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Colorado Mandates Hospital Staffing Plans

Effective Sept. 1, Colorado hospitals must develop staffing plans and report them, along with the number of beds that can be staffed, to the health department, under legislation Gov. Jared Polis (D) signed May 18. The law mirrors a 2021 New York law that requires hospitals to form clinical staffing committees.

In Colorado, clinical nursing staff must comprise at least 60 percent of each hospital’s nurse staffing committee, and the committee must designate a leader of workplace violence prevention and reduction efforts. Each committee must develop and oversee an annual master nurse staffing plan that includes:

  • minimum staffing requirements as established by the state boards;
  • strategies that promote the health, safety, and welfare of the hospital’s employees and patients; and
  • guidance and processes to reduce nurse-to-patient assignments.

After committee approval, the plan must be reviewed by hospital leadership and published. Hospitals must provide internal quarterly reports for the staffing committee’s review.

Further, the new law requires hospitals to report annually the baseline number of beds they can staff and current bed capacity, which the health department will use to ensure hospitals are meeting required staffed-bed capacities. If a hospital’s ability to meet staffed-bed capacity falls below 80 percent of the hospital’s reported baseline for more than seven and less than 14 days, the hospital must develop an emergency plan or apply for a hardship waiver, which accounts for hospital size and geographic location. The hospital may accrue fines if the staffing issues last longer than 14 days.

The law also includes provisions to follow during public health emergencies and includes penalties up to $10,000 if hospitals do not:

  • scale up to 125 percent of staffed-bed capacity within 14 days of a state public health emergency or other notification about a surge capacity;
  • include the number of vaccines necessary in its annual emergency plan; or
  • include necessary testing capabilities necessary in its annual emergency plan.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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