Nevada personal care agency surveys: the prelicensure survey, 55 tags and the 10-day plan of correction

Nevada checks your policies before it licenses you, not by upload. The statute gives the Division the power, on an application, 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 general licensing rule makes it a step: "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) That rule still applies to personal care agencies after the 2025 move to chapter 449B. AB 519, section 147(2)

Where the sources are silent. We found no HCQC statement on whether the prelicensure survey is on site, remote or a document review, how long after a complete application it happens, or whether a new agency with no attendants yet must show staff files. We found no list of common findings either. Ask HCQC at (702) 486-6515 what to expect.

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 page of the workbook has a P&P column next to each rule, so the surveyor records whether a written policy exists for it. Workbook, column headings The workbook ends with a checklist of 55 tags (P0015 to P0950) naming the policy, form or document the surveyor expects for each rule. Workbook, final pages

Grouped by what you will have on the table (our grouping of HCQC’s tags; the tag numbers are HCQC’s):

Three things to know about the workbook

• It predates the 2026 rule changes. The workbook is dated 12.2024. LCB File No. R089-24, which rewrote parts of the personal care agency rules, was approved and filed on February 27, 2026. R089-24 So the workbook has no tags for medication assistance, nail care, exercise or appointments. By our reading, a surveyor applies the rules in force; what changed is on the Nevada guide.
• Some rows are HCQC’s expectation more than rule text. HCQC’s checklist applies NAC 449.0109 to personal care agencies: 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 NAC 449.0109 is addressed to facilities for the dependent, a group that does not list personal care agencies in NRS chapter 449. HCQC applies it in its personal care workbook anyway. NAC 449.0109(1) Plan for those rows regardless.
• It asks for a 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

• At any time. Any authorized member or employee of the Division may enter and inspect any building or premises at any time to secure compliance with chapter 449B. NRS 449B.350 The Division may inspect at any time, with or without notice, and ADSD-designated investigators may look into complaints. NRS 449B.360
• No fixed cycle that we found. Neither the statute nor the personal care rules set a routine survey interval after the prelicensure survey, and we found no HCQC statement giving one for personal care agencies.
• The report. After its inspections the Division prepares a report on compliance, gives it to the agency, and includes its recommendation for correcting any deficiencies. NRS 449B.370
• Cooperation is part of the license. "The failure or refusal to cooperate fully with an investigation or inspection by the Bureau" is a ground for the Division to deny, suspend or revoke a license. NAC 449.0118(6)
• Records where the surveyor expects them. 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) Personnel files, including electronic files, must be available for Division review on request; they may be kept in a locked cabinet. NAC 449.3976(4)
• Costs. The Division may charge an agency the actual cost of enforcing chapter 449B, including the cost of an inspection or investigation, but not for work tied to issuing or renewing a license that carries a fee. NRS 449B.150

• What the Division may look at. On a complaint (other than one about the cost of services), the Division may investigate the agency’s staff qualifications, methods of operation, policies, procedures and records, and those of any other agency with information pertinent to the complaint. NRS 449B.145(2)
• How fast. HCQC says each complaint is prioritized by the harm it may involve, and "an investigation could begin in as little as 48 hours or when staff resources are available". HCQC, Health Facilities - Complaints
• How. HCQC says its investigators may use interviews, records reviews, in-person observations, phone calls and policy or procedure evaluations. HCQC, Health Facilities - Complaints
• Outcomes. HCQC says each allegation is substantiated (a citation) or unsubstantiated (no citation); a citation must be answered with a plan of correction, and depending on its severity there may be fines or other sanctions. HCQC, Health Facilities - Complaints
• Your clients know how to complain. Your written rights statement gives each client the right "to receive the telephone number of the Bureau which may be contacted for complaints". NAC 449.398(5) Which HCQC number to print is not settled; ask HCQC.

The rule: "The plan of correction must include specific requirements for corrective action, which must include times within which the deficiencies are to be corrected." NAC 449.9987(1) Each deficiency needs its own plan, and the facility must "submit the plan to the Bureau for approval within 10 days after receipt of the statement of deficiencies". NAC 449.9987(1)

• If the plan is not accepted. If a plan of correction is not acceptable, the Bureau may have the facility resubmit it or write a directed plan of correction the facility must follow. NAC 449.9987(2)
• If the plan is late. Missing the 10-day deadline is itself a separate deficiency, subject to monetary penalties rated at the same severity and scope as the highest deficiency on the notice. NAC 449.9987(3) Failing or refusing to return an adequate plan of correction within 10 days of receiving a statement of deficiencies is a ground for the Division to deny, suspend or revoke a license. NAC 449.0118(5)
• Who sees it. A plan of correction the Bureau has not approved is confidential, though the Bureau may share it within the state health department or with CMS. If the Bureau writes a directed plan, both stop being confidential 14 days after it is sent. NAC 449.9987(4)

Our reading on who the rule binds. NAC 449.9987 is written for "the facility", and NAC 449.998255 defines facility as a medical facility or facility for the dependent. NAC 449.998255 A personal care agency is not on the chapter 449 list of facilities for the dependent. NRS 449.0045 But NAC 449.0118(5) makes a missing plan a license ground for any licensee, HCQC says a citation must be answered with a plan of correction, HCQC, Complaints and the statute’s inspection report carries the Division’s recommendations for correcting deficiencies. NRS 449B.370 So treat 10 days as your deadline, and write each plan to the NAC 449.9987 standard.

Our suggestions, not rule text. Write the date you received the statement and the 10-day due date on the plan the day it arrives. For each deficiency, say what you did for the clients or staff affected, how you found others affected the same way, what changed (a revised policy, retraining), how you will check it is working, and a real completion date with a named person. Keep the evidence with the plan.

• Other license grounds. Abuse, neglect or exploitation of an infirm person, a person with an intellectual disability or other disability, or a person 60 or older is a ground to deny, suspend or revoke a license. NAC 449.0118(8) So is continuing to employ someone with a disqualifying conviction, contrary to NRS 449B.340. NRS 449B.440
• Criteria the Board must set. The State Board of Health must set criteria for each sanction by regulation: incrementally more severe sanctions for repeated or uncorrected violations, less severe ones for lesser violations, and a penalty where a violation harms or risks harm to more than one person. NRS 449B.415 We found no regulation adopted under chapter 449B that sets those criteria for personal care agencies, so we cannot tell you how HCQC grades a deficiency.
• After a suspension or closure. If the Division suspends a license, or the agency otherwise stops operating, the Division may take control of the agency’s records to keep them safe. NRS 449B.430(1)
• Operating without a 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

• Notice first. Before denying, suspending or revoking a license or imposing a sanction, the Division gives reasonable notice by certified mail with its legal authority and reasons. Where public health requires immediate action, it may summarily suspend the license or impose a sanction while proceedings continue. NRS 449B.420(1)
• Appeals under the Board’s rules. To contest the Division’s action, a person files an appeal under the Board’s regulations, and the Division then holds a hearing. NRS 449B.420(2)-(3)
• The rule in the compiled code today. The general rule in the compiled code: an applicant or licensee aggrieved by the Division’s denial, suspension or revocation of a license may appeal under NAC 439.300 to 439.395. NAC 449.0119 By our reading this still applies until the Board adopts new appeal rules, because general NAC 449 rules keep applying to personal care agencies until replaced. AB 519, section 147(2) Ask HCQC which procedure it uses for your notice.

What you report between surveys is part of what a surveyor or investigator checks. The administrator must ensure that suspected abuse, neglect, exploitation, isolation or abandonment of a client is reported under NRS 200.5093 and 632.472. NAC 449.3973(4), as amended by R089-24

• Everyone at the agency reports. NRS 200.5093 names "every person who maintains or is employed by an agency to provide personal care services in the home". 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
• Within 24 hours. 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 and willfully failing to report is a misdemeanor. NRS 200.5093(1), (9) 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
• Deaths. If a reporter believes an older or vulnerable person died from abuse, neglect, isolation or abandonment, report it to the medical examiner or coroner. NRS 200.5093(6)
• Nurses and nursing assistants. 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) If you employ a nurse, nursing assistant or medication aide - certified, by our reading you also keep a record of their work assignments for at least 5 years. NRS 632.4725
• 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
• Your own investigation. 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) The personal care rules set no deadline for it.
• HCQC’s self-report form. HCQC’s Facility-Reported Incidents page offers providers a Health Facility Self-Reporting Form (and a separate nursing home form) for the self-reporting it calls required. HCQC, Facility-Reported Incidents We found no personal care agency rule that requires it, so ask HCQC whether it wants incidents reported there too.
• Medicaid providers. Medicaid providers file a Serious Occurrence Report within 24 hours of discovering events such as suspected abuse, unplanned hospital visits, falls needing treatment, medication errors, theft or loss of contact for three scheduled days. MSM 3503

The whole abuse section, with training: abuse, neglect, exploitation, isolation and abandonment on the Nevada guide.