Nevada Revised Statutes
Chapter 449A - Care and Rights of Patients
NRS 449A.636 - Provider to comply with advance directive; exceptions.


1. When acting under the authority of an advance directive for psychiatric care, an attending physician or other provider of health care shall comply with the advance directive unless:
(a) Compliance, in the opinion of the attending physician or other provider, is not consistent with generally accepted standards of care for the provision of psychiatric care for the benefit of the principal;
(b) Compliance is not consistent with the availability of psychiatric care requested;
(c) Compliance is not consistent with applicable law;
(d) The principal is admitted to a mental health facility or hospital pursuant to NRS 433A.145 to 433A.330, inclusive, or required to receive assisted outpatient treatment pursuant to NRS 433A.335 to 433A.345, inclusive, and a course of treatment is required pursuant to those provisions; or
(e) Compliance, in the opinion of the attending physician or other provider, is not consistent with appropriate psychiatric care in case of an emergency endangering the life or health of the principal or another person.
2. In the event that one part of the advance directive is unable to be followed because of any of the circumstances set forth in subsection 1, all other parts of the advance directive must be followed.
(Added to NRS by 2017, 696; A 2021, 3112)

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Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 449A - Care and Rights of Patients

NRS 449A.001 - Definitions. [Effective through December 31, 2021.] Definitions. [Effective January 1, 2022.]

NRS 449A.003 - "Agency to provide nursing in the home" defined. [Effective through December 31, 2021.]

NRS 449A.005 - "Agency to provide personal care services in the home" defined. [Effective through December 31, 2021.]

NRS 449A.007 - "Board" defined.

NRS 449A.009 - "Community-based living arrangement services" defined. [Effective through December 31, 2021.]

NRS 449A.011 - Community health worker" defined. [Effective through December 31, 2021.]

NRS 449A.013 - Community health worker pool" defined. [Effective through December 31, 2021.]

NRS 449A.015 - "Community triage center" defined. [Effective through December 31, 2021.]

NRS 449A.017 - "Division" defined.

NRS 449A.019 - "Facility for hospice care" defined. [Effective through December 31, 2021.]

NRS 449A.021 - "Facility for intermediate care" defined. [Effective through December 31, 2021.]

NRS 449A.023 - "Facility for modified medical detoxification" defined. [Effective through December 31, 2021.]

NRS 449A.025 - "Facility for refractive surgery" defined. [Effective through December 31, 2021.]

NRS 449A.027 - "Facility for skilled nursing" defined. [Effective through December 31, 2021.]

NRS 449A.029 - "Facility for the care of adults during the day" defined. [Effective through December 31, 2021.]

NRS 449A.031 - "Facility for the dependent" defined.

NRS 449A.033 - "Facility for the treatment of alcohol or other substance use disorders" defined. [Effective through December 31, 2021.]

NRS 449A.035 - "Facility for the treatment of irreversible renal disease" defined. [Effective through December 31, 2021.]

NRS 449A.037 - "Facility for transitional living for released offenders" defined. [Effective through December 31, 2021.]

NRS 449A.039 - "Halfway house for persons recovering from alcohol or other substance use disorders" defined. [Effective through December 31, 2021.]

NRS 449A.041 - "Home for individual residential care" defined. [Effective through December 31, 2021.]

NRS 449A.043 - "Hospice care" defined. [Effective through December 31, 2021.]

NRS 449A.045 - "Hospital" defined.

NRS 449A.047 - "Independent center for emergency medical care" defined. [Effective through December 31, 2021.]

NRS 449A.050 - "Medical facility" defined. [Effective through December 31, 2021.] "Medical facility" defined. [Effective January 1, 2022.]

NRS 449A.052 - "Mobile unit" defined. [Effective through December 31, 2021.]

NRS 449A.054 - "Nursing pool" defined. [Effective through December 31, 2021.]

NRS 449A.056 - "Obstetric center" defined. [Effective through December 31, 2021.]

NRS 449A.058 - "Palliative services" defined. [Effective through December 31, 2021.]

NRS 449A.060 - Peer support recovery organization" defined. [Effective through December 31, 2021.]

NRS 449A.062 - Peer support services" defined. [Effective through December 31, 2021.]

NRS 449A.064 - "Provider of health care" defined.

NRS 449A.066 - "Provider of supported living arrangement services" defined. [Effective through December 31, 2021.]

NRS 449A.068 - "Psychiatric hospital" defined. [Effective through December 31, 2021.]

NRS 449A.071 - "Registered nurse" defined.

NRS 449A.073 - "Residential facility for groups" defined. [Effective through December 31, 2021.]

NRS 449A.075 - "Rural clinic" defined. [Effective through December 31, 2021.]

NRS 449A.077 - "Supported living arrangement services" defined. [Effective through December 31, 2021.]

NRS 449A.079 - "Surgical center for ambulatory patients" defined. [Effective through December 31, 2021.]

NRS 449A.081 - "Terminally ill" defined.

NRS 449A.100 - Facility to provide necessary services or arrange for transfer of patient; explanation of need for transfer and alternatives available.

NRS 449A.103 - Facility to forward medical records upon certain transfers of patient.

NRS 449A.106 - Specific rights: Information concerning facility; treatment; billing; visitation.

NRS 449A.109 - Specific rights: Designation of persons authorized to visit patient in facility.

NRS 449A.112 - Specific rights: Care; refusal of treatment and experimentation; privacy; notice of appointments and need for care; confidentiality of information concerning patient.

NRS 449A.114 - Certain facilities to notify patient and State Long-Term Care Ombudsman of intent to transfer patient and provide opportunity for patient or representative to meet with administrator; exceptions. [Effective through December 31, 2021.]...

NRS 449A.115 - Owner and administrator of certain facility prohibited from receiving certain money or property from resident or former resident; exception.

NRS 449A.118 - Patient to be informed of rights upon admission to facility; required disclosures and notices.

NRS 449A.121 - Procedure to insert implant in breast of patient: Informed consent required; withdrawal of consent; penalty.

NRS 449A.124 - Procedure to insert implant in breast of patient: Contents of explanation form and consent form; fee for forms.

NRS 449A.150 - Definitions.

NRS 449A.153 - "Hospital care" defined.

NRS 449A.156 - "Responsible party" defined.

NRS 449A.159 - Limitations on efforts of hospitals to collect; date for accrual of interest; rate of interest; limitations on additional fees.

NRS 449A.162 - Limitations on efforts of hospital to collect when hospital has contractual agreement with third party that provides health coverage for care provided; return to patient of any excess amount collected; exception. [Effective through Dec...

NRS 449A.165 - Manner of collection.

NRS 449A.200 - Definitions.

NRS 449A.203 - "Aversive intervention" defined.

NRS 449A.206 - "Chemical restraint" defined.

NRS 449A.209 - "Corporal punishment" defined.

NRS 449A.212 - "Electric shock" defined.

NRS 449A.215 - "Emergency" defined.

NRS 449A.218 - "Facility" defined. [Effective through December 31, 2021.] "Facility" defined. [Effective January 1, 2022.]

NRS 449A.221 - "Mechanical restraint" defined.

NRS 449A.224 - "Person with a disability" defined.

NRS 449A.227 - "Physical restraint" defined.

NRS 449A.230 - "Verbal and mental abuse" defined.

NRS 449A.233 - Aversive intervention: Prohibition on use.

NRS 449A.236 - Forms of restraint: Restrictions on use.

NRS 449A.239 - Physical restraint: Permissible use; report of use in emergency.

NRS 449A.242 - Mechanical restraint: Permissible use; report of use in emergency.

NRS 449A.245 - Chemical restraint: Permissible use; report of use.

NRS 449A.248 - Authorized use of certain forms of restraint by certain facilities.

NRS 449A.251 - Education and training of members of staff of facility.

NRS 449A.254 - Violations: Criminal penalties; ineligibility for employment; disciplinary action.

NRS 449A.257 - Violations: Report required; development and review of and compliance with corrective plan.

NRS 449A.260 - Prohibition on retaliation against person for reporting or providing information regarding violation.

NRS 449A.263 - Entry of denial of rights in patient’s record; notice and report of denial; action by Division.

NRS 449A.300 - Definitions.

NRS 449A.303 - Aftercare" defined.

NRS 449A.306 - Caregiver" defined.

NRS 449A.309 - Representative of the patient" defined.

NRS 449A.312 - Designation of caregiver for a patient, removal of designation and designation of new caregiver under certain circumstances; designation does not establish obligation to patient.

NRS 449A.315 - Hospital to provide opportunity to designate caregiver for patient before discharge or when patient regains competence.

NRS 449A.318 - Hospital to record designation or change of caregiver and request consent to release medical information to caregiver if required; hospital to record declination to designate caregiver.

NRS 449A.321 - Hospital to attempt to notify caregiver before planned discharge or transfer of patient.

NRS 449A.324 - Hospital to attempt to provide caregiver with discharge plan; contents of discharge plan; hospital to attempt to consult with caregiver regarding aftercare.

NRS 449A.327 - Hospital to document certain actions and instructions in medical record of patient; hospital to proceed with planned discharge or transfer of patient if unable to reach caregiver.

NRS 449A.330 - Hospital and employees and contractors of hospital not liable for aftercare provided improperly or not provided by caregiver.

NRS 449A.400 - Short title; uniformity of application and construction.

NRS 449A.403 - Definitions.

NRS 449A.406 - "Advanced practice registered nurse" defined.

NRS 449A.409 - "Attending advanced practice registered nurse" defined.

NRS 449A.412 - "Attending physician" defined.

NRS 449A.415 - "Declaration" defined.

NRS 449A.418 - "Life-sustaining treatment" defined.

NRS 449A.421 - "Person" defined.

NRS 449A.424 - "Provider of health care" defined.

NRS 449A.427 - "Qualified patient" defined.

NRS 449A.430 - "Terminal condition" defined.

NRS 449A.433 - Declaration relating to use of life-sustaining treatment.

NRS 449A.436 - Form of declaration directing physician or advanced practice registered nurse to withhold or withdraw life-sustaining treatment.

NRS 449A.439 - Form of declaration designating another person to decide to withhold or withdraw life-sustaining treatment.

NRS 449A.442 - Time declaration becomes operative; duty of providers of health care.

NRS 449A.445 - Revocation of declaration; entry of revocation in medical records of declarant.

NRS 449A.448 - Recording determination of terminal condition and declaration.

NRS 449A.451 - Treatment of qualified patients; withholding or withdrawal of artificial nutrition and hydration; treatment of pregnant patient.

NRS 449A.454 - Written consent to withhold or withdraw life-sustaining treatment.

NRS 449A.457 - Transfer of care of declarant.

NRS 449A.460 - Immunity from civil and criminal liability and discipline for unprofessional conduct.

NRS 449A.463 - Consideration of declaration and other factors; failure to follow directions of patient.

NRS 449A.466 - Assumption of validity of declaration; presumption of intent to use, withhold or withdraw life-sustaining treatment not created.

NRS 449A.469 - Death does not constitute suicide or homicide; effect of declaration on policy of insurance; prohibiting or requiring execution of declaration prohibited as condition for insurance or receipt of health care.

NRS 449A.472 - Penalties.

NRS 449A.475 - Actions contrary to reasonable medical standards not required; mercy-killing, assisted suicide or euthanasia not authorized.

NRS 449A.478 - Other right or responsibility regarding use of life-sustaining treatment or withholding or withdrawal of medical care not limited.

NRS 449A.481 - Validity of declaration executed in another state; effect of previously executed instrument.

NRS 449A.500 - Definitions.

NRS 449A.503 - "Advanced practice registered nurse" defined.

NRS 449A.506 - "Attending advanced practice registered nurse" defined.

NRS 449A.509 - "Attending physician" defined.

NRS 449A.512 - "Attending physician assistant" defined.

NRS 449A.515 - "Do-not-resuscitate identification" defined.

NRS 449A.518 - "Do-not-resuscitate order" defined.

NRS 449A.521 - "Emergency care" defined.

NRS 449A.524 - "Health care facility" defined.

NRS 449A.527 - "Life-resuscitating treatment" defined.

NRS 449A.530 - "Life-sustaining treatment" defined.

NRS 449A.533 - "Other types of advance directives" defined.

NRS 449A.536 - "Physician assistant" defined.

NRS 449A.539 - "Provider of health care" defined.

NRS 449A.542 - "Provider Order for Life-Sustaining Treatment form" or "POLST form" defined.

NRS 449A.545 - "Representative of the patient" defined.

NRS 449A.548 - Board to prescribe standardized POLST form; requirements.

NRS 449A.551 - Explanation of POLST form to patient; completion of form; validity of form; actions authorized for patient who regains capacity.

NRS 449A.554 - Revocation of POLST form; entry of revocation in medical records of patient.

NRS 449A.557 - Conflict with other advance directive or do-not-resuscitate identification.

NRS 449A.560 - Immunity from civil and criminal liability and from discipline for unprofessional conduct.

NRS 449A.563 - Provider of health care required to comply with valid POLST form; modification by provider; transfer of care of patient; exceptions.

NRS 449A.566 - Assumption of validity of POLST form; presumption of intent of patient not created if patient has revoked or not executed POLST form.

NRS 449A.569 - Death does not constitute suicide or homicide; effect of POLST form on policy of insurance; prohibiting or requiring execution of POLST form prohibited as condition for insurance or receipt of health care.

NRS 449A.572 - Unlawful acts; penalty.

NRS 449A.575 - Actions contrary to reasonable medical standards not required; mercy-killing, euthanasia or assisted suicide not authorized; rights associated with other advance directives not impaired; right to make decisions concerning emergency car...

NRS 449A.578 - Validity of POLST form executed in another state.

NRS 449A.581 - Regulations.

NRS 449A.600 - Definitions.

NRS 449A.603 - "Advance directive for psychiatric care" or "advance directive" defined.

NRS 449A.606 - "Attending physician" defined.

NRS 449A.609 - "Principal" defined.

NRS 449A.612 - "Provider of health care" defined.

NRS 449A.615 - "Psychiatric care" defined.

NRS 449A.618 - Execution of advance directive; period of effectiveness.

NRS 449A.621 - Form.

NRS 449A.624 - Requirements for advance directive to become operative; effect.

NRS 449A.627 - No presumption concerning intention of person without advance directive.

NRS 449A.630 - Provider to make advance directive part of principal’s medical record.

NRS 449A.633 - Revocation.

NRS 449A.636 - Provider to comply with advance directive; exceptions.

NRS 449A.639 - Transfer of care of principal.

NRS 449A.642 - Provider to inquire whether person has advance directive for psychiatric care; immunity from liability for certain actions relating to advance directive.

NRS 449A.645 - Validity of advance directive executed in another state or instrument executed before May 26, 2017.

NRS 449A.700 - Definitions.

NRS 449A.703 - "Advance directive" defined.

NRS 449A.706 - "Registrant" defined.

NRS 449A.709 - "Registry" defined.

NRS 449A.712 - Establishment and maintenance; information to be included in Registry.

NRS 449A.715 - Registration of advance directive: Requirements; duties of Secretary of State.

NRS 449A.718 - Access to advance directive.

NRS 449A.721 - Removal of advance directive of deceased registrant.

NRS 449A.724 - Secretary of State not required to determine accuracy of contents of advance directive or validity of advance directive; effect of registration, failure to register and failure to notify Secretary of State of revocation of advance dire...

NRS 449A.727 - Provider of health care not required to inquire whether patient has registered advance directive or access Registry; immunity of provider of health care from criminal and civil liability.

NRS 449A.730 - Immunity of Secretary of State and deputies, employees and attorneys of Secretary of State.

NRS 449A.733 - Suspension of components of Registry and duties of Secretary of State if sufficient money not available; fees authorized; acceptance of gifts and grants.

NRS 449A.736 - Deposit, accounting and use of money received; interest and income earned on money received; payment of claims.

NRS 449A.739 - Regulations.