How to start a home care agency in Nevada (personal care agency license, 2026)

The duty is in the statute, which defines an agency to provide personal care services in the home as "any person, other than a natural person, which provides services authorized pursuant to NRS 449B.465 to elderly persons or persons with disabilities in the home" (NRS 449B.015(1)). The services in NRS 449B.465 start with "Nonmedical services related to personal care to elderly persons or persons with disabilities to assist those persons with activities of daily living" (NRS 449B.465), and the statute defines those nonmedical services broadly: toileting (elimination of wastes), dressing and undressing, bathing, grooming, preparing and eating meals, laundry, shopping, cleaning, transportation and other minor personal hygiene needs (NRS 449B.050). Nothing in the definition depends on who pays, so private pay agencies need the license too.

Companion and homemaker businesses

Our reading: a company that offers only shopping, cleaning, laundry, meals, rides or companionship to elderly persons or persons with disabilities in their homes very likely needs the license, because the statute lists those tasks as nonmedical personal care services. HCQC has not published a ruling on companion-only businesses; ask HCQC before you start without one.

Self-directed care. A licensed personal care agency does not need a separate certificate to operate an intermediary service organization (the fiscal agent model for self-directed care). (NRS 449B.530(2))

Before the license. Operating a personal care agency without a license is a misdemeanor. The Division may serve a cease and desist order, and a court may add a civil penalty of up to $10,000 for a first offense ($10,000 to $25,000 after that). (NRS 449B.485) Your name, signs and listings must not mislead: "The name, sign, listing or other designation of an agency to provide personal care services in the home must not contain any terms misleading to the public with regard to the services offered." (NRS 449B.475)

Assembly Bill 519 moved the personal care agency law out of NRS chapter 449 into a new chapter 449B, "without changing the current substantive provisions that govern such agencies and organizations" (AB 519, digest). It took effect on approval, May 30, 2025 (AB 519, section 151(1)). AB 519 itself still named the Division of Public and Behavioral Health as the regulator; a separate 2025 law moved the job to the Nevada Health Authority, and HCQC’s workshop notice ties that transfer to Senate Bill 494 of 2025 (HCQC, R164-26 notice). Three things follow for a new agency:

• The regulator’s name. In chapter 449B as it now reads, the Division is "the Health Care Purchasing and Compliance Division of the Nevada Health Authority" (NRS 449B.030) HCQC, the bureau that licenses and inspects, sits within it. Some HCQC pages, its background check FAQ and its 2024 workbook still name the Division of Public and Behavioral Health and the old NRS 449 section numbers; HCQC’s personal care agency page, for example, still points to NRS 449.0021, which AB 519 repealed (HCQC PCA page). Your policies should cite the new numbers.
• The rules carry on. AB 519 says the existing personal care rules, NAC 449.396 to 449.3982, "shall be deemed to have been adopted pursuant to section 9, 13, 14, 48, 60, 61, 63, 66, 72, 73, 75, 77, 79, 81, 83, 86, 87 or 88 of this act, as applicable, and continue in effect until amended or repealed" (AB 519, section 147(1)). Other NAC 449 rules that apply to personal care agencies (fees, licensing procedure, cultural competency and similar) keep applying until the Board replaces them. (AB 519, section 147(2))
• Old numbers, same duties. Background checks are now NRS 449B.300 to 449B.340, elder abuse training NRS 449B.225, infection control training NRS 449B.220 and non-discrimination NRS 449B.260 (NRS chapter 449B). Licenses issued under the old chapter stayed valid until they expired, and training completed before AB 519 still counts (AB 519, section 148).

The State Board of Health sets the standards, and it "shall require that the practices and policies of each agency to provide personal care services in the home provide adequately for the protection of the health, safety and physical, moral and mental well-being of each person served by the agency." (NRS 449B.125(2)).

An attendant is "a person who is employed by or retained pursuant to a contract by an agency for the purpose of providing personal care services to a client" (NAC 449.3963). Before care starts, the agency makes sure the services requested assist the client with activities of daily living (NAC 449.3981(3)(d)). The table shows the tasks the rules name, as amended by R089-24.

Who trains the health-related tasks. Before doing these tasks, each year after, and whenever the device changes, the attendant is trained and shows understanding, follows the manufacturer’s instructions and meets CLIA rules where they apply. Trainers are a physician, PA, licensed nurse, pharmacist (insulin and glucose) or an experienced trained employee. (NAC 449.39775(1), (7)) These trainers are the only clinicians the rules require you to employ or contract, and only if you offer those tasks; each attendant also needs a health care provider’s health certificate and a TB test (below).

Never allowed. Catheter insertion or irrigation; irrigation of any body cavity (ears, enemas, douches); dressings with prescription medication or aseptic technique; injections (except insulin pens under the rule); physical assessments; specialized feeding; digital rectal exams; massage; and any skilled nursing task beyond a CNA’s scope. The rule’s last item reads: "Any task identified in chapter 632 of NRS and the regulations adopted by the State Board of Nursing as requiring skilled nursing care, except any services that are within the scope and practice of a certified nursing assistant." (NAC 449.3978(2), as amended). The administrator keeps every attendant within their scope of service (NAC 449.3978(1)), and your disclosure statement tells each client in plain words that "it is not within the scope of the license of the agency to manage the medical and health conditions of clients should the conditions become unstable or unpredictable" (NAC 449.3979(2)(a)).

Medication courses. R089-24 ties the attendant medication course to the approved courses for residential facilities for groups (LCB File No. R043-22). HCQC’s medication management page is still written for group homes. (HCQC, Medication Management) Ask HCQC which approved courses count for personal care attendants before you offer medication assistance.

Personal assistants. For a person with a disability, a provider of health care may authorize a personal assistant to perform specific simple medical or nursing tasks the person would normally do themselves, if the condition is stable and predictable; the provider notes the authorization in the medical record. (NRS 629.091; NRS 449B.465(1))

Nevada does not ask for your policies with the application. Instead, once the application is complete, "the Division shall conduct an investigation concerning the premises, facilities, qualifications of personnel, methods of operation and policies of the applicant and perform a prelicensure survey" (NAC 449.0112(1)). The statute gives the Division the same power: to "conduct an investigation into the qualifications of personnel, methods of operation, policies and purposes of any person proposing to engage in the operation of an agency" (NRS 449B.145(1)). The license issues only on full compliance with NRS 449B and "substantial compliance with the standards and regulations adopted by the Board" (NRS 449B.200(1)).

HCQC’s personal care agency page links an "Initial Inspection Workbook for Agencies to Provide Personal Care Services in the Home" (HCQC PCA page). Every rule in it is a numbered tag with a column for a written policy (P&P) and one for a form or document (workbook, column headings), and it ends with a checklist headed "PCS - Policies & Procedures/Form/Document Checklist" listing 55 tags (workbook, final pages):

Where the checklist goes beyond the rule text

• Infection control program and emergency plan. Tags P0920 to P0945 apply NAC 449.0109: an infection control program and policy reviewed every year, a responsible person and designee with training, and an emergency preparedness plan that covers emerging infectious diseases. (checklist, P0920 to P0945). Its training summary adds "Infection Control Program staff member and designee(NAC 449.0109) - 15 hours of infection Control Training" (workbook, training requirements). But NAC 449.0109 opens "A facility for the dependent shall:", and the chapter 449 definition of that term does not list personal care agencies (NAC 449.0109(1); NRS 449.0045). We treat these rows as HCQC’s survey expectation, not clear rule text, and plan for them anyway.
• Signed acknowledgement of the rules. HCQC’s checklist asks for attendants’ signed statements that they received, read and understood the personal care rules, though the workbook body notes that a signed statement is not required (an acknowledgement or a policy will do). (checklist, P0150) A signed statement covers both readings.
• Supervision frequency. For supervisory visits and calls, HCQC’s workbook asks for a policy stating how often they happen and who performs them; the rule itself sets no frequency. (workbook, P0225)
• The notice of the right to complain about discrimination (P0605). The checklist asks about posting a notice that a client who has experienced prohibited discrimination may file a complaint with the Division, under NAC 449.011921, which sets the size and type. R004-24 repealed NAC 449.011919, the rule that required that notice to be posted (R004-24 section 17). NRS 449B.260 now asks a personal care agency to post its non-discrimination statement on any website it markets on, and says nothing about posting in an office. By our reading, a printed copy at your office, at the size NAC 449.011921 sets, costs little and answers the tag; ask HCQC what its surveyor looks for.
• Extras HCQC names. Job descriptions for each position, a list of community resources, examples for special populations, an evaluation form, and screening, service plan, disclosure, rights, grievance and supervisory forms (checklist).

What is not published

We found no published timetable for the prelicensure survey, no statement of whether it is on site or remote, and no list of common findings. The tag numbers are HCQC’s, and the workbook predates R089-24, so it has no tags for medication assistance or the new tasks (the 2026 changes).

"An agency shall maintain written policies and procedures concerning the qualifications, responsibilities and conditions of employment for each attendant and other members of the staff of the agency." They "must be reviewed and revised as needed", and given to attendants and staff on hire and whenever they change (NAC 449.3974). "At a minimum, the policies and procedures must" cover these 13 topics, each one a tag on HCQC’s checklist:

Other written duties in the rules and statute:

Where the sources are silent

• Supervision frequency. NAC 449.3982 sets none; HCQC wants your policy to state one (above). Choose a frequency you can always keep.
• Initial training hours. None: HCQC’s workbook says initial attendant training has no hour requirement, only the required subjects, completed no more than 12 months before the attendant starts care. (HCQC workbook)
• Record retention. NAC 449.396 to 449.3982 set no retention period for client records. Background check records are kept for the length of employment (NRS 449B.330). If you bill Medicaid, its manual says records are kept under the state record retention policy, "which is currently six years from the date of payment for the specified service", and longer while any litigation, claim or audit is open (Medicaid Services Manual, chapter 3500). Your policy should name a period.
• Templates. Nothing in the rules stops you using templates. The policies must describe how your agency actually works, because HCQC investigates your methods of operation as well as your policies.

1. The online application

"Apply for a new license/renew an existing license - myhealthfacilitylicense.nv.gov" (HCQC PCA page). The statute asks the application to describe, "in specific terms, the nature of services and type of care to be offered, as defined in the regulations", with the applicant, principal place of business and person in charge (NRS 449B.155). HCQC’s checklist says: "For all initial/CHOW licensure applications the following items are required to be uploaded to your application":

• The administrator. A resume, the high school diploma (or equivalent), proof of age and a copy of current elder abuse, neglect and exploitation training (Licensing Checklist).
• The business. The state business license, LLC or corporate documents, and a three-year business history: owners show three years of owning the same type of facility, or else give a resume and one letter of reference for each owner. (Licensing Checklist).
• The office. Every licensed agency needs a physical location in Nevada, shown by a fully executed lease (or recorded deed) proving the agency may operate from that address. A copy of the city or county business license, conditional use verification or special use permit, showing the agency name and physical location. Receipts are not accepted. (Licensing Checklist)
• Insurance. The certificate of liability insurance names the agency and its physical address as insured and lists the Health Care Purchasing and Compliance Division in Carson City as certificate holder. (Licensing Checklist)
• The surety bond. The bond must name the State of Nevada, Department of Human Services, Aging and Disability Services as obligee, show the DBA name and physical address, be signed by the owner and carry the bond company’s original seal. (Licensing Checklist)
• Owners. Each owner with 10% or more completes a fingerprint background check; the statute requires every applicant to submit fingerprints to the Central Repository for an FBI report. (Licensing Checklist; NRS 449B.300(1))

Policies are not on the upload list. Pay the state fee in the same system. "An application for a license is valid for 1 year after the date on which the application is submitted." (NAC 449.013(4))

2. The prelicensure survey

The Division investigates your premises, staff qualifications, methods of operation and policies and performs a prelicensure survey (above). Personal care agencies are exempt from the State Fire Marshal or local fire department inspection that other facilities need before licensing. (NAC 449.0112(2)(b))

3. The license

• One location, one licensee. Each license is issued to a specific person for a specific location. An agency may work from several work stations if it keeps client, staff and operations records at the licensed location. (NAC 449.3972(1)) A work station is "a satellite office of an agency that is established for the sole purposes of providing a location where copies of records may be sent to an agency" and as a base for attendants serving an area outside their usual one (NAC 449.3968).
• Not transferable. "A license applies only to the person to whom it is issued and is not transferable." A change of ownership needs a new application (NRS 449B.200(2)).
• Display it. "Upon receipt of a license, the licensee shall display the license at a conspicuous location within the facility." (NAC 449.0114(1))

4. After licensing

• Background check account. "You must receive your license from the Division of Public and Behavioral Health before you can open an account with the Department of Public Safety" (HCQC Background Check FAQ). HCQC’s FAQ still names the old division; the point is the order: license first, then the account.
• Changes. Report a new administrator within 30 days, and any change of ownership, location or services immediately (NAC 449.0114(4)-(5)).
• Inspections. The Division may inspect at any time, with or without notice, and ADSD-designated investigators may look into complaints. (NRS 449B.360) HCQC prioritizes complaints by harm; an investigation can start within 48 hours, may include record reviews and policy evaluations, and a substantiated allegation means a citation and a plan of correction. (HCQC, complaints)
• Findings. After a statement of deficiencies, the agency submits a plan of correction with timeframes within 10 days; failing to do so is a further deficiency and a ground for license action. (NAC 449.9987(1); 449.0118(5)) For violations the Division may bar the agency from providing services to clients until corrected, impose penalties of up to $5,000 a day per violation, or appoint temporary management. (NRS 449B.410(1))
• Personnel files on request. "The administrator shall make the personnel files, including, without limitation, any electronic files, available for review by the Division upon request." (NAC 449.3976(4))

Medicaid, if you want it

Nevada Medicaid’s personal care program needs this license first. To enroll as a Nevada Medicaid personal care provider (provider type 30), an agency must hold this license. (Medicaid Services Manual 3503). Enrolled providers must "utilize an EVV system that meets the requirements of the 21st Century Cures Act" (MSM 3503), keep a phone line available 24 hours a day with backup caregivers (MSM 3503), and file serious occurrence reports within 24 hours (MSM 3503).

The surety bond. With each application and renewal the agency files a surety bond of $5,000 (fewer than 7 employees), $25,000 (7 to 25) or $50,000 (more than 25), payable to the Aging and Disability Services Division to cover property damage to clients aged 60 or older. (NRS 449B.185) "A license is suspended by operation of law when the agency is no longer covered by a surety bond" (NRS 449B.185(5)). The amount is the bond’s face value; what you pay is the premium a surety company charges, which we have not priced. HCQC’s checklist words the middle tier as 7 to 24 employees while the statute says 7 to 25; we follow the statute.

Wrong license, lost fee. HCQC warns that "application fees are non-refundable as stated in NAC 449.013" (HCQC PCA page).

Renewal. Each renewal includes "a statement that the agency is in compliance with the provisions of NRS 449B.300 to 449B.340, inclusive, and 449B.440", and a statement on elder abuse training (NRS 449B.210(2)).

When the license expires: not settled. The statute says a license "expires on December 31 following its issuance and is renewable for 1 year upon reapplication and payment of all fees" (NRS 449B.210(1)), and HCQC’s renewal page says to renew "no later than Nov. 15 to avoid a 50% late penalty (licenses expire on Dec. 31)" (HCQC, License Renewal). But HCQC’s licensee list shows recent licenses expiring one year after issue (for example first issued 08/26/2026, expiring 08/25/2027), in line with AB 544 for chapter 449 licenses, although NRS 449B.210 still says December 31. 50 licenses first issued in 2026 expire on their anniversary in 2027, while 26 others first issued in 2026 still expire on December 31, 2026. (HCQC licensee export, our count). That matches R116-25, a 2026 rule for chapter 449 licenses: "A new applicant for a health facility license will receive the initial license valid for an entire year" (R116-25 notice). Until HCQC says which applies, put both dates in your calendar and renew by November 15 or your anniversary date, whichever comes first.

Other costs. Liability insurance (the rules say adequate coverage but set no dollar minimum), business licenses, the surety bond premium, and fingerprinting. Applicants pay their own fingerprinting and state and federal background check costs. For staff, the agency may recover no more than half the Central Repository fee from the employee, in installments if asked. (HCQC Background Check FAQ; NRS 449B.310(7)) Training costs for staff are the agency’s (NAC 449.39735).

Timeline. HCQC publishes no processing time. The application is valid for a year (NAC 449.013(4)). We cannot give you a date.

The background check

The clock starts at hire: "within 10 days after hiring an employee, accepting an employee of a temporary employment service or entering into a contract with an independent contractor", the agency gets a signed statement on convictions, confirms it, checks any license or certificate, and submits fingerprints to the Central Repository for an FBI report (NRS 449B.310(1)).

• Through NABS. HCQC says agencies "must utilize Nevada’s Automated Background Check System (NABS) to conduct background checks of all new employees and existing employees due for their five-year background check" (HCQC Background Check FAQ). A personal criminal history check is not accepted at inspection.
• Every 5 years. "At least once every 5 years after the date of the initial investigation." (NRS 449B.310(4)(b))
• Disqualifying crimes. NRS 449B.440 lists them: murder, voluntary manslaughter or mayhem, assault or battery with intent to kill or commit sexual assault or mayhem, felony sexual offenses, felony domestic violence, child abuse or neglect, abuse, neglect, exploitation, isolation or abandonment of older or vulnerable persons, Medicaid fraud under NRS 422.450 to 422.590, and other felonies involving force, violence or a deadly weapon bar with no time limit; misdemeanor sexual or domestic violence offenses, drug offenses, theft and fraud offenses and Medicare or Medicaid crimes bar for 7 years. (NRS 449B.440) The agency ends the employment or contract of a person convicted of a listed crime; if the person disputes the result, the agency first gives at least 30 days to correct it. (NRS 449B.340)
• Before results arrive. An agency that has complied with the check rules is not liable just because the person worked before results arrived, but the person may not have unsupervised contact with a child before then. (NRS 449B.340(3)(a)) If the Central Repository cannot finish a check, the agency notifies the person within 10 working days to supply information within 30 days, and protects clients meanwhile by leave, direct supervision or an investigation. (NAC 449.0113)
• Records. Keep the fingerprint submission proof, the written authorization and other documentation for the length of employment, available to the Division (NRS 449B.330).
• Who is not checked. "Volunteers and individuals not hired by the agency or facility but rather are hired directly by a resident at your licensed entity do not need to be background checked." (HCQC Background Check FAQ)
• Temporary staffing services. Your agreement requires the service to "notify the agency if the investigation conducted of an employee of the temporary employment service pursuant to NRS 449B.310 has not been conducted within the immediately preceding 5 years" (NRS 449B.320(2)).

Health certificate and TB testing

Attendant files must show the tests and certificates NAC 441A.375 requires: before starting, a physical examination or health care provider certificate that the person is free of active TB and other communicable disease, and a TB screening test within the past 12 months. (NAC 441A.375(3); NAC 449.3976(1)(c)) Then a TB screening test within 12 months after the month the job offer was accepted, and every year after, unless a documented risk assessment allows less often. (NAC 441A.375(4)) HCQC’s checklist lists "Pre-employment Physical Clearance and TB Testing" among the personnel file items (checklist, P0130).

The rest of the personnel file

Name, address and phone; start date; reference checks; background check evidence; first aid and CPR within 6 months; proof of age; auto insurance if the attendant drives clients; and all training and performance evaluations, with each course’s content, date, hours, instructor’s name and signature and a certificate (NAC 449.3976(1)-(2)). Files may be locked, but the Division may see them on request (NAC 449.3976(4)).

Attendants need no certification. Each one is at least 18, mature, understands the rules and can "demonstrate the ability to read, write, speak and communicate effectively with the clients of the agency" (NAC 449.3975(1)-(5)). Training is set by topic, not hours:

Who pays. The agency provides or arranges required training, pays its cost and travel, and pays staff their wage for training and travel time (not for a course the employee fails to complete). (NAC 449.39735) Proof. HCQC says facility inspectors check employee files for proof of cultural competency training. (HCQC, Cultural Competency)

Everyone reports. NRS 200.5093 names "every person who maintains or is employed by an agency to provide personal care services in the home" among those who must report suspected abuse, neglect, exploitation, isolation or abandonment of an older person or a vulnerable person (NRS 200.5093(4)(d)). Older persons are 60 or older. A vulnerable person is 18 or older and either has a physical or mental incapacitation because of a developmental disability, organic brain damage or mental illness, or has a physical or mental limitation that restricts normal activities of daily living. (NRS 200.5092)

• When and where. Reports go to the local Aging and Disability Services Division office, a police department or sheriff’s office, or ADSD’s toll-free line, as soon as reasonably practicable and within 24 hours. Knowingly failing to report is a misdemeanor. (NRS 200.5093(1), (9)) If ADSD or the police are involved in the abuse, report to a different agency (NRS 200.5093(2)).
• The numbers. Las Vegas/Clark County (702) 486-6930; statewide (888) 729-0571; or ADSD’s online intake form. Call police or EMS if the person is in immediate danger. (ADSD, Report Abuse)
• What to say. When possible: the person’s name and address, the caregiver’s, the alleged abuser’s, the nature and extent of the harm, evidence of previous injuries and the basis for the belief. (NRS 200.5094(2))
• Deaths. A reporter who believes an older or vulnerable person died from abuse, neglect, isolation or abandonment reports it to the medical examiner or coroner (NRS 200.5093(6)).
• The administrator’s duty. The administrator ensures clients are not abused, neglected or exploited by staff or visitors while staff are present, and that suspected abuse, neglect, exploitation, isolation or abandonment is reported under NRS 200.5093 and 632.472. (NAC 449.3973(4))
• Nursing Board reports. Owners and employees of a personal care agency must report in writing to the State Board of Nursing any conduct of a Board licensee or certificate holder (such as a nurse, nursing assistant or medication aide) that violates the nursing law. (NRS 632.472(1)(d))
• Children. People employed by an agency furnishing care to a child are mandated reporters of child abuse or neglect (to child welfare or law enforcement, within 24 hours), and their employer must tell them in writing and keep their acknowledgement. Our reading: this applies when an agency serves a child with a disability. (NRS 432B.220)
• Training. Elder abuse training before care and every year (above), with topics that include recognizing and responding to abuse and the laws on it (NRS 449B.225).

The rules do not set an internal investigation timeline for a personal care agency. The grievance, incident and complaint procedure applies: the administrator or designee personally investigates in a timely manner and tells the client what was done (NAC 449.398(2)). Medicaid providers also file a serious occurrence report within 24 hours (MSM 3503).

Before care starts

• Initial screening and service plan. The administrator or designee screens each prospective client and develops (or accepts) a service plan, documented, dated and signed. (NAC 449.3981(1)-(2)) A service plan is "a plan which includes a written description of the needs of a client for personal care services and which specifies the tasks that an attendant is authorized to provide for the client" (NAC 449.3967).
• Before the first visit. Check you have the resources to meet the request, review the plan with the client (the schedule, what happens if an attendant does not deliver it, your hiring and training policies, your responsibilities, the grievance procedure and the prohibited services), review what happens if an attendant does not arrive or an extra visit is needed, confirm the services assist with daily living, and coordinate with the client’s other providers (NAC 449.3981(3)).
• The written disclosure statement. On acceptance, each client gets a written disclosure statement, signs it, and a copy goes in the client record. It covers: the limit on managing unstable medical conditions; attendant qualifications and training; charges, billing methods, payment systems and due dates; how you notify clients of price increases; the criteria for ending services and how you give notice; how to reach the administrator or designee during all service hours and your on-call policy; and client rights and the grievance procedure (NAC 449.3979).

Supervision

The administrator or designee makes supervisory home visits or phone calls to each client, documented, dated and signed, evaluating five things: safe techniques, plan followed, plan meeting needs, attendant training, and follow-up needed. (NAC 449.3982) The rule sets no frequency; choose one and write it in your policy (HCQC asks for it).

Client rights

• The written rights statement. The agency writes a description of client rights, gives a copy at the start of the service plan, and keeps a signed and dated receipt in the client record. (NAC 449.398(4)) It includes six statements: considerate and respectful care; taking part in and getting a copy of the service plan; the Bureau’s complaint phone number; notice of the Division’s authority to examine client records; responses to reasonable requests; and information on agency policies, charges and service plan decisions on request (NAC 449.398(5)).
• The patients’ rights law. For chapter 449A (patients’ rights), a personal care agency counts as a facility for the dependent, so clients must be told on admission of the rights in NRS 449A.100 and 449A.106 to 449A.115. (NRS 449A.031; 449A.118(1)) An owner or administrator may not receive money or property left by a client’s will or life insurance proceeds, unless they are the client’s spouse, guardian or next of kin. (NRS 449A.115)
• Advocates. "A client is not prohibited from speaking to any person who advocates for the rights of the clients of the agency" (NAC 449.398(1)).
• Privacy. The agency keeps sexual orientation, gender identity and HIV status confidential, keeps staff not giving care out of the room while a client is unclothed without permission, uses doors, curtains or screens, and lets clients refuse educational observation. (NRS 449B.270)
• Grievances and complaints. The administrator sets up a procedure for grievances, incidents and complaints in which the administrator or designee is told of each one, personally investigates in a timely way, and tells the client what was done or why nothing was done. (NAC 449.398(2)) You also need a written policy on how a complaint may be filed and how it will be documented, investigated and resolved, and a log of discrimination complaints with the action taken or why none was taken. (NAC 449.011926)
• Non-discrimination. The agency and its staff may not discriminate on race, color, religion, national origin, ancestry, age, gender, disability, sexual orientation, gender identity or expression or HIV status, and must post a set statement on any marketing website. (NRS 449B.260) Policies on discharge and services must not discriminate by source of payment. (NAC 449.011916)

Working with other services

Coordinate your services with care the client gets from other organizations and people (NAC 449.3981(3)(e)). When a hospital discharges a patient home to the agency’s care, the agency consults a dietitian as appropriate so the patient or main carer understands the dietary needs. (NRS 449B.460) An agency or employee may not refer anyone to an unlicensed residential facility for groups, or to one unsuitable for the person’s condition; civil penalties up to $10,000, then $10,000 to $20,000. (NRS 449B.480) Before transferring a client elsewhere, explain why and the alternatives, unless the client’s condition needs an immediate transfer to a higher level of care and the client cannot understand the explanation (NRS 449A.100).

HCQC’s licensee list had 443 active personal care agency licenses on October 2, 2026 (HCQC licensee export, our count). Our reading: an agency licensed before February 27, 2026 that has not revised since likely wrote its policies before R089-24, which neither the compiled code nor HCQC’s 2024 workbook shows (and before R004-24, filed November 15, 2024, if licensed before then). Policies must be "reviewed and revised as needed", and given to staff "whenever revisions are made" (NAC 449.3974), and HCQC may inspect at any time (NRS 449B.360). Check your manual against this list.

When you revise, give staff the revised policies and keep a record that you did. In CareRulebook’s Nevada manual, choose “Already licensed” in the first step: policy 1.3 then ends with a checklist of what changed since 2023, each item with the policy that now answers it, with a target date and a box to check off each item. Preview the manual.

HCQC’s licensee export shows 443 active licenses on October 2, 2026 (415 under credential code PCS and 28 under code PCO, same license type); 397 in Clark County and 34 in Washoe. 146 were first issued in 2025 or 2026. (HCQC licensee export, our count). In July 2025, the Division’s memo on R089-24 referred to "Nevada’s 373 agencies to provide personal care services in the home" (R089-24 Board packet). What the two credential codes mean is not published.