Nurse Staffing

Page Updated: Oct. 13, 2023

CHA Advocacy Principle: Promote rational regulations to ensure staff resources are focused on patient care.

What Has Been Completed:

Origin: House Bill (HB) 22-1401 builds on the work from the past two years to update the nursing section of the Chapter 4 regulations governing hospital and nurse staffing and address “hospital readiness” for pandemic response.

Background: On April 19, the Board of Health finalized three rules implementing HB22-1401. The requirements under HB 22-1401 had been in place up to April 19 under emergency rulemaking until the Department could undertake a formal rulemaking process. Per the finalized rules, effective June 14, hospitals are required to: 

    • Establish a nurse staffing committee that is required to create, implement, and evaluate a nurse staffing plan and to receive, track, and resolve complaints and receive feedback from direct-care nurses and other staff;
    • Submit its nurse staffing plan to CDPHE on an annual basis;
    • Evaluate its nurse staffing plan on a quarterly basis and, based on complaint and recommendations of patients and staff, revise the nurse staffing plan accordingly;
    • Prepare a quarterly report containing the details of the evaluation;
    • Update emergency management plans annually and as often as necessary, as circumstances warrant, and include specific provisions to maximize staffed-bed capacity and appropriate utilization of hospital beds to the extent necessary for a public health emergency;
    • Assign direct care providers only to a nursing unit or clinical area of a hospital that the provider is properly trained in;
    • Continue to report hospital bed capacity on a biweekly basis (Tuesdays and Fridays) in EMResource; and
    • Report on communicable diseases and related events to CDPHE and local public health agencies.

Information for Critical Access Hospitals (CAHs): Facilities that have 25 inpatient beds or fewer and are federally certified, or undergoing federal certification, under 42 CFR 485.600, et seq., as critical access hospitals shall meet Chapter 4 requirements, except that the staffing qualifications, level of staffing, hours of operation, and quality management requirements shall not exceed the requirements established in the aforementioned federal regulations.

Per HB 22-1401, a hospital with fewer than 25 beds does not have to include in its emergency plan a demonstrated ability to surge to 125% after a statewide emergency (Section 25-3-128(6), et seq., C.R.S.).

Dates of Notice:

    • June 30 – The first staffing plan submissions were due to [email protected] 
      • For any questions, the contact is CDPHE’s acute care section manager, Erica Brudjar 
      • The next staffing plan submissions will be due at the time of the hospital license renewal


CHA Staff Contact: Adeline Ewing, CHA policy analyst, [email protected]