Sections 3,7 4 and 1518 ofprescribe thiserequirements billgoverning define certain terms, and section 2 of this bill establishes the applicabilityuse of thea definitionsremote setinterpreter. forth in sections 3 and 4.

Sections 93, 4 and 1015 of this bill makedefine conformingcertain changesterms, toand establishsection 2 of this bill establishes the applicability of certainthe provisions.definitions set forth in sections 3 and 4.

-Sections 83rd9 Sessionand (2025)10 –of 2this –bill 20 and 21 of this bill prescribe various mechanisms for the enforcement of sections 5-8 andand3, 16-19, including the imposition of administrative sanctions against a health facility that fails to comply with those provisions and professional discipline against a provider of health care who fails to comply with those provisions.

EXPLANATION – Matter in bolded italics is new;

matter between brackets [omitted material] is material to be omitted.

In determining whether a particular action is necessary to comply with subsection 1, a health facility shall, and in determining whether a health facility is in compliance with sub(a)subsection Evaluate,1, and give substantial weight to, the natureDivision andshall: importance of the services or programs provided by the health facility and the relevant communications to the person with limited English proficiency;

(a) Evaluate, and give substantial weight to, the nature and importance of the services or programs provided by the health facility and the relevant communications to the person with limited English proficiency;

-(b) 83rdBe Sessionaccurate (2025)in –translation 3or –interpretation and provided in a timely manner;

andn translation or interpretation and provided in (c) Protect the privacy and ability of the person with limited English proficiency to make independent decisions.

4.Assembly Amendment No.

560 to Senate Bill No.

188 First Reprint Page 5 4.

A health facility shall ensure that a translator who is qualified pursuant to section 8 of this act reviews a machine-machine-translated translated document if the document:

(b) Must be accurately translated to ensure compliance with subsection 1 or protect the health and well-being of a person with limited English proficiency;

or (d) Utilize an employee, a contractor or a volunteer of the health facility who is not an interpreter or a translator qualified pursuant to section 8 of this act to interpret or facilitate communication for a person with limited English proficiency.

-(b) 83rdAn Sessioninterpreter (2025)who – 4 – act is notqualified immediately available;ified pursuant to section 8 of this (c)act The health facility is attemptingnot toimmediately findavailable; an interpreter who is qualified pursuant to section 8 of this act;

(c) The health facility is attempting to find an interpreter who is qualified pursuant to section 8 of this act;

(c) Documented in the record of the person with limited Eng(d)English Deemedproficiency; appropriate under the circumstances by the person providing the program or service on behalf of the health facility.

and (d) Deemed appropriate under the circumstances by the person providing the program or service on behalf of the health facility.

A health facility may use a remote interpreter to provide interpreting services necessary to comply with section 5 of this act if the health facilityAssembly utilizesAmendment audio-visualNo. communication technology or audio communication technology that includes, without limitation, synchronous interaction with audio and, if applicable, video over a high-speed, wide-bandwidth connection or wireless connection that, to the extent possible:

560 to Senate Bill No.

188 First Reprint Page 6 facility utilizes audio-visual communication technology or audio communication technology that includes, without limitation, synchronous interaction with audio and, if applicable, video over a high-speed, wide-bandwidth connection or wireless connection that, to the extent possible:

and (c) If applicable, produces a high-quality video image that is not blurry or grainy and is large enough to display the face of the ofinterpreter bodyand position.ersonperson with limited English proficiency, regardless 2.of body position.

2.

- 83rd Session (2025) – 5 – Sec.

Has demonstrated proficiency in and understanding of spo(a)spoken Englishor andwritten, atas leastapplicable: one other language;

(a) English and at least one other language;

Any facility conducted by and for the adherents of any church or religious denomination for the purpose of providing facilities for the care and treatment of the sick who depend solely upon spiritual means through prayer for healing in the practice of the religion of the church or denomination, except that such a facility shall comply with all regulations relative to sanitation and saf2.ysafety aFosterapplicable homesto asother definedfacilities inof NRSa 424.014.larsimilar category.

2.

Foster homes as defined in NRS 424.014.

(a) Violation by the applicant or the licensee of any of the provisions of NRS 439B.410, 449.029 to 449.245, inclusive, and sections 2 to 8, inclusive, of this act, or 449A.100 to 449A.124, inclusive, and 449A.270 to 449A.286, inclusive, or of anyAssembly otherAmendment lawNo. - 83rd Session (2025) – 6 – thereunder.te or of the standards, rules and regulations adopted (b) Aiding, abetting or permitting the commission of any illegal act.

560 to Senate Bill No.

188 First Reprint Page 7 any other law of this State or of the standards, rules and regulations adopted thereunder.

(b) Aiding, abetting or permitting the commission of any illegal act.

(e) Failure of the applicant to obtain written approval from the Director of the Department of Health and Human Services as required by NRS 439A.100 or 439A.102 or as provided in any regulation adopted pursuant to NRS 449.001 to 449.430, inclusive, and sections 2 to 8, inclusive, of this act and 449.435 to 449.531, inclusive, and chapter 449A of NRS if such approval is required, including, without limitation, the closure or conversion of any hospital in a county whose population is 100,000 or more that is own(f)owned Failureby to comply with the provisionslicensee ofwithout NRSapproval 441A.315 and any regulations adopted pursuant theretoto or NRS 449.2486.439A.102.

(f) Failure to comply with the provisions of NRS 441A.315 and any regulations adopted pursuant thereto or NRS 449.2486.

or (c) Is ordered by the appropriate governmental agency to correct toa correctviolation theof violation.,a building, safety or health code or regulation but fails 3.to correct the violation.

3.

-(b) 83rdA Sessionreport (2025)of –any 7investigation –conducted with respect to the complaint;

andtand of any investigation conducted with respect to the (c) A report of any disciplinary action taken against the facility.

In addition to the payment of the amount required by NRS 449.0308, if a medical facility, facility for the dependent or facility which is required by the regulations adopted by the Board pursuant to NRS 449.0303 to be licensed violates any provision 449.029related to 449.2428,its inclusive,licensure, andincluding sectionsany 2provision toof 8,NRS inclusive,439B.410 ofor this act or any449.029 condition,to standard449.2428, orinclusive, regulationand adoptedsections by2 theto Board,8, theinclusive, Division,of inAssembly accordanceAmendment withNo. the regulations adopted pursuant to NRS 449.165, may:

560 to Senate Bill No.

188 First Reprint Page 8 this act or any condition, standard or regulation adopted by the Board, the Division, in accordance with the regulations adopted pursuant to NRS 449.165, may:

(d) Except where a greater penalty is authorized by subsection 2, impose an administrative penalty of not more than $5,000 per day for each violation, together with interest thereon at a rate not to exceed 10 percent per annum;

andhand interest thereon at a rate not to (e) Appoint temporary management to oversee the operation of the facility and to ensure the health and safety of the patients of the facility, until:

-2. 83rd Session (2025) – 8 – national provider identifier that is distinct from the national provider identifier used by the main campus and any other off-campus location of the hospital in violation of NRS 449.1818, the Division may impose against the hospital an administrative penalty of not more than $10,000 for each day of such failure, together with interest thereon at a rate not to exceed 10 percent per annum, in addition to any other action authorized by this chapter.

If an off-campus location of a hospital fails to obtain a national provider identifier that is distinct from the national provider identifier used by the main campus and any other off-campus location of the hospital in violation of NRS 449.1818, the Division may impose against the hospital an administrative penalty of not more than $10,000 for each day of such failure, together with interest thereon at a rate not to exceed 10 percent per annum, in addition to any other action authorized by this chapter.

The Division may require any facility that violates any provision of NRS 439B.410 or 449.029 to 449.2428, inclusive, and sections 2 to 8, inclusive, of this act or any condition, standard or regulation adopted by the Board to make any improvements,improvements standard or necessary to correct the violation.

449.240 The district attorney of the county in which the facility is located shall, upon application by the Division, institute and conduct the prosecution of any action for violation of any provisions inclusive, of thisNRS act.45,449.029 to 449.245, inclusive [.] , and sections 2 to 8, Sec.inclusive, of this act.

Sec.

-Assembly 83rdAmendment SessionNo. (2025) – 9 – Sec.

560 to Senate Bill No.

188 First Reprint Page 9 Sec.

In determining whether a particular action is necessary to com(a)comply Evaluate,with andsubsection give1, substantiala weight to, the nature and importance of the services or programs provided by the provider of health care andshall: the relevant communications to the person with limited English proficiency;

(a) Evaluate, and give substantial weight to, the nature and importance of the services or programs provided by the provider of health care and the relevant communications to the person with limited English proficiency;

A provider of health care shall ensure that a machine-machine-translated document is reviewed by a translator who is qualified pursuant to section 19 of this act if the document:

is qualified (a) Relates to the rights of a person with limited English proficiency, the goods or services provided by the provider of health care or the ability of a person with limited English proficiency to obtain necessary health care;

(b) Utilize an adult who is not qualified as an interpreter pursuant to section 19 of this act to interpret or facilitate - 83rd Session (2025) – 10 – communication for a person with limited English proficiency except where authorized pursuant to subsection 2 or 3;

(c) Utilize a child who is less than 18 years of age to interpret or facilitate communication for a person with limited English pro(d)proficiency Utilizeexcept awhere personauthorized under the supervision of the provider of health care who is not an interpreter or a translator qualified pursuant to sectionsubsection 192; of this act to interpret or facilitate communication for a person with limited English proficiency.

or (d) Utilize a person under the supervision of the provider of health care who is not an interpreter or a translator qualified pursuant to section 19 of this act to interpret or facilitate communication for a person with limited English proficiency.

(c)Assembly TheAmendment providerNo. of health care is attempting to find an interpreter who is qualified pursuant to section 19 of this act;

560 to Senate Bill No.

188 First Reprint Page 10 (c) The provider of health care is attempting to find an interpreter who is qualified pursuant to section 19 of this act;

A provider of health care may utilize an adult who is not qualified as an interpreter pursuant to section 19 of this act to interpret or facilitate communication for a person with limited English proficiency if the person with limited English proficiency requests for the adult to interpret or facilitate communication for him or her.

or facilitate communication for (a) Made without the adult present to an interpreter who is qualified pursuant to section 19 of this act;

A provider of health care may use a remote interpreter to provide interpreting services necessary to comply with section 16 of this act if the provider of health care utilizes audio-visual communication technology or audio communication technology that includes, without limitation, synchronous interaction with audio and, if applicable, video over a high-speed, -wide- 83rdbandwidth Session (2025) – 11 – wide-bandwidth connection or wireless connection that, to the extent possible:

and(b)(b) Provides transmission of voice that is clear and audible;

and (c) If applicable, produces a high-quality video image that is not blurry or grainy and is large enough to display the face of the interpreter and person with limited English proficiency, regardless of body position.

Has demonstrated proficiency in interpreting or translating, as applicable, effectively, accurately and impartially, including, without limitation, using specialized vocabulary or terSec.terms without change, omission or addition.

Sec.

1.changA1. provider of health care who violates any provision of sections 15 to 20, inclusive, of this act may be disciplined by the board, agency or other entity in this State by which he or she is licensed, certified or regulated.

A provider of health care who violates any provision of sections 15 to 20, inclusive, of this act [is guilty of unprofessional conduct and is subject to disciplinary action] may be disciplined by the board, agency or other entity in this State by which he or she is licensed, certified or regulated.

Sec.Assembly Amendment No.

560 to Senate Bill No.

188 First Reprint Page 11 Sec.

The Board may, after notice and an opportunity for a hearing as required by law, impose an administrative fine of not more than $10,000 for each violation on, recover reasonable investigative fees and costs incurred from, suspend, revoke, deny the issuance or renewal of or place conditions on the license of, and - 83rd Session (2025) – 12 – place on probation or impose any combination of the foregoing on any licensee who:

(d) Aids or abets any person in the violation of any of the provisions of NRS 449.029 to 449.2428, inclusive, and sections 2 to 8, inclusive, of this act or 449A.100 to 449A.124, inclusive, and 449A.270 to 449A.286, inclusive, as those provisions pertain to a facility for skilled nursing, facility for intermediate care or a residential facility for groups.

~~~~~ 25 - 83rd Session (2025)