AB281A - Revises provisions governing senior living facilities. (BDR 40-457)

EXEMPT (Reprinted with amendments adopted on June 3, 2023) SECOND REPRINT A.B. 281 - *AB281_R2* ASSEMBLY BILL NO. 281–ASSEMBLYMEN GORELOW; ANDERSON, CARTER, COHEN, DURAN AND NGUYEN MARCH 14, 2023 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions governing senior living facilities. (BDR 40-457) FISCAL NOTE: Effect on Local Government: No. Effect on the State: No. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to health care; requiring the administrators of certain senior living facilities to ensure that such a senior living facility is equipped with a functional ventilation system; establishing requirements governing the detection of carbon dioxide at such a senior living facility; establishing requirements for the assessment of and any repair, upgrade or installation to heating, ventilation and air-conditioning systems at such senior living facilities; requiring certain personnel to complete and review an assessment report on such a ventilation system; requiring the administrators of certain senior living facilities to prepare a report on work performed on such a ventilation system; providing that such a report is a public record; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law sets forth various requirements for certain medical facilities that 1 provide care to persons who are aged or infirm, including, without limitation, a 2 facility for intermediate care, facility for skilled nursing, a residential facility for 3 groups and a home for individual residential care. (Chapter 449 of NRS) This bill 4 establishes requirements for the heating, ventilation and air-conditioning systems of 5 a senior living facility. 6 Section 7 of this bill defines “senior living facility” as any facility that receives 7 any federal funding from Medicare, Medicaid or other federal health care program 8 and which provides living assistance and related care to a resident of the facility 9 who is an aged or infirm person, including, without limitation, a facility for 10 intermediate care, facility for skilled nursing, a residential facility for groups and a 11 – 2 – - *AB281_R2* home for individual residential care. Sections 3-8.7 of this bill define other terms 12 related to ventilation systems in senior living facilities. 13 Section 9 of this bill sets forth a legislative declaration relating to ventilation 14 systems in senior living facilities. Section 9.2 of this bill limits the applicability of 15 the provisions of this bill to senior living facilities located in a county whose 16 population is 100,000 or more (currently Clark and Washoe Counties). Section 9.5 17 of this bill requires the State Board of Health to review each new edition of certain 18 standards incorporated into this bill to determine their suitability for this State. 19 Section 10 of this bill requires, to the extent money is available, the 20 administrator of a senior living facility to ensure that the senior living facility is 21 equipped with a functional ventilation system and to have periodic assessments of 22 the existing system conducted by qualified adjusting personnel or qualified testing 23 personnel. Section 10 also authorizes a facility that is certified as an assisted living 24 facility to use certain federal money received to upgrade and maintain the 25 ventilation system of that facility. 26 Section 14 of this bill prescribes requirements governing carbon dioxide 27 detectors at a senior living facility. Section 14 also requires the administrator of a 28 senior living facility to cause an adjustment to the ventilation if the concentration of 29 carbon dioxide exceeds a certain amount. 30 Section 14.5 of this bill sets forth the requirements for qualified testing 31 personnel to assess the heating, ventilation and air-conditioning system of a senior 32 living facility. Section 14.5 also requires qualified testing personnel to prepare a 33 heating, ventilation and air-conditioning assessment report, including certain 34 information relating to the assessments conducted pursuant to that section. 35 Section 18 of this bill: (1) requires a heating, ventilation and air-conditioning 36 assessment report to be reviewed by a mechanical engineer; and (2) imposes certain 37 duties on the mechanical engineer to facilitate improvements determined necessary 38 based on the report. 39 Section 19 of this bill requires a senior living facility to take certain corrective 40 actions in response to a heating, ventilation and air-conditioning assessment report 41 and review by a mechanical engineer. Section 20 of this bill imposes certain 42 requirements governing the workforce used to perform such corrective actions. 43 Section 21 of this bill requires the administrator of a senior living facility to 44 prepare a report on the work performed pursuant to a heating, ventilation and air- 45 conditioning assessment report and review by a mechanical engineer and to submit 46 the report to the Division of Public and Behavioral Health of the Department of 47 Health and Human Services. 48 Section 22 of this bill provides that a heating, ventilation and air-conditioning 49 assessment report and a report created by an administrator of a senior living facility 50 pursuant to section 21 are public records and available for public inspection. 51 Sections 22.5 and 23 of this bill provide for the expiration of the provisions of this 52 bill where there is no longer sufficient federal money available to facilitate 53 compliance with its provisions. 54 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 449 of NRS is hereby amended by adding 1 thereto the provisions set forth as sections 2 to 22, inclusive, of this 2 act. 3 Sec. 2. As used in sections 2 to 22, inclusive, of this act, 4 unless the context otherwise requires, the words and terms defined 5 – 3 – - *AB281_R2* in sections 3 to 8.7, inclusive, of this act have the meanings 1 ascribed to them in those sections. 2 Sec. 3. “Apprenticeship program” means an apprenticeship 3 program approved by the State Apprenticeship Council created by 4 NRS 610.030. 5 Sec. 3.1. “ASHRAE” means the American Society of 6 Heating, Refrigerating and Air-Conditioning Engineers. 7 Sec. 3.2. “Certified TAB technician” means a technician 8 who is certified to perform testing, adjusting and balancing of 9 HVAC systems by the Associated Air Balance Council, National 10 Environmental Balancing Bureau, Inc. or the Testing, Adjusting 11 and Balancing Bureau, or a similar successor organization. 12 Sec. 3.3. “Functional ventilation system” means a heating, 13 ventilation and air-conditioning system that provides the minimum 14 acceptable level of ventilation in accordance with the edition of 15 ASHRAE Standard 62.1, Ventilation and Acceptable Indoor Air 16 Quality most recently approved by the Board pursuant to section 17 9.5 of this act. 18 Sec. 3.4. “HVAC” means heating, ventilation and air- 19 conditioning. 20 Sec. 3.5. “Mechanical engineer” means a professional 21 engineer who is licensed in the discipline of mechanical 22 engineering by this State and who has professional experience 23 with heating, ventilation and air-conditioning systems. 24 Sec. 3.6. “MERV” means minimum efficiency reporting 25 value, as established by ASHRAE Standard 52.2-2017, Method of 26 Testing General Ventilation Air-Cleaning Devices for Removal 27 Efficiency by Particle Size. 28 Sec. 4. (Deleted by amendment.) 29 Sec. 5. “Qualified adjusting personnel” means either of the 30 following: 31 1. A certified TAB technician; or 32 2. A skilled and trained workforce under the supervision of a 33 certified TAB technician. 34 Sec. 6. “Qualified testing personnel” means either of the 35 following: 36 1. A certified TAB technician; or 37 2. A person certified to perform assessments of heating, 38 ventilation and air-conditioning systems by a certifying body in 39 accordance with the edition of standard ISO/IEC 17024, 40 Conformity assessment -- General requirements for bodies 41 operating certification of persons, of the International 42 Organization for Standardization most recently approved by the 43 Board pursuant to section 9.5 of this act. 44 – 4 – - *AB281_R2* Sec. 7. “Senior living facility” means any facility that 1 receives any federal funding from Medicare, Medicaid or other 2 federal health care program and which provides living assistance 3 and related care to a resident of the facility who is an aged or 4 infirm person including, without limitation, a facility for 5 intermediate care, facility for skilled nursing, residential facility 6 for groups or home for individual residential care. 7 Sec. 8. “Skilled and trained workforce” means a workforce 8 not less than 60 percent of which is composed of graduates of an 9 apprenticeship program for the applicable occupation. 10 Sec. 8.3. “Ventilation verification assessment” means an 11 assessment to determine the status of a ventilation system 12 performed in accordance with section 14 of this act. 13 Sec. 8.7. “Zone” means an area of a senior living facility 14 where the temperature is controlled by one thermostat. 15 Sec. 9. The Legislature finds and declares that: 16 1. Studies have found: 17 (a) Most ventilation systems are improperly installed; and 18 (b) Many of the problems with ventilation systems are linked to 19 the use of inadequately trained personnel to install, test, adjust 20 and balance ventilation systems. 21 2. Ventilation systems should operate as efficiently as 22 possible and inspections and repairs should be performed by 23 qualified personnel. 24 3. In addition to increasing the risk of infectious, airborne 25 diseases, inadequate ventilation systems in senior living facilities 26 negatively impact the health of residents and staff in senior living 27 facilities. 28 4. Improving indoor air quality in senior living facilities may 29 protect the health of residents and staff, reduce the risk of 30 infectious, airborne diseases and save energy. 31 5. Senior living facilities should have functioning ventilation 32 systems that meet or exceed recommended health and safety 33 standards. 34 6. Consistent statewide standards for senior living facilities 35 are necessary to protect the health and safety of residents and 36 staff. 37 Sec. 9.2. The provisions of sections 2 to 22, inclusive, of this 38 act apply only to senior living facilities located in a county whose 39 population is 100,000 or more. 40 Sec. 9.5. The Board shall review the editions of ASHRAE 41 Standard 62.1, Ventilation and Acceptable Indoor Air Quality, 42 Standard ISO/IEC 17024, Conformity assessment -- General 43 requirements for bodies operating certification of persons, of the 44 International Organization for Standardization, and the Uniform 45 – 5 – - *AB281_R2* Mechanical Code of the International Association of Plumbing 1 and Mechanical Officials in effect on the effective date of this act 2 to ensure the suitability of the new edition for this State. Each new 3 edition of those standards shall be deemed approved by the Board 4 unless the edition is disapproved by the Board within 60 days after 5 the date of publication of the new edition. 6 Sec. 10. 1. To the extent that money is available, the 7 administrator of a senior living facility shall ensure that the senior 8 living facility is equipped with a functional ventilation system that 9 is tested, adjusted and, if necessary or cost-effective, repaired, 10 upgraded or replaced to increase efficiency and performance in 11 accordance with the provisions of sections 2 to 22, inclusive, of 12 this act. Money shall be considered available if the senior living 13 facility: 14 (a) Receives federal or state money and allocates such money 15 to equip the senior living facility with a functional ventilation 16 system or improve the ventilation system or indoor air quality in 17 the senior living facility; or 18 (b) As a condition of receiving federal or state money is 19 required to ensure the senior living facility is equipped with a 20 functional ventilation system or improve the ventilation system or 21 indoor air quality in the senior living facility. 22 2. Not later than July 1, 2025, and at least once every 5 years 23 thereafter, the administrator of a senior living facility or any other 24 person that ensures a senior living facility is equipped with a 25 functional ventilation system pursuant to this section shall employ 26 qualified adjusting personnel or qualified testing personnel, or 27 cause such persons to be contracted, to perform a ventilation 28 verification assessment in accordance with section 14.5 of this act 29 to determine the status of and make any necessary improvements 30 to the heating, ventilation and air-conditioning system of the 31 senior living facility. 32 3. A senior living facility that is an assisted living facility 33 certified by the Housing Division of the Department of Business 34 and Industry pursuant to NRS 319.147 may use federal money 35 received pursuant to paragraph (a) of subsection 1 to upgrade and 36 maintain the ventilation system of that facility. 37 Sec. 11. (Deleted by amendment.) 38 Sec. 12. (Deleted by amendment.) 39 Sec. 13. (Deleted by amendment.) 40 Sec. 14. 1. Except as otherwise provided in subsection 2, 41 each zone in a senior living facility must be equipped with a 42 carbon dioxide monitor and at least one carbon dioxide monitor 43 for each 10,000 square feet of floor space. Such a carbon dioxide 44 monitor must: 45 – 6 – - *AB281_R2* (a) Be hardwired, plugged in or battery-operated and mounted 1 to the wall at least 3 feet but not more than 6 feet above the floor 2 and at least 5 feet away from any door or operable window; 3 (b) Display readings of the concentration of carbon dioxide to 4 appropriate personnel through a display on the monitor or 5 through an application on an Internet website or a cellular 6 telephone; 7 (c) Provide a visual notification, including, without limitation, 8 through an indicator light, electronic mail, text message or an 9 application on a cellular telephone, when the concentration of 10 carbon dioxide in th [Text truncated for display. Full text available on LegiScan.]