax for the maintenance and
operation of the county public hospital, excluding the establishment,
maintenance or operation of any facility located outside the county or
counties where the county hospital is established.
3. The resolution adopted by the board of county commissioners
imposing a tax levy for a county public hospital must state:
(a) The portion of the levy which is necessary to retire hospital
bonds and any other outstanding hospital securities, and to pay interest
thereon;
(b) The portion of the levy which is necessary to pay for the care
of indigent patients; and
(c) The portion of the levy which is necessary to pay for the cost
of new equipment, replacement of old equipment and other improvements to
the hospital not covered by specific bond issues or other securities and
not included in the cost of care of indigent patients as provided in
paragraph (b). The cost must be prorated to the county in accordance with
the number of patient days of care of county patients.
4. The board of county commissioners may not levy a tax for the
care of indigents in the county public hospital as a hospital expense
unless the levy and its justification are included in the budget for the
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)
1. The board of hospital trustees has the exclusive control of:
(a) The expenditures of all money collected to the credit of the
hospital fund.
(b) The purchase of the site or sites.
(c) The purchase or construction of any hospital building or
buildings.
(d) The supervision, care and custody of the grounds, rooms or
buildings purchased, constructed, leased or set apart for that purpose.
2. With the approval of the board of county commissioners of the
county or counties where the county hospital is established, the board of
hospital trustees may lease buildings in that county or those counties
for medical purposes or for purposes of related health care activities.
3. All money received for the hospital must be deposited in the
county treasury of the county in which the hospital is situated to the
credit of the hospital fund, and paid out only upon warrants drawn by the
board of hospital trustees of the county or counties upon properly
authenticated vouchers of the board of hospital trustees, after their
approval by the county auditor, except that all money received for a
hospital may be deposited in a separate account established and
administered by the board of hospital trustees under the provisions of
NRS 354.603 .
[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)
The board of trustees of a
county hospital, with the approval of the board of county commissioners,
if the board of county commissioners is not the board of hospital
trustees, may, by resolution:
1. Mortgage or pledge the personal property of the hospital,
including accounts receivable, and enter into agreements for the sale and
leasing back to the hospital of its personal property to provide security
for acquiring money for the operation of the hospital; and
2. Acquire real property for the expansion of the hospital by
entering into a contract for purchase of a type and duration and on such
terms as the governing body determines, including a contract secured by a
mortgage or other security interest in the real property.
(Added to NRS by 1987, 295; A 1997, 3100)
The board of
hospital trustees may:
1. By proper legal action, collect claims due to the public
hospital.
2. Accept as settlement of a claim due an amount less than that of
the claim.
3. Pay from the hospital fund all fees and expenses necessarily
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
Whenever any county or counties in
this state shall have provided for the appointment and election of
hospital trustees, and have voted for the issuance of bonds for hospital
purposes, as authorized by law, each such county shall issue bonds in
such sums and amounts as the board of hospital trustees shall certify to
the board of county commissioners to be necessary for the purpose stated
in the bond question approved at the election, but such bonds in the
aggregate shall not exceed the maximum amount authorized by the bond
question.
[Part 6:169:1929; NCL § 2230]—(NRS A 1965, 634)
1. Whenever the board of hospital trustees of any county 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 other acquisition of
additional fixtures, structures, and buildings for the public hospital,
equipment and furnishings therefor, and additional sites therefor, or any
combination thereof, the board shall, by resolution, request the board of
county commissioners of the county to issue general obligation bonds
therefor and shall specify in the resolution the maximum amount of money
proposed to be expended 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 debt management
commission of the proposal to issue the county hospital bonds, submit the
question of issuing the bonds to the qualified electors of the county at
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)
1. Subject to the provisions of NRS 450.010 to 450.510 ,
inclusive, for any hospital project stated in a bond question approved as
provided in NRS 350.070 , the board of
county commissioners, at any time, in the name and on the behalf of the
county, may issue:
(a) General obligation bonds, payable from taxes; and
(b) General obligation bonds, payable from taxes, which payment is
additionally secured by a pledge of gross or net revenues derived from
the operation of the hospital facilities, and, if so determined by the
board of county commissioners, further secured by a pledge of gross or
net revenues derived from any other income-producing project of the
county or from any license or other excise taxes levied by the county for
revenue, as may be legally made available for their payment.
2. The board of county commissioners of any county, in the name
and on behalf of the county, may issue, for any hospital project, without
the securities being authorized at any election, special obligation
municipal securities payable solely from net revenues or gross revenues
derived from 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)
Subject to the provisions of NRS 450.290 , for any hospital facilities authorized by NRS
450.010 to 450.510 , inclusive, the board of county commissioners
may, on the behalf and in the name of the county, borrow money, otherwise
become obligated, and evidence obligations by the issuance of bonds and
other county securities, and in connection with the undertaking or
facilities, the board may otherwise proceed as provided in the Local
Government Securities Law.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]—(NRS A 1965,
635; 1969, 1606; 1985, 293)
In order to insure the payment of the
general obligation bonds of the county, the payment of which is
additionally secured by a pledge of revenues of such hospital facilities,
of any such other income-producing project and of any such excise taxes,
as provided in NRS 450.290 , or other
such additionally secured general obligation securities of the county,
there may be established and maintained, and from time to time revised, a
schedule or schedules of fees, rates and charges for services, facilities
and commodities rendered by or through such facilities and any such other
income-producing project and a schedule or schedules of any such excise
taxes, as the case may be, by the board of hospital trustees for such
hospital facilities and otherwise by the board of county commissioners,
in an amount sufficient for that purpose and also sufficient to discharge
any covenant in the proceedings authorizing the issuance of any of the
bonds or other securities, including any covenant for the establishment
of reasonable reserve funds.
[Part 1:169:1929; A 1931, 231; 1943, 213; 1953, 365]—(NRS A 1965,
636; 1969, 1607)
Administration
1. Every county hospital in this State being supported by public
money, and every hospital established under NRS 450.010 to 450.510 ,
inclusive, must be for the benefit of that county or counties and of any
person falling sick or being injured or maimed within its limits, but the
governing body of the hospital may extend the privileges and use of the
hospital to persons residing outside of the county or counties upon such
terms and conditions as the governing body may by its rules and
regulations prescribe.
2. Every inhabitant or person who is not a pauper and every
relative required by the laws of this State to support an inhabitant or
person who is a pauper shall pay to the governing body, or an officer it
designates, a reasonable compensation for occupancy, nursing, care,
medicine and attendance, other than medical or surgical attendance,
according to the rules and regulations prescribed by the governing body.
If after demand by the governing body, or its designated officer, the
inhabitant, person or relative fails, refuses or neglects to pay the
compensation, it may be recovered in a suit at law brought by the
governing body.
3. The hospital is subject to such reasonable rules and
regulations as the governing body may adopt in order to render the use of
the hospital of the greatest benefit to the greatest number of people.
4. The governing body may exclude from the use of the hospital any
and all inhabitants and persons who willfully violate those rules and
regulations.
5. The provisions of this section do not prohibit the hospital
from exercising other powers granted to it by the provisions of this
chapter.
[9:169:1929; NCL § 2233] + [1:132:1941; 1931 NCL § 2245]—(NRS A
1987, 388)
1. When the privileges and use of the hospital are extended to a
resident of another county who is reasonably believed to be indigent, 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 other county; or
(b) Injured, maimed or falls sick in the other county,
Ê the governing head shall notify the board of county commissioners of
that county within 3 working days after the person is admitted to that
hospital.
2. The notice must be in writing and addressed to the board of
county commissioners of that county.
3. Except in the case of an injury suffered in a motor vehicle
accident, the board of county commissioners receiving the notice shall
cause the person to be removed immediately to that county, and shall pay
a reasonable sum to the hospital for the temporary occupancy, care,
nursing, medicine, and attendance, other than medical or surgical
attendance, furnished to him.
4. If the board of county commissioners neglects or refuses to
remove the person, or if in the opinion of the attending physician it is
not advisable to remove the person, the governing head has a legal claim
against the county for all charges for occupancy, nursing, care,
medicine, and attendance, 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 A 1983, 1943;
1991, 1000; 1993, 1974)
1. Supervising boards of county hospitals may:
(a) Provide for treatment to sick or injured persons and require
the payment of reasonable charges therefor.
(b) Contract for the provision of such treatment on a periodic
prepaid basis with any person authorized by the Commissioner of Insurance
pursuant to title 57 of NRS to arrange for or provide health care
services on a periodic prepaid basis.
Ê The treatment of such persons must not be permitted to interfere with
the treatment of purely charitable cases.
2. Every person treated by a county hospital and required to pay
charges for hospitalization, shall pay the charges fixed by the
supervising board therefor, which charges, when paid, must be paid
forthwith into the county treasury and deposited to the credit of the
hospital fund.
3. Every person treated by a county hospital and required to pay
charges to the hospital has the right to the services of a physician or
surgeon of his own choice, and has the right to employ such special
nurses as may be necessary, but the cost of the physician, surgeon or
nurses must not become a claim against the county.
4. Supervising boards shall fix and determine reasonable charges
to be paid by sick and injured persons treated by county hospitals, which
charges must include the board and lodging of the person and the
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)
1. The board of county commissioners of the county in which a
public hospital is located may determine whether patients presented to
the public hospital for treatment are subjects of charity. Except as
otherwise provided in NRS 439B.330 ,
the board of county commissioners shall establish by ordinance criteria
and procedures to be used in the determination of eligibility for medical
care as medical indigents or subjects of charity.
2. The board of hospital trustees shall fix the charges for
treatment of those persons able to pay for the charges, as the board
deems just and proper. The board of hospital trustees may impose an
interest charge of not more than 12 percent per annum on unpaid accounts.
The receipts must be paid to the county treasurer and credited by him to
the hospital fund. In fixing charges pursuant to this subsection the
board of hospital trustees shall not include, or seek to recover from
paying patients, any portion of the expense of the hospital which is
properly attributable to the care of indigent patients.
3. Except as provided in subsection 4 of this section and
subsection 3 of NRS 439B.320 , the
county is chargeable with the entire cost of services rendered by the
hospital and any salaried staff physician or employee to any person
admitted for emergency treatment, including all reasonably necessary
recovery, convalescent and follow-up inpatient care required for any such
person as determined by the board of trustees of the hospital, but the
hospital shall use reasonable diligence to collect the charges from the
emergency patient or any other person responsible for his support. Any
amount collected must be reimbursed or credited to the county.
4. The county is not chargeable with the cost of services rendered
by the hospital or any attending staff physician or surgeon to 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)
1. The board of county commissioners of a county in which a county
hospital is established may, upon approval by a majority of the voters
voting on the question in an election held throughout the county, levy an
ad valorem tax of not more than 2.5 cents on each $100 of assessed
valuation upon all taxable property in the county, to pay the cost of
services rendered in the county by the hospital pursuant to subsection 3
of NRS 450.420 . The approval required
by this subsection may be requested at any primary or general election.
2. Any tax imposed pursuant to this section is in addition to the
taxes imposed pursuant to NRS 428.050 ,
428.185 and 428.285 . The proceeds of any tax levied pursuant to
this section are exempt from the limitations imposed by NRS 354.59811
, 428.050 and 428.285
and must be excluded in determining the maximum rate of tax authorized by
those sections.
(Added to NRS by 1987, 878; A 1989, 2086; 1991, 482; 1993, 1079;
1995, 334)
1. In the management of the public hospital, no discrimination may
be made against physicians, podiatric physicians or dentists licensed
under the laws of this state or licensed practitioners of the allied
health professions, and all such physicians, dentists, podiatric
physicians and practitioners have privileges in treating patients in the
hospital in accordance with their training and ability, except that
practitioners of the allied health professions may not be members of the
staff of physicians described in NRS 450.440 . Practitioners of the allied health
professions are subject to the bylaws and regulations established by the
board of hospital trustees.
2. The patient has the right to employ, at his own expense, his
own physician, if that physician is a member of the hospital staff, or
his own nurse, and when acting for any patient in the hospital, the
physician employed by the patient has charge of the care and treatment of
the patient, and the nurses in the hospital shall comply with the
directions of the physician concerning that patient, subject to the
regulations established by the board of hospital trustees.
[Part 11:169:1929; A 1955, 194]—(NRS A 1957, 780; 1975, 641; 1979,
150; 2001, 1830 )
1. The board of hospital trustees shall organize a staff of
physicians composed of each regular practicing physician, podiatric
physician and dentist in the county in which the hospital is located who
requests staff membership and meets the standards set forth in the
regulations prescribed by the board of hospital trustees.
2. The staff shall organize in a manner prescribed by the board so
that there is a rotation of service among the members of the staff to
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 of county
commissioners may offer the following assistance to members of the staff
to attract and retain them:
(a) Establishment of clinic or group practice;
(b) Malpractice insurance coverage under the hospital’s policy of
professional liability insurance;
(c) Professional fee billing; and
(d) The opportunity to rent office space in facilities owned or
operated by the hospital, as the space is available, if this opportunity
is offered to all members of the staff on the same terms and conditions.
[Part 11:169:1929; A 1955, 194]—(NRS A 1963, 346; 1967, 996; 1979,
150, 1408, 1409; 2001, 1830 ; 2005, 2557 )
When a county hospital is established, the
physicians, nurses, attendants, the persons sick therein, and all persons
approaching or coming within the limits of the same, and all furniture
and other articles used or brought there shall be subject to such rules
and regulations as the board of hospital trustees may prescribe.
[10:169:1929; NCL § 2234]
A board of
hospital trustees may institute and maintain training programs in the
county hospital for resident physicians, including interns and
postgraduates. Such programs must meet the standards for recognition by
the American Medical Association and for accreditation by the Liaison
Committee on Graduate Medical Education.
(Added to NRS by 1963, 455; A 1979, 676)
The board of hospital
trustees may establish and maintain in connection with a county hospital
and as a part thereof a training school for nurses. Upon completion of
the prescribed course of training the board of hospital trustees shall
give diplomas to such nurses as complete the course satisfactorily.
[12:169:1929; NCL § 2236]
1. If the county hospital is located at the county seat, the board
of hospital trustees shall, at all times, provide a suitable room that
may be used for the examination of persons who are alleged to be mentally
ill and who are to be brought before the judge of the district court for
proceedings to determine the issue of involuntary court-ordered admission
as provided in chapter 433A of NRS. This
section does not prohibit or limit the examination of persons alleged to
be mentally ill at a private hospital as provided in chapter 433A of NRS.
2. The board of trustees of such a county hospital, in cooperation
with the local law enforcement agencies, may provide a suitable room that
may be used for the custodial supervision of persons who are alleged to
be:
(a) Mentally ill; or
(b) Dangerous to themselves or others.
[13:169:1929; NCL § 2237]—(NRS A 1967, 1679; 1975, 1634; 1993, 834)
A hospital or rescue unit which meets minimum
requirements established by the State Board of Health, or an ambulance
service which meets minimum requirements established by the State Board
of Health in a county whose population is less than 100,000, or a county
or district board of health in a county whose population is 100,000 or
more, may use advanced emergency medical technicians, 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 transport to a hospital;
2. While in a hospital emergency department; and
3. Until responsibility for care is assumed by the regular staff
of the hospital.
(Added to NRS by 1973, 610; A 1975, 37; 1987, 2206; 1993, 2827)
The board of hospital trustees may
contract for the use of a facility for intermediate care or a facility
for skilled nursing for the treatment of patients who may safely be
discharged to such a facility.
(Added to NRS by 1987, 295)
Transfer
1. The board of county commissioners of any county for which a
public hospital has been established or is administered pursuant to NRS
450.010 to 450.510 , inclusive, and whose public hospital is the
only hospital in the county, may convey the hospital for an amount not
less than its appraised value or lease it for a term of not more than 50
years to any corporation if all of the following conditions are met:
(a) The corporation must provide in its articles of incorporation
for an advisory board for the hospital. The advisory board must consist
of persons who represent a broad section of the people to be served by
the hospital.
(b) The corporation must contract to:
(1) Care for indigent patients at a charge to the county
which does not exceed the actual cost of providing that care, or in
accordance with NRS 439B.300 to
439B.340 , inclusive, if applicable;
and
(2) Receive any person falling sick or maimed within the
county.
(c) The corporation must agree to accept all the current assets,
including accounts receivable, to assume all the current liabilities, and
to take over and maintain the records of the existing public hospital.
(d) The agreement must provide for the transfer of patients, staff
and employees, and for the continuing administration of any trusts or
bequests pertaining to the existing public hospital.
(e) The agreement must provide for the assumption by the
corporation of all indebtedness of the county which is attributable to
the hospital, and:
(1) If the hospital is conveyed, for payment to the county
of an amount which is not less than the appraised value of the hospital,
after deducting any indebtedness so assumed, immediately or by deferred
installments over a period of not more than 30 years.
(2) If the hospital is leased, for a rental which will, over
the term of the lease, reimburse the county for its actual capital
investment in the hospital, after deducting depreciation and any
indebtedness so assumed. The lease may provide a credit against the
rental so required for the value of any capital improvements made by the
corporation.
2. If any hospital which has been conveyed pursuant to this
section ceases to be used as a hospital, unless the premises so conveyed
are sold and the proceeds used to erect or enlarge another hospital for
the county, the hospital so conveyed reverts to the ownership of the
county. If any hospital which has been leased pursuant to this section
ceases to be used as a hospital, the lease is terminated.
(Added to NRS by 1981, 1186; A 1987, 879)
1. Except as otherwise provided in NRS 450.490 , the board of county commissioners of any
county for which a public hospital has been established pursuant to NRS
450.010 to 450.510 , inclusive, or established otherwise but
administered pursuant to NRS 450.010 to
450.510 , inclusive, may convey the
hospital, or lease it for a term of not more than 50 years, to a
nonprofit corporation if all of the following conditions are met:
(a) The governing body of the nonprofit corporation must be
composed initially of the incumbent members of the board of hospital
trustees, as individuals. The articles of incorporation must provide for:
(1) A membership of the corporation which is broadly
representative of the public and includes residents of each incorporated
city in the county and of the unincorporated area of the county or a
single member which is a nonprofit corporation whose articles of
incorporation provide for a membership which is broadly representative of
the public and includes residents of each incorporated city in the county
and of the unincorporated area of the county;
(2) The selection of the governing body by the membership of
the corporation or, if the corporation has a single member, by the single
member;
(3) The governing body to select its members only to fill a
vacancy for an unexpired term; and
(4) The terms of office of members of the governing body,
not to exceed 6 years.
(b) The nonprofit corporation must contract to:
(1) Care for indigent patients at a charge to the county
which does not exceed the actual cost of providing such care, or in
accordance with NRS 439B.300 to
439B.340 , inclusive, if applicable;
and
(2) Receive any person falling sick or maimed within the
county.
(c) The nonprofit corporation must agree to accept all the current
assets, including accounts receivable, to assume all the current
liabilities, and to take over and maintain the records of the existing
public hospital.
(d) The agreement must provide for the transfer of patients, staff
and employees, and for the continuing administration of any trusts or
bequests pertaining to the existing public hospital.
(e) The agreement must provide for the assumption by the
corporation of all indebtedness of the county which is attributable to
the hospital, and:
(1) If the hospital is conveyed, for payment to the county
of its actual capital investment in the hospital, after deducting
depreciation and any indebtedness so assumed, immediately or by deferred
installments over a period of not more than 30 years.
(2) If the hospital is leased, for a rental which will over
the term of the lease reimburse the county for its actual capital
investment in the hospital, after deducting depreciation and any
indebtedness so assumed. The lease may provide a credit against the
rental so required for the value of any capital improvements made by the
corporation.
2. Boards of county commissioners which have joint responsibility
for a public hospital may jointly exercise the power conferred by
subsection 1, and are subject jointly to the related duties.
3. If any hospital which has been conveyed pursuant to this
section ceases to be used as a nonprofit hospital, unless the premises so
conveyed are sold and the proceeds used to erect or enlarge another
nonprofit hospital for the county, the hospital so conveyed reverts to
the ownership of the county. If any hospital which has been leased
pursuant to this section ceases 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)
1. The board of county commissioners of any county whose
population is less than 100,000 may contract with any nonprofit
corporation to which a public hospital has been conveyed or leased, for
the care of indigent patients from the contracting county and the
receiving of other persons falling sick or being maimed or injured within
the contracting county. 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 the enlargement or
alteration of the hospital.
(Added to NRS by 1969, 216; A 1969, 1545; 1979, 551; 1987, 881;
1993, 2661)
Miscellaneous Provisions
1. For the purposes of NRS 450.043 , 450.060 and
450.280 , a special election may be held
only if the board of county commissioners determines, by a unanimous
vote, that an emergency exists.
2. The determination made by the board is conclusive unless it is
shown that the board acted with fraud or a gross abuse of discretion. An
action to challenge the determination made by the board must be commenced
within 15 days after the board’s determination is final.
3. As used in this section, “emergency” means any unexpected
occurrence or combination of occurrences which requires immediate action
by the board to prevent or mitigate a substantial financial loss to the
county or to enable the board to provide an essential service to the
residents of the county.
(Added to NRS by 1993, 1078; A 1995, 334)
1. A county hospital may, with the approval of the governing body
of the hospital, become a member of a purchasing group for the purpose of
purchasing supplies, materials and equipment used by the county hospital.
2. A county hospital that becomes a member of a purchasing group
may, in accordance with the requirements of NRS 450.530 , purchase supplies, materials and equipment
through the purchasing group without complying with the requirements for
competitive bidding set forth in chapter 332
of NRS.
(Added to NRS by 1999, 190 )
A county
hospital that is authorized pursuant to NRS 450.191 or 450.525
to purchase supplies, materials and equipment in accordance with this
section through the purchasing contracts of the company that manages the
hospital or through a purchasing group may purchase the supplies,
materials and equipment without complying 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 or purchasing
group, are summarized in writing and, together with a sworn statement by
an officer or agent of the company or purchasing group that the prices
were obtained by the company or purchasing group through a process of
competitive bidding, are presented to the governing body of the county
hospital at its next regularly scheduled meeting; and
2. The governing body, after reviewing the summary and statement,
finds that the proposed purchase will be made at a lower price than the
lowest price reasonably obtainable by the hospital through competitive
bidding pursuant to chapter 332 of NRS or
available to the hospital pursuant to NRS 333.470 and approves the proposed purchase.
(Added to NRS by 1999, 190 )
COUNTY HOSPITAL DISTRICTS
As used in NRS 450.550 to 450.760 ,
inclusive, unless the context otherwise requires:
1. “Board of trustees” means:
(a) A board of hospital trustees:
(1) Elected pursuant to NRS 450.620 and a physician who is appointed pursuant to
subsection 1 of NRS 450.640 , if
applicable; or
(2) Appointed pursuant to NRS 450.625 and a physician who is appointed pursuant to
subsection 1 of NRS 450.640 , if
applicable; or
(b) A board of county commissioners, if that board enacts an
ordinance which provides that the board of county commissioners is, ex
officio, the board of hospital trustees, and a physician who is appointed
pursuant to subsection 1 of NRS 450.640 , if applicable.
2. “District hospital” means a hospital constructed, maintained
and governed pursuant to NRS 450.550 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 )
1. The board of county commissioners of any county may of its own
motion establish a hospital district in the manner prescribed in NRS
450.550 to 450.750 , inclusive. The establishment of a hospital
district is in addition to any other powers granted to a board of county
commissioners pursuant to NRS 450.010
to 450.510 , inclusive.
2. Except as otherwise provided in this subsection, a hospital
district specified in subsection 1 may include territory within more than
one county. If the establishment of such a district is proposed by a
board of county commissioners, the district may be established only if
the board of county commissioners of each county included within the
district, other than the county of the board of county commissioners that
proposes to establish the district, adopts a resolution approving the
establishment of the district.
(Added to NRS by 1969, 1387; A 1997, 3100, 3135; 1999, 639 )
The notice of intent to establish a hospital district must:
1. State the name of the proposed district and the name of the
county or counties in which the proposed district is located.
2. State the time and place fixed by the board of county
commissioners for a hearing on the proposed establishment of the district.
3. Describe the territory or specify the exterior boundaries of
the territory proposed to be included within the district, which
boundaries, so far as practicable, must be the centerlines of highways.
4. Be published once a week for 2 successive weeks before the time
fixed for the hearing in a newspaper designated by the board of county
commissioners.
(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639 )
1. At or before the time fixed for the hearing of the proposed
establishment of a hospital district, any person interested may file
written objections to the establishment of the district with the clerk of
the board of county commissioners that proposes to establish the district.
2. At the hearing, the board of county commissioners shall hear
and consider any objections filed pursuant to subsection 1.
3. The board may:
(a) Sustain any objections filed pursuant to subsection 1;
(b) Change or alter the boundaries of the proposed district to
conform to the requirements of the district; and
(c) Exclude from the district any land that will not be benefited
by the establishment of the district.
(Added to NRS by 1969, 1387; A 1997, 3101, 3136; 1999, 639 )
1. Except as otherwise provided in subsection 3, if 25 percent or
more of the holders of title or evidence of title to lands lying within
the proposed district, whose names appear as such upon the last county
assessment roll, present a petition to the board of county commissioners
of the county in which the land lies, setting forth the exterior
boundaries of the proposed district and asking that the district so
described be established within a county hospital district pursuant to
the provisions of NRS 450.550 to
450.750 , inclusive, the board of county
commissioners shall adopt a resolution declaring the intention of the
board to include the territory within a county hospital district, naming
the district and describing its exterior boundaries.
2. The resolution must:
(a) Fix a time and place for the hearing of the proposed
establishment of the district not less than 30 days after its adoption.
(b) Direct the clerk of the board of county commissioners to
publish:
(1) The notice of intention of the board of county
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 a newspaper of
general circulation published in the county and circulated in the
proposed county hospital district, or if there is no newspaper so
published and circulated, then in a newspaper of general circulation
circulated in the proposed district.
3. The provisions of this section do not apply to a proposed
hospital district if it includes territory within more than one county.
(Added to NRS by 1969, 1388; A 1997, 3101, 3136; 1999, 639 )
Upon the hearing of the
petition, the board of county commissioners shall determine whether or
not the petition complies with the requirements and purposes of NRS
450.550 to 450.750 , inclusive, and must hear all competent and
relevant testimony offered in support or in objection thereto.
(Added to NRS by 1969, 1388)
If after a hearing, the
board of county commissioners determines that the creation of the
proposed hospital district is desirable, the board shall by resolution
provide for the creation of such district, designating the name of the
district and establishing the boundaries of the district.
(Added to NRS by 1969, 1388)
1. Except as otherwise provided in subsection 2 and NRS 450.625
, if a hospital district is created
pursuant to NRS 450.550 to 450.750
, inclusive, the board of county
commissioners 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 not exceed 4
years; and
(c) The times and manner of the election of the trustees, which
must be nonpartisan.
2. If a hospital district specified in subsection 1 does not
include territory within more than one county, the board of county
commissioners may enact an ordinance providing that the board of county
commissioners is, ex officio, the board of hospital trustees of the
district hospital. If such an ordinance is enacted in a county:
(a) The county commissioners shall serve as the hospital trustees
of the district hospital during their terms of office as county
commissioners; and
(b) If hospital trustees have been elected pursuant to subsection
1, the term of office of each hospital trustee of the district hospital
who is serving in that capacity on the effective date of the ordinance is
terminated as of the effective date of the ordinance.
3. Except as otherwise provided in NRS 450.710 , a board of county commissioners shall not
enact an ordinance pursuant to subsection 2 unless it determines that:
(a) The county has fully funded its indigent care account created
pursuant to NRS 428.010 ;
(b) The county has fulfilled its duty to reimburse the hospital for
indigent care provided to qualified indigent patients; and
(c) During the previous calendar year:
(1) At least one of the hospital’s accounts payable was more
than 90 days in arrears;
(2) The hospital failed to fulfill its statutory financial
obligations, including the payment of taxes, premiums for industrial
insurance or contributions to the Public Employees’ Retirement System;
(3) One or more of the conditions relating to financial
emergencies set forth in subsection 1 of NRS 354.685 existed at the hospital; or
(4) The hospital received notice from the Federal Government
or the State of Nevada that the certification or license of the hospital
was in imminent jeopardy of being revoked because the hospital had not
carried out a previously established plan of action to correct previously
noted deficiencies found by the regulatory body.
(Added to NRS by 1969, 1388; A 1995, 793; 1997, 572, 3102, 3137;
1999, 639 , 2077 )
1. If a hospital district created pursuant to NRS 450.550 to 450.750 ,
inclusive, includes territory within more than one county, the board of
trustees of the hospital district must consist of three members of the
board of county commissioners that created the district and:
(a) Three members of the board of county commissioners of each
county other than the county of the board of county commissioners that
created the district, if the portion of the county included in the
district is two-thirds or more of the total area of the county;
(b) Two members of the board of county commissioners of each county
other than the county of the board of county commissioners that created
the district, if the portion of the county included in the district is
more than one-third of the total area of the county but less than
two-thirds of the total area of the county; or
(c) One member of the board of county commissioners of each county
other than the county of the board of county commissioners that created
the district, if the portion of the county included in the district is
one-third or less of the total amount of the area of the county.
2. Each member of the board of trustees appointed pursuant to this
section must be appointed by the board of county commissioners of which
he is a member.
3. The term of office of the members of the board of trustees is 3
years.
4. A member who ceases to be a member of the board of county
commissioners that appointed him ceases to be a member of the board of
trustees.
5. Any vacancy must be filled for the unexpired term by the board
of county commissioners that appointed the member who created the vacancy.
(Added to NRS by 1997, 3099; A 1997, 3134; 1999, 639 )
The board of trustees shall:
1. Carry out the spirit and intent of NRS 450.550 to 450.750 ,
inclusive, in establishing and maintaining 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 such hospital;
and
(b) Fixing the charges for treatment of patients.
(Added to NRS by 1969, 1388; A 1987, 390)
The board of trustees may:
1. After the board is formed pursuant to the provisions of NRS
450.620 or 450.625 , increase the number of members who serve on
the board by appointing, as a voting member of the board, one physician
who is the chief of staff of physicians for a district hospital. The term
of office of a member who is appointed pursuant to this subsection is 2
years, commencing on the date of appointment by the board of trustees. A
vacancy in the term of a member appointed pursuant to this subsection
must be filled in the same manner as the original appointment for the
remainder of the unexpired term.
2. Appoint a chief executive officer and necessary assistants for
each hospital, and fix the compensations of such persons.
3. Employ physicians, surgeons and interns, as the board
determines necessary, and fix their compensation.
4. Remove such appointees and employees.
5. Remove persons who are appointed or employed pursuant to this
section.
6. Control the admission of physicians, surgeons and interns to
the staff by promulgating rules, regulations and standards governing such
appointments.
(Added to NRS by 1969, 1389; A 1987, 390; 2001, 469 )
The board of trustees of each county
hospital district shall prepare annual budgets in accordance with NRS
354.470 to 354.626 , inclusive.
(Added to NRS by 1969, 1389)
1. At the time of making the levy of county taxes for that year,
each board of trustees shall levy a tax sufficient, together with the
revenue which will result from application of the rate to the net
proceeds of minerals, to raise the amount so budgeted upon any real and
personal property that is subject to taxation within the boundaries of
the district. Any tax levied on interstate or intercounty telephone
lines, power lines and other public utility lines pursuant to this
section must be based upon valuations as established 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 county that is
included within the district; and
(b) Collected in the same manner as state and county taxes.
3. When the tax is collected it must be:
(a) Placed in the treasury of the county in which the district
hospital is located;
(b) Credited to the current expense fund of the district; 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 )
1. The board of trustees may borrow money and incur or assume
indebtedness on behalf of the county hospital district if the total
amount of the indebtedness, excluding revenue bonds and other securities
constituting special obligations which are not debts, does not exceed an
amount equal to 10 percent of the total of the last assessed valuation of
taxable property, excluding motor vehicles, located within the district.
2. The board of trustees shall not borrow money or issue
securities to evidence such borrowing until the board has obtained the
approval of the:
(a) Debt management commission; and
(b) Board of county commissioners,
Ê of each county in which the hospital district is located.
(Added to NRS by 1989, 1011; A 1995, 774; 1997, 3103, 3138; 1999,
639 )
The board of trustees may issue and sell,
for each district in its jurisdiction:
1. General obligation bonds, payable from taxes;
2. General obligation bonds, payment of which is additionally
secured by a pledge of gross or net revenues derived from the operation
of hospital facilities; and
3. Special obligation bonds, payable solely from gross or net
revenues derived from the operation of hospital facilities,
Ê for the purpose of providing funds for the purchase of hospital
equipment, the acquisition of property, the construction of buildings and
improvement of property owned by the district for use in any one county
hospital district.
(Added to NRS by 1969, 1389; A 1989, 1011)
The board of
trustees, with the approval of the board of county commissioners, if the
board of county commissioners is not the board of hospital trustees, or,
if the district in which the hospital is located includes territory
within more than one county, with the approval of the board of county
commissioners of each of those counties, may, by resolution:
1. Mortgage or pledge the personal property of the hospital,
including accounts receivable, and enter into agreements for the sale and
leasing back to the hospital of its personal property to provide security
for acquiring money for the operation of the hospital; and
2. Acquire real property for the expansion of the hospital by
entering into a contract for purchase of a type and duration and on such
terms as the governing body determines, including a contract secured by a
mortgage or other security interest in the real property.
(Added to NRS by 1997, 3100)
1. If a board of trustees desires to avail itself of the power
conferred by NRS 450.670 and submission
to the voters is required by the provisions of NRS 350.020 to 350.070 ,
inclusive, the board shall submit the question of issuing the bonds to
the registered voters of the district in accordance with those provisions.
2. The provisions of the Local Government Securities Law apply to
any bonds authorized to be issued pursuant to NRS 450.670 , except to the extent those provisions are
inconsistent with the provisions of NRS 450.550 to 450.750 ,
inclusive.
(Added to NRS by 1969, 1389; A 1981, 964; 1989, 1012)
Any person, firm, organization,
corporation or society desiring to make donations of money, personal
property or real property for the benefit of any district hospital may
make such donations to the district. Any such donation is effective when
accepted by the board of trustees according to the terms of the deed,
gift, devise or bequest of such property.
(Added to NRS by 1969, 1389)
1. The board of trustees may determine whether patients presented
to the district hospital for treatment are subjects of charity. Except as
otherwise provided in NRS 439B.330 ,
the board of trustees shall establish the criteria and procedures to be
used in the determination of eligibility for medical care as medical
indigents or subjects of charity.
2. The board of trustees shall fix the charges for treatment of
those persons who are able to pay for the treatment. The receipts for
those charges must be paid to the county treasurer of the county in which
the district hospital is located and credited by him to the fund for the
district.
(Added to NRS by 1969, 1389; A 1987, 390, 881; 1997, 3104, 3138;
1999, 639 )
1. A board of county commissioners may create a hospital district
in an area where no hospital district exists for the sole purpose of
contracting with a public agency or a privately owned hospital to provide
the services of a hospital to the residents of the district. If such a
contract 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 indebtedness pursuant to
NRS 450.665 .
2. A board of county commissioners shall not create a hospital
district pursuant to this section unless it determines that:
(a) The proposed hospital district constitutes a geographic area of
the county that is not served by adequate medical services;
(b) There is no county hospital or the county hospital is not
capable of providing the necessary services; and
(c) The proposal is approved by a majority of the votes cast on the
issue by persons in the proposed hospital district.
3. If a hospital district is created pursuant to this section, the
board of county commissioners may be designated by ordinance as, ex
officio, the board of trustees of the hospital district, notwithstanding
the provisions of subsection 3 of NRS 450.620 .
(Added to NRS by 1999, 2075 )
The board of trustees may contract with a public
agency or a privately owned hospital to provide the services of a
hospital to the residents of the hospital district if it determines that:
1. There is a need to provide medical services to the residents of
the district which are not being provided by the district; or
2. It is less costly or more efficient to provide the services of
a hospital to the residents of the district by contracting with a public
agency or a privately owned hospital.
(Added to NRS by 1999, 2075 )
1. The board of trustees may contract with a company which manages
hospitals for the rendering of management services in a district hospital.
2. The agreement may provide:
(a) That the chief executive officer of the hospital must be an
employee of the company which manages the hospital; and
(b) That the hospital may, in accordance with the requirements of
NRS 450.730 , purchase supplies,
materials and equipment through the purchasing contracts of the company
which manages the hospital, or through a purchasing group, without
complying with the requirements for competitive bidding set forth in
chapter 332 of NRS.
(Added to NRS by 1999, 2076 )
1. A district hospital may, with the approval of the board of
trustees, become a member of a purchasing group for the purpose of
purchasing supplies, materials and equipment used by the district
hospital.
2. A district hospital that becomes a member of a purchasing group
may, in accordance with the requirements of NRS 450.730 , purchase supplies, materials and equipment
through the purchasing group without complying with the requirements for
competitive bidding set forth in chapter 332
of NRS.
(Added to NRS by 1999, 2076 )
A district
hospital that is authorized pursuant to NRS 450.720 or 450.725
to purchase supplies, materials and equipment in accordance with this
section through the purchasing contracts of the company that manages the
hospital or through a purchasing group may purchase the supplies,
materials and equipment without complying 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 or purchasing
group, are summarized in writing and, together with a sworn statement by
an officer or agent of the company or purchasing group that the prices
were obtained by the company or purchasing group through a process of
competitive bidding, are presented to the board of trustees at its next
regularly scheduled meeting; and
2. The board of trustees, after reviewing the summary and
statement, finds that the proposed purchase will be made at a lower price
than the lowest price reasonably obtainable by the hospital through
competitive bidding pursuant to chapter 332
of NRS or available to the hospital pursuant to NRS 333.470 and approves the proposed purchase.
(Added to NRS by 1999, 2076 )
For the purposes of NRS 422.382 , if a hospital district created pursuant to
NRS 450.550 to 450.750 , inclusive, includes territory within more
than one county, the board of county commissioners of the county in which
the hospital is located shall be deemed to be the local government
responsible for transferring payments of money to the Department of
Health and Human Services for treatment of medically indigent patients
pursuant to the provisions of that section.
(Added to NRS by 1997, 3099)
In a county whose population is
less than 400,000:
1. Except as otherwise provided in subsection 2, if a majority of
the members of the board of county commissioners determine that it is in
the best interests of the county and of the hospital district that the
hospital district be dissolved, the board of county commissioners shall
so determine by ordinance, after there is first found, determined and
recited in the ordinance that:
(a) All outstanding indebtedness and bonds of all kinds of the
hospital district have been paid; and
(b) The services of the hospital district are no longer needed or
can be more effectively performed by an existing unit of government.
2. If the hospital district includes territory within more than
one county, the hospital district may be dissolved only if a majority of
the members of the board of county commissioners of each county included
within the district take the actions described in subsection 1.
3. In determining pursuant to subsection 1 whether the dissolution
of a hospital district is in the best interests of the county and of the
hospital district, a board of county commissioners must consider, without
limitation, whether:
(a) The hospital district is capable of providing sufficient health
care services to the residents of the county or counties within the
territory of the hospital district in an economical manner;
(b) The basic health care needs of the residents of the county or
counties within the territory of the hospital district will be met if the
hospital district is dissolved;
(c) There have been substantial changes in the financial status of
the hospital district during the immediately preceding 2 years; and
(d) There has been an increased tax burden on the residents of the
county or counties within the territory of the hospital district during
the immediately preceding 2 years.
4. The county clerk of each county within which any territory of
the hospital district is located shall thereupon certify a copy of the
ordinance to the board of trustees of the hospital district and shall
mail written notice to all qualified electors who reside within the
hospital district in his county, containing:
(a) The adoption of the ordinance;
(b) The determination of the board of county commissioners of that
county that the district should be dissolved; and
(c) The time and place for the hearing on the dissolution.
(Added to NRS by 2005, 1446 )
1. On or before the date fixed for the hearing on the dissolution
of a hospital district, any qualified elector who resides within the
hospital district may protest against the dissolution of the hospital
district by filing a written protest with the county clerk of the county
in which he resides.
2. If, at or before the time fixed by the ordinance and notice,
written protest is filed pursuant to subsection 1 by a majority of the
qualified electors who reside within the hospital district, the hospital
district must not be dissolved. If any written protests are filed and:
(a) If the hospital district does not include territory within more
than one county, the board of county commissioners determines that the
protests so filed represent less than a majority of the qualified
electors who reside within the hospital district, the board may complete
the dissolution by the adoption of a final ordinance of dissolution,
which ordinance must contain a recital of the protests, and the recital
is binding and conclusive for all purposes; or
(b) If the hospital district includes territory within more than
one county, the board of county commissioners of each county included
within the hospital district determines that the protests so filed
represent less than a majority of the qualified electors who reside
within the hospital district, the dissolution may be completed by the
adoption of a final ordinance of dissolution by the board of county
commissioners of each county included within the hospital district, which
ordinance must contain a recital of the protests, and the recital is
binding and conclusive for all purposes.
(Added to NRS by 2005, 1446 )
Except as otherwise provided in subsection 2 of NRS
450.753 , at the place, date and hour
specified for the hearing on the dissolution of a hospital district in
the notice mailed pursuant to NRS 450.751 or at any subsequent time to which the hearing
may be adjourned, the board of county commissioners of each county within
which any territory of the hospital district is located shall give full
consideration to all protests which have been filed pursuant to NRS
450.753 and shall hear all persons
desiring to be heard and shall thereafter adopt either the final
ordinance of dissolution or an ordinance determining that the hospital
district must not be dissolved. The dissolution may be completed by the
adoption of a final ordinance of dissolution by the board of county
commissioners of each county included within the hospital district.
(Added to NRS by 2005, 1447 )
Within 30 days after the
effective date of each ordinance which is required for the dissolution of
a hospital district pursuant to NRS 450.753 or 450.755 ,
each county clerk shall file a copy of the ordinance in his office and
shall cause to be filed an additional copy of the ordinance in the Office
of the Secretary of State, which filings must be without fee and must
otherwise be filed in the same manner as articles of incorporation are
required to be filed under chapter 78 of NRS.
(Added to NRS by 2005, 1447 )
In
a county whose population is less than 400,000:
1. All outstanding and unpaid tax sales and levies and all special
assessment liens of a dissolved hospital district are valid and remain a
lien against the property against which they are assessed or levied until
paid, subject to the limitations of liens provided by general law. Taxes
and special assessments paid after the dissolution of a hospital district
must be placed in the general fund of the county in which the district
hospital was located.
2. The board of county commissioners of the county in which the
district hospital was located has the same power to enforce the
collection of all special assessments and outstanding tax sales of the
hospital district as the hospital district had if it had not been
dissolved.
(Added to NRS by 2005, 1447 )
In a county
whose population is less than 400,000:
1. Before dissolving a hospital district pursuant to NRS 450.751
to 450.760 , inclusive, the board of county commissioners
of the county in which the district hospital is located shall determine
whether the proceeds from the taxes currently being levied in the
hospital district, if any, for the operation of the hospital and the
repayment of debt are sufficient to repay any outstanding obligations of
the hospital district within a reasonable period after the dissolution of
the hospital district. If there are no taxes currently being levied for
the hospital district or the taxes being levied are not sufficient to
repay the outstanding obligations of the hospital district within a
reasonable period after the dissolution of the hospital district, before
dissolving the hospital district pursuant to NRS 450.751 to 450.760 ,
inclusive:
(a) If the hospital district does not include territory within more
than one county, the board of county commissioners may levy a property
tax on all of the taxable property in the hospital district that is
sufficient, when combined with any revenue from taxes currently being
levied in the hospital district, to repay the outstanding obligations of
the hospital district within a reasonable period after the dissolution of
the hospital district; or
(b) If the hospital district includes territory within more than
one county, the board of county commissioners of each county within which
any territory of the hospital district is located may levy a property tax
on all of the taxable property in the county that is within the hospital
district that is sufficient, when combined with any revenue from taxes
currently being levied in the hospital district, to repay the outstanding
obligations of the hospital district within a reasonable period after the
dissolution of the hospital district.
2. The allowed revenue from taxes ad valorem determined pursuant
to NRS 354.59811 does not apply to
any additional property tax levied pursuant to subsection 1. If the
hospital district is being managed by the Department of Taxation pursuant
to NRS 354.685 to 354.725 , inclusive, at the time of dissolution, the
rate levied pursuant to subsection 1 must not be included in the total ad
valorem tax levy for the purposes of the application of the limitation in
NRS 361.453 , but the rate levied when
combined with all other overlapping rates levied in the State must not
exceed $4.50 on each $100 of assessed valuation. A board of county
commissioners shall discontinue any rate levied pursuant to subsection 1
on a date that will ensure that no taxes are collected for this purpose
after the outstanding obligations of the hospital district have been paid
in full.
3. If, at the time of the dissolution of the hospital district
pursuant to NRS 450.751 to 450.760
, inclusive, there are any outstanding
loans, bonded indebtedness or other obligations of the hospital district,
including, without limitation, unpaid obligations to organizations such
as the Public Employees’ Retirement System, unpaid salaries or unpaid
loans made to the hospital district by the county, the taxes being levied
in the hospital district at the time of dissolution must continue to be
levied and collected in the same manner as if the hospital district had
not been dissolved until all outstanding obligations of the hospital
district have been paid in full, but for all other purposes, the hospital
district shall be considered dissolved from the date on which each board
of county commissioners of each county included within the hospital
district has adopted a final ordinance of dissolution pursuant to NRS
450.753 or 450.755 .
4. If the hospital district is being managed by the Department of
Taxation pursuant to NRS 354.685 to
354.725 , inclusive, at the time of
dissolution, the management ceases upon dissolution, but the board of
county commissioners of the county in which the district hospital was
located shall continue to make such financial reports to the Department
of Taxation as the Department deems necessary until all outstanding
obligations of the hospital district have been paid in full.
5. The property of the dissolved hospital district may be retained
by the board of county commissioners of the county in which the district
hospital was located for use as a hospital or disposed of in any manner
the board deems appropriate.
6. Any proceeds of the sale or other transfer of the property of
the dissolved hospital district and any proceeds from taxes which had
been levied and received by the hospital district before dissolution,
whether levied for operating purposes or for the repayment of debt, must
be used by the board of county commissioners of the county in which the
district hospital was located to repay any indebtedness of the hospital
district.
(Added to NRS by 1999, 86 ; A 2005, 1448 )
MISCELLANEOUS PROVISIONS
1. In addition to having the powers conferred under chapter 277
of NRS, a county or district hospital may
contract with a private hospital or other organization for emergency
medical services, including the transportation of patients, or any other
services performed in connection with or related to the operation of a
hospital. The services may be performed by the parties to the contract or
the parties may establish a separate organization for that purpose.
2. A county or district hospital may enter into a contract to
provide services:
(a) For persons, whether or not admitted to the hospital, if those
services are performed in connection with or related to the operation of
the hospital.
(b) Necessary for the health and welfare of the general public.
(Added to NRS by 1981, 511; A 1987, 391)
