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The Regulations: NRS 449.103

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Cultural Competency Regulations : NRS 449.103

"Nevada's population has grown faster than that of any other state. As a result, Nevada now has a diverse population of women, people of color, people who are lesbian, gay, bisexual, transgender, and questioning, as well as a wide variety of ethnic and other cultural backgrounds. This is why I believe it is vital that our population should have access to medical services that are culturally competent and reflect their diversity, and that the people treating them understand their specific needs. If not, language and cultural barriers impede information about care and restrict communication with medical providers."


-Pat Spearman, Nevada Senate District 1


The diversity of Nevada residents has expanded more significantly than any other state in recent years, yet standard training for equitable care for diverse cultural backgrounds and identities has not been prioritized to match the demographic shift. Discriminations in health care has been experienced by Nevadans on the basis of religion, race, ethnicity, and sexual orientation and identity, and countless other cultural traits. Both indirect and direct discrimination arise from poor understanding and familiarity with these diverse cultures, and can result in cultural barriers that prevent quality care and dignity from being provided to all patients. In order to address the lack of standards for cultural inclusivity and awareness in health care, cultural competence training will be required annually for all employees within health facilities.

Section 449.103 -

Training relating to cultural competency

1. To enable an agent or employee of a medical facility, facility for the dependent or facility which is otherwise required by regulations adopted by the Board pursuant to NRS 449.0303 to be licensed who provides care to a patient or resident of the facility to more effectively treat patients or care for residents, as applicable, the Board shall, by regulation, require such a facility to conduct training relating specifically to cultural competency for any agent or employee of the facility who provides care to a patient or resident of the facility so that such an agent or employee may better understand patients or residents who have different cultural backgrounds.

Required topics in approved trainings include:

  • Best Practices For:

    • Various gender, racial and ethnic backgrounds;

    • Various religious backgrounds;

    • Lesbian, gay, bisexual, transgender and questioning persons;

    • Children and senior citizens;

    • Persons with a mental or physical disability;

    • Part of any other population that such an agent or employee may need to better understand, as determined by the Board

  • Discriminatory Language and Behaviors

  • Welcoming and Safe Environments

  • Cultural Competency Overview

  • Implicit Bias

  • Indirect Discrimination

  • Assumptions and Myths

  • Gender

  • Race and ethnicity

  • Religion

  • Sexual Orientation and Gender Identities

  • Mental and physical disabilities

  • Barriers to care

More Information: