Chapter 4 Regulations

What Nurses Need to Know

The Colorado Department of Public Health and Environment (CDPHE) Health Facilities and Emergency Medical Services Division provides oversight on a number of regulatory standards related to health care. Included among those are the Standards for Hospitals and Health Facilities, and Chapter 4 focuses on “General Hospitals,” which includes all acute care hospitals.

The Chapter 4 regulations encompass a vast set of hospital regulatory standards divided into 29 categories covering everything from building and fire safety provisions to patient rights. Nursing Services are one component of the Chapter 4 regulations, and the most recent revisions to the entire set of regulations focused on the Nursing Services section in particular through House Bill (HB) 22-1401. More information on the changes from HB 22-1401 can be found here.

For Nurses

Recent revisions to Chapter 4 build on extensive work from the past few years setting a standard for nurse staffing while ensuring the ability of frontline nurses to contribute to decision making through shared governance. Each hospital must establish a nurse staffing committee that develops and oversees a master nurse staffing plan for the hospital. Simultaneously, the new changes require each hospital with more than 25 beds to expand its emergency plan to describe the facility’s ability to increase its capacity in certain circumstances, such as a public health emergency across the state.


Learn More About CDPHE Oversight

CDPHE’s Health Facilities and Emergency Medical Services Division provides oversight for the Chapter 4 regulations.

CHA Resources

CHA has developed the following resources for its member hospitals and their frontline nurses to better understand the Chapter 4 regulations: