Nevada personal care agency administrator and designee requirements

NAC 449.3973(1), as amended by R089-24 (filed February 27, 2026), says the administrator must:

1. Be at least 18 years of age.
2. Have a high school diploma or its equivalent, "or be licensed by the Board of Examiners for Long-Term Care Administrators pursuant to chapter 654 of NRS" ((1)(b), as amended by R089-24 section 58).
3. "Be responsible and mature and have the personal qualities which will enable the administrator to understand the problems of elderly persons and persons with disabilities" ((1)(c)).
4. Understand the personal care rules and the statute. R089-24 rewrote the statute reference to the chapter "consisting of sections 2 to 90, inclusive, of Assembly Bill No. 519", which is NRS chapter 449B ((1)(d); AB 519).
5. "Demonstrate the ability to read, write, speak and understand the English language." ((1)(e))

• No degree, license or experience is required. The rule sets no years of experience and no college degree. The long-term care administrator license is an alternative to the diploma, not an extra requirement.
• HCQC’s workbook lags. HCQC’s 12.2024 inspection workbook still prints the rule as it stood before R089-24: "(b) Have a high school diploma or its equivalent", with no license route (HCQC workbook, tag P0015). The amended rule is the one in force (R089-24, filed February 27, 2026); keep a copy of section 58 ready for the surveyor.
• How maturity and English are judged is not set. The rule gives no test. By our reading, the interview, references and written work are your evidence; note how you judged them in the administrator’s file.

Not settled: the license route. HCQC’s checklist lists the diploma and does not mention the long-term care administrator license. HCQC has not said what it wants from an administrator who qualifies by license. Our suggestion: upload a copy of the license with a short note citing NAC 449.3973(1)(b) as amended by R089-24, plus the diploma if the administrator has one, and ask HCQC at (702) 486-6515 (HCQC).

Your policies are not uploaded. HCQC reviews them, with the administrator’s file, at the prelicensure survey (NAC 449.0112(1)). Every upload, with the fees and bond, is on the Nevada license application guide, and how the survey works is on the Nevada survey guide.

The administrator "shall represent the licensee in the daily operation of the agency", and the responsibilities include, without limitation (NAC 449.3973(2), as amended by R089-24):

If attendants help with medication. The administrator of an agency whose attendants assist with medication must "develop a program to ensure that attendants receive the training required by subsection 2" and make sure a medication record is kept for each client (R089-24 section 14(3)). What attendants may do is on our Nevada attendant tasks guide.

Where to write the duties. HCQC’s checklist asks for a job description and qualifications under tag P0015, and job descriptions for each position under P0035 (HCQC workbook, P0015; P0035). All 13 policy topics and 55 tags: Nevada policies and procedures.

The administrator "shall appoint a person to exercise his or her authority in the administrator’s absence" (NAC 449.3973(2)), and the duty list repeats it: "Designating one or more employees of the agency to be in charge of the agency during those times when the administrator is absent" ((2)(g)).

• Access to all records. The designee must have access to all records kept at the agency. "Confidential information may be removed from a file to which an employee designated to be in charge of the agency has access if the confidential information is maintained separately by the administrator." (NAC 449.3973(3)) HCQC’s surveyor checks this under tag P0025, "Administrator Designee’s Access to all Records" (HCQC workbook).
• An employee. The rule says "one or more employees of the agency", so by our reading a contractor or an outside friend cannot be your designee.
• No set qualifications. The rule sets none for the designee. By our reading, pick someone who could meet the administrator’s, since they exercise the administrator’s authority while in charge.
• In writing. The rule does not say the appointment must be written, but HCQC’s checklist looks for the appointment of the administrator designee (P0020). A signed letter is the simplest proof.

Jobs the rules give to "the administrator or designee". Several rules let either one act, not only when the administrator is away:

• The initial screening of each prospective client and the service plan (NAC 449.3981(1)-(2)).
• Supervisory home visits or phone calls to each client (NAC 449.3982).
• Personally investigating each grievance, incident or complaint in a timely way (NAC 449.398(2)).
• Supervising each new attendant’s on-the-job instruction (NAC 449.3977(1)(b)).
• Taking contact from clients during all service hours. The disclosure statement must give clients the "procedures for contacting the administrator of the agency or the administrator’s designee during all hours in which personal care services are provided and the on-call policy of the agency" (NAC 449.3979(2)(f)).

If the administrator or designee gives care. HCQC’s workbook notes beside the attendant training rule: "Note: Also required for Administrator and/or Admin. Designee if will provide direct care to Clients." (HCQC workbook, tag P0152). By our reading, anyone who gives personal care is working as an attendant and meets the attendant rules for that work.

Two more people appear in the licensing rules:

• On the license. "The name of the person who is designated as responsible for the conduct of the agency must appear on the face of the license." (NAC 449.3972(2))
• On the application. The application names the person in charge of the agency, and a company applicant gives evidence of reputable and responsible character for its members and that person. The statute’s words: "similar evidence must be submitted as to the members thereof and the person in charge of the agency for which the application is made" (NRS 449B.155(4), (6)).

Not settled: whether the person designated as responsible for the conduct of the agency should be the administrator or an owner. The rule does not say. By our reading the administrator, who represents the licensee in daily operation, fits best, and in a small agency the owner may also be the administrator. Ask HCQC when you apply.

Can the owner be the administrator? The rules do not stop it, if the owner meets the qualifications. The owner still needs a designee. Separately, each owner of 10% or more completes a fingerprint background check (HCQC Licensing Checklist; NRS 449B.300(1)).

NRS 449B.225 sets training to recognize and prevent the abuse of older persons at several points:

• Before the license. The applicant (for a company, the person in charge) completes training to recognize and prevent abuse of older persons before the license is issued, then yearly before each renewal. "If an applicant or licensee who is required by this section to obtain training is not a natural person, the person in charge of the agency must receive the training required by this section." (NRS 449B.225(1)-(3))
• Training you already have. Elder abuse training completed in the year before the application counts, if the application includes evidence of it. (NRS 449B.225(1))
• The administrator and staff. The administrator before the agency provides care, and every employee who provides care before their first client, then every year. The agency pays for it. (NRS 449B.225(4)-(7))
• Topics. The training covers recognizing abuse of older persons (including sexual abuse), responding to reports of alleged abuse, and the federal, state and local laws on elder abuse and on personal care agencies. (NRS 449B.225(6))
• At renewal. Each renewal includes statements that the agency complies with the background check rules and that the licensee, administrator and employees have completed elder abuse training. (NRS 449B.210(2))
• Where to take it. HCQC’s Training & Education page links an Elder Abuse/Adult Protective Services course. (HCQC Training & Education)

Every training course attendants need, and when: Nevada caregiver training.

Not settled: the designee. The statute covers the administrator "or other person in charge". Whether HCQC expects the designee to complete the training before care and every year is not stated. By our reading, train the designee too: they are in charge whenever the administrator is absent.

Cultural competency. Staff who give care or support with direct client contact at least weekly on average, and their supervisors, complete an approved cultural competency course within 90 days of hire and at least 2 hours every two years. Staff who take such a course for their own license renewal are exempt. By our reading that includes an administrator who supervises attendants (NAC 449.011931; NRS 449B.280(2)-(3)).

Nevada’s personal care rules name no separate supervisor or manager post. The administrator or designee does the supervising:

• Supervisory visits or calls. 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) 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. (HCQC workbook, P0225) HCQC’s checklist says the supervisory visit or call form must include the rule’s five questions and be signed and dated by the administrator or the designee. (HCQC checklist, P0225)
• Only trained attendants. The administrator makes sure only trained attendants serve clients, following the service plan (NAC 449.3973(2)(b)).
• Protecting clients. The administrator ensures clients are not abused, neglected or exploited by staff, or by visitors while staff are present, and that suspected cases are reported under NRS 200.5093 and 632.472 (NAC 449.3973(4)). Every person who maintains (runs) or is employed by the agency is a mandated reporter (NRS 200.5093(4)(d)).
• If you employ nurses or nursing assistants. Keep a record of the work assignments of each nurse, nursing assistant or medication aide - certified the agency employs, for at least 5 years. (NRS 632.4725) Whether HCQC or the State Board of Nursing expects this of a personal care agency that employs a CNA as an attendant is not settled; by our reading the statute applies to "each employer".

By our reading, an administrator who is away often needs a designee who can do these jobs, not only hold the keys. Our manual sets supervision frequency in Policy 2.7 and on-call cover in Policy 2.8; those frequencies are the manual’s choices, not the rule’s.

The administrator needs a diploma or equivalent, or a long-term care administrator license, and nothing in NAC 449.3973 asks for a nurse (NAC 449.3973(1)). Attendants need no certification such as CNA (NAC 449.3975).

Clinicians appear in the rules only as trainers for optional health-related tasks: trainers are a physician, PA, licensed nurse, pharmacist (insulin and glucose) or an experienced trained employee. (NAC 449.39775(7)). Each attendant also needs a health care provider’s certificate and a TB test (NAC 441A.375; 449.3976(1)(c)). Skilled nursing at home is a different license; see when a client needs a nursing agency.