Nurse Staffing

Page Updated: March 11, 2024

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, 2023, the Board of Health finalized three rules implementing HB22-1401. Per the finalized rules, 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:

Resources: 

• • Nurse Staffing Plan Submission Portal
  • Nurse Staffing Plan Annual Report Table of Contents Requirements
  • Health Facilities Complaint Process – File a Complaint
  • CDPHE slides for CHA’s Regulatory Update deep dive
  • Finalized Rules:
    • • 6 CCR 1009-5, outlining hospital bed reporting;
      • 6 CCR 1011-1, Chapter 4, General Hospitals, outlining requirements for hospital nurse staffing committees, nurse staffing plans, and emergency management plans;
      • 6 CCR 1011-1, Chapter 2, General Licensure Standards, establishing regulations regarding infection control and prevention practices in licensed health facilities; and
      • 6 CCR 1009-1, Epidemic and Communicable Disease Control, outlining communicable diseases and related events reporting.
  • CDPHE Link to Receive HB 22-1401 Information
  • CHA HB 22-1401 Issue Brief
  • CHA Staffed-Bed Hardship Waiver
  • CHA Chapter 4 Webpage
  • CHA Chapter 4 Webinar Recording

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