C.R.S. § 12-255-101 Short title
12-255-101. Short title. The short title of this article 255 is the "Nurse and Nurse Aide Practice Act".
Nurses and Nurse Aides
C.R.S. tit. 12, art. 255
in effectC.R.S. § 12-255-102 Legislative declaration
12-255-102. Legislative declaration. (1) The general assembly hereby declares it to be the policy of this state that, in order to safeguard the life, health, property, and public welfare of the people of this state and in order to protect the people of this state from the unauthorized, unqualified, and improper application of services by individuals in the practice of nursing and the practice as a certified midwife, it is necessary that a proper regulatory authority be established. The general assembly further declares it to be the policy of this state to regulate the practice of nursing and the practice as a certified midwife through a state agency with the power to enforce this article 255.
(2) It is declared to be the policy of the state of Colorado that, in order to safeguard life, health, property, and the public welfare of the people of the state of Colorado, and in order to protect the people of the state of Colorado against unauthorized, unqualified, and improper application of services by nurse aides in a medical facility, it is necessary that a proper regulatory authority be established. The general assembly further declares it to be the policy of this state to regulate the practice of nurse aides in medical facilities through a state agency with the power to enforce the provisions of this article 255 that pertain to the practice of nurse aides. Any person who practices as a nurse aide in a medical facility without qualifying for proper certification and without submitting to the regulations provided in this article 255 endangers the public health thereby. The general assembly hereby finds and declares that the provisions of this article 255 that pertain to the practice of nurse aides will meet the requirements of the federal "Omnibus Budget Reconciliation Act of 1987", as amended, Pub.L. 100-203, 101 Stat. 1330.
C.R.S. § 12-255-103 Applicability of common provisions
12-255-103. Applicability of common provisions. Articles 1, 20, and 30 of this title 12 apply, according to their terms, to this article 255.
C.R.S. § 12-255-104 Definitions
12-255-104. Definitions. As used in this article 255, unless the context otherwise requires:
(1) "Advanced practice registered nurse" means a registered professional nurse who is licensed to practice pursuant to this part 1, who obtains specialized education or training as provided in section 12-255-111, and who applies to and is accepted by the board for inclusion in the advanced practice registry established pursuant to section 12-255-111.
(2) "Approved education program" means a course of education conducted by an educational or health-care institution that implements the basic practical or professional nursing curriculum or the basic nurse aide curriculum, as applicable, prescribed and approved by the board.
(3) "Board" means the state board of nursing created in section 12-255-105.
(3.2) "Certified midwife" means an individual who meets the qualifications for practice as a certified midwife, as specified in this part 1 and by the American Midwifery Certification Board, or its successor entity, and who is currently licensed by the board. Only an individual who holds a license to practice as a certified midwife in this state pursuant to this part 1 has the right to use the title "certified midwife" and its abbreviation, "C.M."
(3.3) "Certified nurse aide" means a person who meets the qualifications specified in part 2 of this article 255 and who is currently certified by the board. Only a person who holds a certificate to practice as a nurse aide in this state pursuant to part 2 of this article 255 has the right to use the title "certified nurse aide" and its abbreviation, "C.N.A."
(3.5) "Collaboration" means the act of licensed health-care providers working cooperatively within each licensed health-care provider's scope of practice to formulate and carry out the plan of patient care.
(4) "Delegated medical function" means an aspect of care that implements and is consistent with the medical plan as prescribed by a licensed or otherwise legally authorized physician, podiatrist, or dentist and is delegated to a registered professional nurse or a practical nurse by a physician, podiatrist, dentist, or physician assistant. For purposes of this subsection (4), "medical plan" means a written plan, verbal order, standing order, or protocol, whether patient specific or not, that authorizes specific or discretionary medical action, which may include but is not limited to the selection of medication. Nothing in this subsection (4) shall limit the practice of nursing as defined in this part 1.
(4.5) (a) "Delegation of patient care" means aspects of patient care that are consistent with a plan of patient care prescribed by a licensed health-care provider within the scope of the provider's practice and that may be delegated to a registered nurse or licensed practical nurse within the scope of the nurse's practice. "Delegation of patient care" includes aspects of patient care that may be delegated by a licensed health-care provider within the scope of the provider's practice and within the provider's professional judgment to a licensed or an unlicensed health-care provider within the scope of that provider's practice. Nothing in this subsection (4.5) limits or expands the scope of practice of any nurse or certified midwife licensed pursuant to this article 255.
nt care that may be delegated by a licensed health-care provider within the scope of the provider's practice and within the provider's professional judgment to a licensed or an unlicensed health-care provider within the scope of that provider's practice. Nothing in this subsection (4.5) limits or expands the scope of practice of any nurse or certified midwife licensed pursuant to this article 255.
(b) As used in this subsection (4.5), "plan of patient care" means a written plan, verbal order, standing order, or protocol, whether patient specific or not, that authorizes specific or discretionary nursing or certified midwife action and that may include the administration of medication.
(5) "Diagnosing" means the use of professional nursing knowledge and skills in the identification of, and discrimination between, physical and psychological signs or symptoms to arrive at a conclusion that a condition exists for which nursing care is indicated or for which referral to appropriate medical or community resources is required. "Diagnosis" has a corresponding meaning.
(5.3) "Home health agency" means a provider of home health services, as defined in section 25.5-4-103 (7), that is certified by the department of public health and environment.
(5.5) "Licensed health-care provider" means an individual who is licensed or otherwise authorized by the state pursuant to this title 12 or article 3.5 of title 25 to provide health-care services.
(5.6) "Medical facility" means a nursing facility licensed by the department of public health and environment or home health agencies certified to receive medicare or medicaid funds, pursuant to the federal "Social Security Act", as amended, distinct part nursing facilities, or home health agencies or entities engaged in nurse aide practice. "Medical facility" does not include hospitals and other facilities licensed or certified pursuant to section 25-1.5-103 (1)(a).
(5.7) "Nursing facility" has the same meaning as set forth in section 25.5-4-103 (14).
(6) "Panel" means either panel of the board created in section 12-255-119 (1).
(7) "Practical nurse", "trained practical nurse", "licensed vocational nurse", or "licensed practical nurse" means a person who holds a license to practice pursuant to this part 1 as a licensed practical nurse in this state or is licensed in another state and is practicing in this state pursuant to section 24-60-3802, with the right to use the title "licensed practical nurse" and its abbreviation "L.P.N." or "licensed vocational nurse" and its abbreviation, "L.V.N."
(7.5) "Practice as a certified midwife" means the performance of services requiring the education, training, and skills specified by the American Midwifery Certification Board, or its successor entity, for midwife certification from that entity.
(8) (a) "Practice of advanced practice registered nursing" means an expanded scope of professional nursing in a scope, role, and population focus approved by the board, with or without compensation or personal profit, and includes the practice of professional nursing.
(b) "Practice of advanced practice registered nursing" includes prescribing medications as may be authorized pursuant to section 12-255-112.
ractice of advanced practice registered nursing" means an expanded scope of professional nursing in a scope, role, and population focus approved by the board, with or without compensation or personal profit, and includes the practice of professional nursing.
(b) "Practice of advanced practice registered nursing" includes prescribing medications as may be authorized pursuant to section 12-255-112.
(c) Nothing in this subsection (8) shall alter the definition of the practice of professional nursing.
(8.5) "Practice of a nurse aide" or "nursing aide practice" means the performance of services requiring the education, training, and skills specified in part 2 of this article 255 for certification as a nurse aide. These services are performed under the supervision of a dentist, physician, podiatrist, professional nurse, licensed practical nurse, or other licensed or certified health-care professional acting within the scope of the professional's license or certificate.
(9) (a) "Practice of practical nursing" means the performance, under the supervision of a licensed health-care provider authorized to practice in this state, of those services requiring the education, training, and experience, as evidenced by knowledge, abilities, and skills required in this part 1 for licensing as a practical nurse pursuant to section 12-255-114, in:
(I) Caring for the ill, injured, or infirm;
(II) Teaching and promoting preventive health measures;
(III) Acting to safeguard life and health;
(IV) Administering treatments and medications prescribed by a licensed health-care provider; or
(V) Participating in the assessment, planning, implementation, and evaluation of the delivery of patient care services that is commensurate with the practical nurse's education.
(b) "Practice of practical nursing" includes:
(I) The performance of delegated medical functions and delegated patient care functions;
(II) The assumption of responsibilities and accountabilities for the performance of acts within the practical nurse's educational background and using procedures leading to predictable outcomes; and
(III) The administration and management of nursing, including directing and assigning nursing interventions that may be performed by other licensed or unlicensed health-care personnel.
(c) Nothing in this part 1 limits or denies a practical nurse from supervising other practical nurses or other licensed or unlicensed health-care personnel.
(10) (a) "Practice of professional nursing" means the delivery of independent and collaborative nursing care to individuals of all ages, families, groups, and communities, whether sick or well, in all settings. The functions include the initiation and performance of nursing care through health promotion, supportive or restorative care, disease prevention, diagnosis and treatment of human disease, ailment, pain, injury, deformity, and physical or mental condition using specialized knowledge, judgment, and skill involving the application of biological, physical, social, and behavioral science principles required for licensure as a professional nurse pursuant to section 12-255-110.
health promotion, supportive or restorative care, disease prevention, diagnosis and treatment of human disease, ailment, pain, injury, deformity, and physical or mental condition using specialized knowledge, judgment, and skill involving the application of biological, physical, social, and behavioral science principles required for licensure as a professional nurse pursuant to section 12-255-110.
(b) The "practice of professional nursing" includes the performance of such services as:
(I) Evaluating health status through the collection and assessment of health data;
(II) Health teaching and health counseling;
(III) Providing therapy and treatment that is supportive and restorative to life and well-being either directly to the patient or indirectly through consultation with, delegation to, supervision of, or teaching of others;
(IV) Executing delegated medical functions and delegated patient care functions;
(V) Referring to medical or community agencies those patients who need further evaluation or treatment;
(VI) Reviewing and monitoring therapy and treatment plans.
(11) "Registered nurse" or "registered professional nurse" means a professional nurse, and only a person who holds a license to practice professional nursing in this state pursuant to this part 1 or who holds a license in another state and is practicing in this state pursuant to section 24-60-3802 may use the title "registered nurse" and its abbreviation, "R.N."
(12) "Treating" means the selection, recommendation, execution, and monitoring of those nursing measures essential to the effective determination and management of actual or potential human health problems and to the execution of the delegated medical functions and delegated patient care functions. The delegated medical functions and delegated patient care functions shall be performed under the responsible direction and supervision of a licensed health-care provider. "Treatment" has a corresponding meaning.
(13) "Unauthorized practice", for purposes of this part 1, means:
(a) The practice of practical nursing or the practice of professional nursing by any individual:
(I) Who has not been issued a license under this part 1;
(II) Who is not practicing in this state pursuant to section 24-60-3802; or
(III) Whose license has been suspended or revoked or has expired; or
(b) The practice as a certified midwife by any individual who has not been issued a license under this part 1 or whose license has been suspended or revoked or has expired.
C.R.S. § 12-255-105 State board of nursing created - removal of board members - meetings of board
12-255-105. State board of nursing created - removal of board members - meetings of board. (1) (a) There is created the state board of nursing in the division, which is a type 1 entity, as defined in section 24-1-105. The board consists of twelve members who are residents of this state, appointed by the governor as follows:
(I) Two members of the board shall be licensed practical nurses engaged in the practice of practical nursing and licensed in this state;
(II) Seven members of the board who are licensed professional nurses, who are actively employed in their respective nursing professions, who are licensed in this state, and who have been employed for at least three years in their respective categories. Members shall be as follows:
(A) One member shall be engaged in professional nursing education;
(B) One member shall be engaged in practical nursing education in a program that prepares an individual for licensure;
(C) One member shall be engaged in home health care;
(D) One member who is registered as an advanced practice registered nurse pursuant to section 12-255-111; except that the member appointed pursuant to this subsection (1)(a)(II)(D) must not be a certified nurse midwife;
(E) One member shall be engaged in nursing service administration; and
(F) Two members shall be engaged as staff nurses, including one staff nurse who is employed in a hospital and one employed in a nursing care facility;
(II.5) One member of the board who is a certified midwife or an advanced practice registered nurse who is a certified nurse midwife;
(III) Two members of the board shall be persons who are not currently licensed and have not been previously licensed as health-care providers, and who are not employed by or in any way connected with, or have any financial interest in, a health-care facility, agency, or insurer.
(b) Any statutory change in board composition shall be implemented when the terms of current members expire, and no member shall be asked to resign before the end of a term due to the statutory changes.
(c) When making appointments to the board, the governor shall strive to achieve geographical, political, urban, and rural balance among the board membership.
(d) (I) Each member of the board shall be appointed for a term of four years.
(II) Any interim appointment necessary to fill a vacancy that has occurred by any reason other than the expiration of a term shall be for the remainder of the term of the individual member whose office has become vacant.
(III) A member may be reappointed for a subsequent term at the pleasure of the governor, but no member shall serve for more than two consecutive terms.
(e) Notwithstanding the provisions of this subsection (1) to the contrary, if, as determined by the governor, an appropriate applicant for membership on the board pursuant to subsection (1)(a) of this section is not available to serve on the board for a particular term, the governor may appoint a nurse whose license is in good standing to fill the vacancy for the length of that term. At the end of the term, if the governor, after a good-faith attempt, cannot find an appropriate applicant pursuant to subsection (1)(a) of this section, the governor may appoint a nurse whose license is in good standing to fill the vacancy for one term.
(2) The board shall elect annually from its members a president.
(3) The governor may remove any board member for negligence in the performance of any duty required by law, for incompetency, for unprofessional conduct, for willful misconduct, or for failure to continue to comply with the requirements of this section.
(4) The board shall meet at least quarterly during the fiscal year and at such other times as it may determine.
C.R.S. § 12-255-106 Employees - executive administrator
12-255-106. Employees - executive administrator. The director shall appoint an executive administrator for the board and other personnel deemed necessary, pursuant to section 13 of article XII of the state constitution.
C.R.S. § 12-255-107 Powers and duties of the board - rules - definition
12-255-107. Powers and duties of the board - rules - definition. (1) The board has the following powers and duties:
(a) (I) To approve, pursuant to rules adopted by the board, educational programs in this state preparing individuals for licensure under this part 1, including approving curricula, conducting surveys, and establishing standards for the educational programs; to deny approval of or withdraw approval from the educational programs for failure to meet required standards as established by this part 1 or pursuant to rules adopted by the board; and to further establish standards in accordance with this part 1 in the form of rules to determine whether institutions outside this state shall be deemed to have acceptable educational programs and whether graduates of institutions outside this state shall be deemed to be graduates of approved educational programs for the purpose of licensing requirements in this state under this part 1; and to determine by rule when accreditation by a state or voluntary agency may be accepted in lieu of board approval;
(II) To approve nurse aide training programs in accordance with section 12-255-118.5;
(b) (I) (A) To examine, license, certify, reactivate, and renew licenses or certifications of qualified applicants, to grant to the applicants temporary licenses and permits, and to engage in the practice of practical nursing and professional nursing, the practice as a certified midwife, or the practice of a nurse aide, as applicable, in this state within the limitations imposed by this article 255. Licenses and certifications issued pursuant to this article 255 are subject to the renewal, expiration, reinstatement, and delinquency fee provisions specified in section 12-20-202 (1) and (2).
(B) The director may increase fees to obtain or renew a professional nurse license, an advanced practice registered nurse authority, or a certified midwife license under this part 1 consistent with section 12-30-105 (4) to fund the division's costs in administering and staffing the nurse-physician advisory task force for Colorado health care created in section 12-30-105 (1).
(C) Any person whose license or certification has expired is subject to the penalties provided in this article 255 or section 12-20-202 (1).
(II) In order to facilitate the licensure and certification of qualified applicants, the board may, in its discretion, assign licensing and certification functions in accordance with this article 255 to either panel. Any action taken by a quorum of the assigned panel constitutes action by the board.
(c) (I) To limit the scope of any license, to place a temporary licensee on probation, or to take disciplinary or other action as specified in section 12-20-404 upon proof that the licensee has committed an act that constitutes grounds for discipline under section 12-255-120 or 12-295-111;
(II) To suspend, revoke, or deny a certification to practice as a nurse aide or authority to practice as a medication aide in accordance with section 12-20-404 (1)(d) or issue a letter of admonition under the circumstances specified in and in accordance with section 12-20-404 (4), upon proof that the person engaged in an act that constitutes grounds for discipline under section 12-255-209;
(d) To permit the executive officer, during the period between board meetings and pursuant to board rules, to:
(I) Administer examinations and competency evaluations to qualified applicants;
(II) Issue licenses or certifications by endorsement, examination, or competency evaluation, as applicable, to qualified applicants;
(III) Renew licenses or certifications of qualified applicants; and
(IV) Issue temporary licenses and permits to qualified applicants;
(e) To adopt and revise rules concerning qualifications needed to practice as a practical nurse when the practice requires preparation and skill beyond that of a practical nurse pursuant to section 12-255-114;
evaluation, as applicable, to qualified applicants;
(III) Renew licenses or certifications of qualified applicants; and
(IV) Issue temporary licenses and permits to qualified applicants;
(e) To adopt and revise rules concerning qualifications needed to practice as a practical nurse when the practice requires preparation and skill beyond that of a practical nurse pursuant to section 12-255-114;
(f) To provide by rule for the legal recognition of nurse licensees from other states and jurisdictions;
(g) To charge and collect appropriate fees;
(h) To investigate and conduct hearings upon charges for the discipline of nurses, certified midwives, and nurse aides in accordance with article 4 of title 24 and section 12-20-403 and to impose disciplinary sanctions as provided in this article 255 and section 12-20-404;
(i) To cause the prosecution and enjoinder, in accordance with section 12-20-406, of any person violating the provisions of this article 255 and incur necessary expenses therefor;
(j) To adopt rules pursuant to section 12-20-204 to carry out the purposes of this article 255, including rules pertaining to the certification of nurse aides to ensure compliance with federal law and regulation relating to nurse aides;
(k) To administer the licensing and regulation of psychiatric technicians pursuant to article 295 of this title 12 and to adopt and revise rules pursuant to section 12-20-204 consistent with the laws of this state as may be necessary:
(I) To renew, grant, suspend, limit the scope of, and revoke licenses of psychiatric technicians in accordance with article 295 of this title 12;
(II) To prescribe standards and approve curricula for educational programs preparing persons for licensure as psychiatric technicians;
(III) To provide for surveys of education programs at such times as the board may deem necessary;
(IV) To accredit education programs that meet the requirements of the board and article 295 of this title 12;
(V) To deny accreditation to or withdraw accreditation from educational programs for failure to meet prescribed standards;
(VI) To conduct hearings pursuant to section 12-295-112;
(VII) To cause the prosecution and enjoinder, in accordance with section 12-20-406, of any person violating the provisions of article 295 of this title 12 and incur necessary expenses therefor;
(l) (I) To conduct criminal history record checks on any individual under the jurisdiction of the board, against whom a complaint has been filed.
(II) For purposes of this subsection (1)(l), "criminal history record check" means a written review of an individual's criminal conviction history.
(m) To facilitate the licensure of nurses under the "Enhanced Nurse Licensure Compact", part 38 of article 60 of title 24, as follows:
(I) Appoint a qualified delegate to serve on the interstate commission of nurse licensure compact administrators;
(II) Participate in the coordinated licensure information system, as that is defined in article II c. of section 24-60-3802;
nal conviction history.
(m) To facilitate the licensure of nurses under the "Enhanced Nurse Licensure Compact", part 38 of article 60 of title 24, as follows:
(I) Appoint a qualified delegate to serve on the interstate commission of nurse licensure compact administrators;
(II) Participate in the coordinated licensure information system, as that is defined in article II c. of section 24-60-3802;
(III) Require an applicant for licensure under the compact to have his or her fingerprints taken by a local law enforcement agency or any third party approved by the Colorado bureau of investigation for the purpose of obtaining a fingerprint-based criminal history record check. The applicant is required to submit payment by certified check or money order for the fingerprints and for the actual costs of the record check at the time the fingerprints are submitted to the Colorado bureau of investigation. Upon receipt of fingerprints and receipt of the payment for costs, the Colorado bureau of investigation shall conduct a state and national fingerprint-based criminal history record check utilizing records of the Colorado bureau of investigation and the federal bureau of investigation and shall forward the results of the criminal history record check to the board. The board shall use the information resulting from the fingerprint-based criminal history record check to investigate and determine whether an applicant is qualified to hold a license pursuant to the compact. The board may verify the information an applicant is required to submit. The results of the criminal history record check are confidential. The board shall not release the results to the public, the interstate commission of nurse licensure compact administrators, or other state licensing boards.
(IV) Notify the interstate commission of nurse licensure compact administrators of any adverse action taken by the board; and
(V) Approve payment of assessments levied by the interstate commission of nurse licensure compact administrators to cover the cost of the operations and activities of the commission and its staff.
(2) The board shall appoint advisory committees pursuant to section 12-255-108 of at least three psychiatric technicians to advise the board on matters pertaining to psychiatric technician testing. The board shall, in its discretion, assign matters referred to the board by the psychiatric technicians advisory committee to a panel for consideration and implementation, if necessary.
(3) When the board determines that rules are completed and established, the board shall make copies available at a reasonable cost.
(4) The board shall, in its discretion, assign matters referred to the board by the nurse aide advisory committee, created pursuant to section 12-255-207, to a panel for consideration and implementation, if necessary.
(5) The authority granted the board under the provisions of this article 255 shall not be construed to authorize the board to arbitrate or adjudicate fee disputes between licensees or between a licensee and any other party.
(6) The board shall maintain a registry of all certified nurse aides and a record of all final disciplinary action taken against persons under this article 255. The registry shall conform to all requirements of federal law and regulation.
(7) The board shall not issue a certificate to a former holder of a nurse aide certificate whose certificate was revoked or surrendered to avoid discipline unless:
(a) The two-year waiting period specified in section 12-20-404 (3) has passed since the date of the revocation or surrender; and
(b) The applicant meets the requirements of this article 255, has successfully repeated an approved educational program as required by the board, and has repeated and passed a competency evaluation.
C.R.S. § 12-255-108 Advisory committee
12-255-108. Advisory committee. The board may appoint advisory committees including professional review committees to assist in the performance of its duties. Each advisory committee shall consist of at least three licensees who have expertise in the area under review. Members of the advisory committees shall receive no compensation for their services but shall be reimbursed for the actual and necessary expenses incurred in the performance of their duties.
C.R.S. § 12-255-109 Examination
12-255-109. Examination. (1) All nurse applicants, unless eligible for licensure by endorsement, shall be required to pass a written examination approved or prepared by the board, relating to the knowledge, skills, and judgments as incorporated in their respective approved education programs.
(2) In accordance with the requirements of this part 1, the board shall hold at least two examinations annually for practical nurses and for professional nurses at such places and at such times as the board shall determine.
C.R.S. § 12-255-110 Requirements for professional nurse licensure
12-255-110. Requirements for professional nurse licensure. (1) The board shall issue a license to engage in the practice of professional nursing to any applicant who:
(a) Submits an application containing the information the board may prescribe;
(b) Submits proof satisfactory to the board in the manner and upon the forms the board may require to show that the applicant has completed a professional nursing educational program that meets the standards of the board for approval of educational programs or that is approved by the board and to show that the applicant holds a certificate of graduation from or a certificate of completion of the approved program;
(c) Passes an examination as provided in section 12-255-109 or is eligible for and is granted licensure by endorsement as provided in subsection (2) of this section;
(d) Pays the required fee.
(2) The board may issue a license by endorsement to engage in the practice of professional nursing in this state to a nurse who satisfies the requirements of the occupational credential portability program.
(3) (a) The board shall design a questionnaire to be sent to all licensees who apply for license renewal. Each applicant for license renewal shall complete the board-designed questionnaire. The purpose of the questionnaire is to determine whether a licensee has acted in violation of this part 1 or has been disciplined for any action that might be considered a violation of this part 1 or that might make the licensee unfit to practice nursing with reasonable care and safety. The board shall include on the questionnaire a question regarding whether the licensee has complied with section 12-30-111 and is in compliance with section 12-280-403 (2)(a). If an applicant fails to answer the questionnaire accurately, the failure constitutes grounds for discipline under section 12-255-120 (1)(v). The board may include the cost of developing and reviewing the questionnaire in the fee paid under subsection (1)(d) of this section. The board may deny an application for license renewal that does not accompany an accurately completed questionnaire.
(b) On and after July 1, 2024, as a condition of renewal of a license, each licensee shall attest that the licensee is in compliance with section 12-280-403 (2)(a) and that the licensee is aware of the penalties for noncompliance with that section.
C.R.S. § 12-255-111 Requirements for advanced practice registered nurse registration - legislative declaration - advanced practice registry - rules
12-255-111. Requirements for advanced practice registered nurse registration - legislative declaration - advanced practice registry - rules. (1) The general assembly hereby recognizes that some registered professional nurses practicing pursuant to this part 1 have acquired additional preparation for advanced nursing practice and hereby determines that it is appropriate for the state to maintain a registry of those individuals. The registry shall be known as the "advanced practice registry".
(2) The board shall establish the advanced practice registry and shall require that a registered professional nurse applying for registration on the advanced practice registry identify the nurse's role and population focus. The board shall establish reasonable criteria for designation of specific role and population foci based on currently accepted professional standards. A registered professional nurse who is included in the advanced practice registry has the right to use the title "advanced practice registered nurse" or, if authorized by the board, to use the title "certified nurse midwife", "clinical nurse specialist", "certified registered nurse anesthetist", or "nurse practitioner". These titles may be abbreviated as "A.P.R.N.", "C.N.M.", "C.N.S.", "C.R.N.A.", or "N.P.", respectively. It is unlawful for any person to use any of the titles or abbreviations listed in this subsection (2) unless included in the registry and authorized by the board to do so.
(3) (a) On and after July 1, 2008, the requirements for inclusion in the advanced practice registry shall include the successful completion of an appropriate graduate degree as determined by the board; except that individuals who are included in the registry as of June 30, 2008, but have not successfully completed that degree, may thereafter continue to be included in the registry and to use the appropriate title and abbreviation.
(b) On and after July 1, 2010, in addition to the requirements of subsection (3)(a) of this section, a registered professional nurse shall obtain national certification from a nationally recognized accrediting agency, as defined by the board by rule, in the appropriate role and population focus in order to be included in the advanced practice registry; except that registered professional nurses who are included in the registry as of June 30, 2010, but have not obtained the national certification, may thereafter continue to be included in the registry and to use the appropriate title and abbreviation.
(c) A registered professional nurse may be included in the advanced practice registry by endorsement if the registered professional nurse meets the requirements of the occupational credential portability program.
(4) A nurse who meets the definition of advanced practice registered nurse and the requirements of section 12-255-112 may be granted prescriptive authority as a function in addition to those defined in section 12-255-104 (10).
(5) An advanced practice registered nurse shall practice in accordance with the standards of the appropriate national professional nursing organization and have a safe mechanism for consultation or collaboration with a physician or, when appropriate, referral to a physician. Advanced practice registered nursing also includes, when appropriate, referral to other health-care providers.
(6) (a) In order to enhance the cost efficiency and continuity of care, an advanced practice registered nurse may, within the nurse's scope of practice and within the advanced practice registered nurse-patient relationship, sign an affidavit, certification, or similar document that:
(I) Documents a patient's current health status;
(II) Authorizes continuing treatment, tests, services, or equipment; or
(III) Gives advance directives for end-of-life care.
ty of care, an advanced practice registered nurse may, within the nurse's scope of practice and within the advanced practice registered nurse-patient relationship, sign an affidavit, certification, or similar document that:
(I) Documents a patient's current health status;
(II) Authorizes continuing treatment, tests, services, or equipment; or
(III) Gives advance directives for end-of-life care.
(b) The affidavit, certification, or similar document may not:
(I) Be the prescription of medication unless the advanced practice registered nurse has been granted prescriptive authority pursuant to section 12-255-112; or
(II) Be in conflict with other requirements of law.
C.R.S. § 12-255-111.5 Requirements for certified midwife licensure - license by endorsement - questionnaire - fees
12-255-111.5. Requirements for certified midwife licensure - license by endorsement - questionnaire - fees. (1) On and after July 1, 2024, the board shall issue a license to engage in the practice as a certified midwife to any applicant who:
(a) Submits an application containing information the board may prescribe;
(b) Submits proof satisfactory to the board, in the manner and upon the forms the board may require, to show that the applicant has obtained and maintains in good standing a midwife certification from the American Midwifery Certification Board or its successor entity;
(c) Pays the required fee; and
(d) Submits to a criminal history record check in the form and manner as described in subsection (2) of this section.
(2) (a) In addition to the requirements of subsection (1) of this section, each applicant must have the applicant's fingerprints taken by a local law enforcement agency or any third party approved by the Colorado bureau of investigation for the purpose of obtaining a fingerprint-based criminal history record check. If an approved third party takes the applicant's fingerprints, the fingerprints may be electronically captured using Colorado bureau of investigation-approved livescan equipment. Third-party vendors shall not keep the applicant's information for more than thirty days unless requested to do so by the applicant. The applicant shall submit payment by certified check or money order for the fingerprints and for the actual costs of the record check at the time the fingerprints are submitted to the Colorado bureau of investigation. Upon receipt of fingerprints and receipt of the payment for costs, the Colorado bureau of investigation shall conduct a state and national fingerprint-based criminal history record check utilizing records of the Colorado bureau of investigation and the federal bureau of investigation and shall forward the results of the criminal history record check to the director.
(b) When the results of a fingerprint-based criminal history record check of an applicant performed pursuant to this subsection (2) reveal a record of arrest without a disposition, the board shall require that applicant to submit to a name-based judicial record check, as defined in section 22-2-119.3 (6)(d).
(3) The board may issue a license by endorsement to engage in the practice as a certified midwife in this state to an applicant who satisfies the requirements of the occupational credential portability program.
(4) (a) (I) The board shall design a questionnaire to be sent to all licensees who apply for license renewal. Each applicant for license renewal shall complete the board-designed questionnaire. The purpose of the questionnaire is to determine whether a licensee has acted in violation of this part 1 or has been disciplined for any action that might be considered a violation of this part 1 or that might make the licensee unfit to practice as a certified midwife with reasonable care and safety. The board shall include on the questionnaire a question regarding whether the licensee has complied with section 12-30-111 and is in compliance with section 12-280-403 (2)(a).
(II) If an applicant fails to answer the questionnaire accurately, the failure constitutes grounds for discipline under section 12-255-120 (1)(v).
(III) The board may include the cost of developing and reviewing the questionnaire in the fee paid under subsection (1)(c) of this section.
(IV) The board may deny an application for license renewal that does not accompany an accurately completed questionnaire.
applicant fails to answer the questionnaire accurately, the failure constitutes grounds for discipline under section 12-255-120 (1)(v).
(III) The board may include the cost of developing and reviewing the questionnaire in the fee paid under subsection (1)(c) of this section.
(IV) The board may deny an application for license renewal that does not accompany an accurately completed questionnaire.
(b) On and after July 1, 2024, as a condition of renewal of a license, each licensee shall attest that the licensee is in compliance with section 12-280-403 (2)(a) and that the licensee is aware of the penalties for noncompliance with that section.
(5) A certified midwife who satisfies the requirements of section 12-255-112 may be granted prescriptive authority as a function in addition to those functions described in section 12-255-104 (7.5).
C.R.S. § 12-255-112 Prescriptive authority - advanced practice registered nurses - certified midwives - limits on prescriptions - rules - financial benefit for prescribing prohibited
12-255-112. Prescriptive authority - advanced practice registered nurses - certified midwives - limits on prescriptions - rules - financial benefit for prescribing prohibited. (1) The board may authorize the following licensees to prescribe controlled substances or prescription drugs, as those terms are defined in section 12-280-103:
(a) An advanced practice registered nurse who is listed on the advanced practice registry, who has a license in good standing without disciplinary sanctions issued pursuant to section 12-255-110, and who has fulfilled the requirements of this section and requirements established by the board pursuant to this section; or
(b) A certified midwife who has a license issued pursuant to section 12-255-111.5 that is in good standing without disciplinary sanctions and who has fulfilled the requirements of this section and requirements established by the board pursuant to this section.
(2) (a) The board shall adopt rules to implement this section.
(b) Rules adopted pursuant to this section shall reflect current, accepted professional standards for the safe and effective use of controlled substances and prescription drugs.
(3) (a) An advanced practice registered nurse or a certified midwife may be granted authority to prescribe prescription drugs and controlled substances to provide treatment to clients within the role and population focus of the advanced practice registered nurse or certified midwife, as applicable.
(b) (I) An advanced practice registered nurse or a certified midwife who has been granted authority to prescribe prescription drugs and controlled substances under this part 1 may advise the nurse's or certified midwife's patients of their option to have the symptom or purpose for which a prescription is being issued included on the prescription order.
(II) A nurse's or certified midwife's failure to advise a patient under subsection (3)(b)(I) of this section is neither:
(A) Grounds for any disciplinary action against the nurse's or certified midwife's professional license issued under this part 1; nor
(B) Grounds for any civil action against a nurse or certified midwife in a negligence or tort action; nor
(C) Evidence in any civil action against a nurse or certified midwife.
(4) (a) An advanced practice registered nurse applying for prescriptive authority shall provide evidence to the board of the following:
(I) An appropriate graduate degree as determined by the board pursuant to section 12-255-111 (3)(a);
(II) Satisfactory completion of specific educational requirements in the use of controlled substances and prescription drugs, as established by the board, either as part of a degree program or in addition to a degree program;
(III) National certification from a nationally recognized accrediting agency, as defined by the board by rule pursuant to section 12-255-111 (3)(b), unless the board grants an exception;
(IV) Professional liability insurance as required by section 12-255-113;
(V) Inclusion on the advanced practice registry pursuant to section 12-255-111; and
(VI) A signed attestation stating that the advanced practice registered nurse has completed at least three years of combined clinical work experience as a professional nurse or as an advanced practice registered nurse.
(a.5) A certified midwife applying for prescriptive authority shall provide evidence to the board that the certified midwife has obtained and maintains:
(I) A midwife certification in good standing from the American Midwifery Certification Board or its successor entity; and
(II) Professional liability insurance as required by section 12-255-113.
urse or as an advanced practice registered nurse.
(a.5) A certified midwife applying for prescriptive authority shall provide evidence to the board that the certified midwife has obtained and maintains:
(I) A midwife certification in good standing from the American Midwifery Certification Board or its successor entity; and
(II) Professional liability insurance as required by section 12-255-113.
(b) The board may grant provisional prescriptive authority to an advanced practice registered nurse, upon satisfaction of the requirements set forth in subsection (4)(a) of this section, or to a certified midwife, upon satisfaction of the requirements set forth in subsection (4)(a.5) of this section. The provisional prescriptive authority that is granted is limited to those patients and medications appropriate to the advanced practice registered nurse's or certified midwife's role and population focus. In order to retain provisional prescriptive authority and obtain and retain full prescriptive authority pursuant to this subsection (4) for patients and medications appropriate for the advanced practice registered nurse's or certified midwife's role and population focus, an advanced practice registered nurse or a certified midwife shall satisfy the following requirements:
(I) (A) Once the provisional prescriptive authority is granted, the advanced practice registered nurse or certified midwife must obtain seven hundred fifty hours of documented experience in a mutually structured prescribing mentorship either with a physician or with an advanced practice registered nurse or a certified midwife who has full prescriptive authority and experience in prescribing medications. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice registered nurse or certified midwife.
(B) Remote communication with the mentor is permissible within the mentorship as long as the communication is synchronous. Synchronous communication does not include communication by e-mail.
(C) The physician or advanced practice registered nurse serving as a mentor shall not require payment or employment as a condition of entering into the mentorship relationship, but the mentor may request reimbursement of reasonable expenses and time spent as a result of the mentorship relationship.
(D) Upon successful completion of the mentorship period, the mentor shall provide the mentor's signature and attestation to verify that the advanced practice registered nurse or certified midwife has successfully completed the mentorship within the required period after the provisional prescriptive authority was granted.
(E) If an advanced practice registered nurse or a certified midwife with provisional prescriptive authority fails to complete the mentorship required by this subsection (4)(b)(I) within three years or otherwise fails to demonstrate competence as determined by the board, the advanced practice registered nurse's or certified midwife's provisional prescriptive authority expires for failure to comply with the statutory requirements.
(II) Repealed.
(III) The advanced practice registered nurse or certified midwife shall maintain professional liability insurance as required by section 12-255-113.
(IV) The advanced practice registered nurse or certified midwife shall maintain national certification, as specified in subsection (4)(a)(III) or (4)(a.5)(I) of this section, unless the board grants an exception.
(V) The certified midwife must complete at least three years of clinical work experience as a certified midwife.
tain professional liability insurance as required by section 12-255-113.
(IV) The advanced practice registered nurse or certified midwife shall maintain national certification, as specified in subsection (4)(a)(III) or (4)(a.5)(I) of this section, unless the board grants an exception.
(V) The certified midwife must complete at least three years of clinical work experience as a certified midwife.
(c) An advanced practice registered nurse who was granted prescriptive authority prior to July 1, 2010, shall satisfy the following requirements in order to retain prescriptive authority:
(I) (Deleted by amendment, L. 2020.)
(II) The advanced practice registered nurse shall maintain professional liability insurance as required by section 12-255-113.
(III) The advanced practice registered nurse shall maintain national certification, as specified in subsection (4)(a)(III) of this section, unless:
(A) The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2010, and has not obtained national certification;
(B) The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2008, and has not completed a graduate degree as specified in section 12-255-111 (3)(a); or
(C) The board grants an exception.
(d) In order to obtain provisional prescriptive authority and obtain and retain full prescriptive authority in this state, an advanced practice registered nurse or a certified midwife from another state must meet the requirements of this section or substantially equivalent requirements, as determined by the board.
(e) and (f) Repealed.
(5) An advanced practice registered nurse or a certified midwife who obtains prescriptive authority pursuant to this section shall be assigned a specific identifier by the state board of nursing. This identifier shall be available to the Colorado medical board and the state board of pharmacy. The state board of nursing shall establish a mechanism to assure that the prescriptive authority of an advanced practice registered nurse or a certified midwife may be readily verified.
(6) An advanced practice registered nurse or a certified midwife with prescriptive authority pursuant to this section is subject to the limitations on prescriptions specified in section 12-30-109.
(7) (a) The scope of practice for an advanced practice registered nurse or a certified midwife may be determined by the board in accordance with this part 1.
(b) The board may consider information provided by nursing, medical, midwifery, or other health professional organizations, associations, or regulatory boards.
(c) (I) Prescriptive authority by an advanced practice registered nurse or a certified midwife is limited to those patients appropriate to the nurse's or certified midwife's scope of practice. Prescriptive authority may be limited or withdrawn and the advanced practice registered nurse or certified midwife may be subject to further disciplinary action in accordance with this part 1 if the nurse or certified midwife has prescribed outside the nurse's or certified midwife's scope of practice or for other than a therapeutic purpose.
(II) Nothing in this section shall be construed to require a registered nurse or certified midwife to obtain prescriptive authority to deliver anesthesia care.
(8) All prescriptions must comply with applicable federal and state laws, including article 280 of this title 12 and part 2 of article 18 of title 18.
(9) Nothing in this section shall be construed to permit dispensing or distribution, as defined in section 12-280-103 (14) and (15), by an advanced practice registered nurse or a certified midwife, except for samples, under article 280 of this title 12 and the federal "Prescription Drug Marketing Act of 1987", Pub.L. 100-293, as amended.
280 of this title 12 and part 2 of article 18 of title 18.
(9) Nothing in this section shall be construed to permit dispensing or distribution, as defined in section 12-280-103 (14) and (15), by an advanced practice registered nurse or a certified midwife, except for samples, under article 280 of this title 12 and the federal "Prescription Drug Marketing Act of 1987", Pub.L. 100-293, as amended.
(10) An advanced practice registered nurse registered pursuant to section 12-255-111 or a certified midwife is not required to apply for or obtain prescriptive authority.
(11) Nothing in this section limits:
(a) The practice of nursing by any nurse, including advanced practice registered nurses; or
(b) The practice as a certified midwife by any certified midwife.
(12) An advanced practice registered nurse or a certified midwife shall not accept any direct or indirect benefit from a pharmaceutical manufacturer or pharmaceutical representative for prescribing a specific medication to a patient. For the purposes of this section, a direct or indirect benefit does not include a benefit offered to an advanced practice registered nurse or certified midwife regardless of whether the specific medication is being prescribed.
C.R.S. § 12-255-113 Professional liability insurance required - advanced practice registered nurses and certified midwives in independent practice - rules
12-255-113. Professional liability insurance required - advanced practice registered nurses and certified midwives in independent practice - rules. (1) It is unlawful for any advanced practice registered nurse or certified midwife engaged in an independent practice of professional nursing or as a certified midwife to practice within the state of Colorado unless the advanced practice registered nurse or certified midwife purchases and maintains or is covered by professional liability insurance in an amount not less than five hundred thousand dollars per claim with an aggregate liability for all claims during the year of one million five hundred thousand dollars.
(2) Professional liability insurance required by this section must cover all acts within the scope of practice of an advanced practice registered nurse or certified midwife as described in this part 1.
(3) Notwithstanding the requirements of subsection (1) of this section, the board, by rule, may exempt or establish lesser liability insurance requirements for advanced practice registered nurses or certified midwives.
(4) Nothing in this section shall be construed to confer liability on an employer for the acts of an advanced practice registered nurse or a certified midwife that are outside the scope of employment or to negate the applicability of the "Colorado Governmental Immunity Act", article 10 of title 24.
C.R.S. § 12-255-114 Requirements for practical nurse licensure - fees - questionnaire
12-255-114. Requirements for practical nurse licensure - fees - questionnaire. (1) The board shall issue a license to engage in the practice of practical nursing to any applicant who:
(a) Submits an application containing information the board may prescribe;
(b) Submits proof satisfactory to the board in the manner and upon the forms the board may require to show that the applicant has completed a practical nursing educational program that meets the standards of the board for approval of educational programs or that is approved by the board and to show that the applicant holds a certificate of graduation from or a certificate of completion of the approved program;
(c) Passes an examination as provided in section 12-255-109 or is eligible for and is granted licensure by endorsement as provided in subsection (2) of this section;
(d) Pays the required fee.
(2) The board may issue a license by endorsement to engage in the practice of practical nursing in this state to any applicant who satisfies the requirements of the occupational credential portability program.
(3) The board shall design a questionnaire to be sent to all licensed practical nurses who apply for license renewal. Each applicant for license renewal shall complete the board-designed questionnaire. The purpose of the questionnaire is to determine whether a licensee has acted in violation of this part 1 or has been disciplined for any action that might be considered a violation of this part 1 or might make the licensee unfit to practice nursing with reasonable care and safety. If an applicant fails to answer the questionnaire accurately, the failure constitutes grounds for discipline under section 12-255-120 (1)(v). The board may include the cost of developing and reviewing the questionnaire in the fee paid under subsection (1)(d) of this section. The board may deny an application for license renewal that does not accompany an accurately completed questionnaire.
C.R.S. § 12-255-115 Volunteer licensure - fees - questionnaire
12-255-115. Volunteer licensure - fees - questionnaire. (1) The board may issue a license to a volunteer nurse or certified midwife who meets the requirements set forth in this section.
(2) A volunteer nursing or certified midwife license shall only be issued to an applicant who:
(a) Currently holds a license to practice nursing, either as a practical nurse or as a professional nurse, or to practice as a certified midwife, and the license is due to expire unless renewed; or
(b) Is not currently engaged in the practice of nursing or as a certified midwife either full-time or part-time and has, prior to ceasing practice, maintained full licensure in good standing in any state or territory of the United States.
(3) (a) A volunteer nursing license shall permit the nurse to engage in volunteer nursing tasks within the scope of the nurse's license.
(b) A volunteer certified midwife license shall permit the certified midwife to engage as a volunteer in the practice as a certified midwife within the scope of the certified midwife's license.
(4) An applicant for a volunteer nursing or certified midwife license shall submit to the board an application containing the information the board may prescribe, a copy of the applicant's most recent nursing or certified midwife license, and a statement signed under penalty of perjury in which the applicant agrees not to receive compensation for any nursing tasks or tasks as a certified midwife that are performed while in possession of the license.
(5) A person who possesses a volunteer nursing or certified midwife license is immune from civil liability for actions performed within the scope of the nursing or certified midwife license unless it is established that injury or death was caused by gross negligence or the willful and wanton misconduct of the licensee. The immunity provided in this subsection (5) applies only to the licensee and does not affect the liability of any other individual or entity. Nothing in this subsection (5) limits the ability of the board to take disciplinary action against a licensee.
(6) The fee for a volunteer nursing or certified midwife license, including assessments for legal defense, peer assistance, and other programs for which licenses are assessed, must not exceed fifty percent of the license renewal fee, including all assessments, established by the board for an active nursing or certified midwife license.
(7) The board shall design a questionnaire to be sent to all volunteer nurses and certified midwives who apply for license renewal. Each applicant for license renewal shall complete the board-designed questionnaire. The purpose of the questionnaire is to determine whether a licensee has acted in violation of this part 1 or has been disciplined for any action that might be considered a violation of this part 1 or might make the licensee unfit to practice nursing or as a certified midwife with reasonable care and safety. If an applicant fails to answer the questionnaire accurately, the failure constitutes grounds for discipline under section 12-255-120 (1)(v). The board may include the cost of developing and reviewing the questionnaire in the fee paid under subsection (6) of this section. The board may deny an application for license renewal that does not accompany an accurately completed questionnaire.
(8) (a) The board shall deny an application for the reactivation of a practical or professional nurse license for a volunteer nurse if the board determines that the nurse requesting reactivation has not actively volunteered as a nurse for the two-year period immediately preceding the filing of the application for license reactivation or has not otherwise demonstrated continued competency to return to the active practice of nursing in a manner approved by the board.
practical or professional nurse license for a volunteer nurse if the board determines that the nurse requesting reactivation has not actively volunteered as a nurse for the two-year period immediately preceding the filing of the application for license reactivation or has not otherwise demonstrated continued competency to return to the active practice of nursing in a manner approved by the board.
(b) The board shall deny an application for the reactivation of a certified midwife license for a volunteer certified midwife if the board determines that the certified midwife requesting reactivation has not actively volunteered as a certified midwife for the two-year period immediately preceding the filing of the application for license reactivation or has not otherwise demonstrated continued competency to return to the active practice as a certified midwife in a manner approved by the board.
C.R.S. § 12-255-116 Persons licensed under previous laws
12-255-116. Persons licensed under previous laws. Any person holding a valid Colorado license to engage in the practice of practical or professional nursing issued prior to July 1, 1980, shall continue to be licensed under the provisions of this part 1.
C.R.S. § 12-255-117 Temporary licenses and permits
12-255-117. Temporary licenses and permits. (1) The board may issue a temporary license to practice for a period of four months to an applicant for licensure by endorsement pursuant to the occupational credential portability program.
(2) The board may issue a permit to practice as a practical or professional nurse for a period not to exceed two years or as determined by the board to any person from another state or a territory of the United States or a foreign country who is in this state for special training or for observation of nursing educational programs upon proof to the board by the person that he or she is currently licensed to practice as a nurse in the state, territory, or country of residency. The nursing practice permitted by the permit shall be limited to that practice performed as part of the special training or nursing educational program.
(3) The board may, as it deems appropriate, issue a permit to a person who is under the supervision of a professional nurse licensed pursuant to this part 1.
(4) A person holding a permit may engage in the practice of practical or professional nursing only under the personal and responsible supervision and direction of a person licensed by the board to engage in the practice of professional nursing.
(5) The board shall summarily withdraw a temporary license or permit issued pursuant to this section if the board determines that the temporary license or permit holder fails to meet the requirements of this section or section 12-255-109, 12-255-110, 12-255-111.5, or 12-255-114. The holder of a temporary license or permit summarily withdrawn has the right to a hearing that shall be conducted pursuant to article 4 of title 24 and section 12-20-403 by the board or by an administrative law judge at the board's discretion.
C.R.S. § 12-255-118 Approval of educational programs
12-255-118. Approval of educational programs. (1) Any institution in this state desiring to receive from the board approval of its educational program that prepares individuals for licensure as a practical or as a professional nurse shall apply to the board and submit evidence that it is prepared to carry out an educational program that complies with the provisions of this part 1 and with rules adopted by the board pursuant to this part 1.
(2) For the practice of practical nursing, the educational program shall include:
(a) Content fundamental to the knowledge and skills required for clinical nursing appropriate to the practice of practical nursing;
(b) Content relating to the principles of biological, physical, social, and behavioral sciences.
(3) For the practice of professional nursing, the educational program shall include:
(a) Content fundamental to the knowledge and skills required for clinical nursing appropriate to the practice of professional nursing;
(b) Content relating to the principles of biological, physical, social, and behavioral sciences.
(4) Any educational program for practical or professional nurses in this state that was accredited by the former boards of nursing prior to July 1, 1980, shall be deemed to be an approved educational program for the purpose of this part 1, but the approval is subject to the powers and duties of the board under section 12-255-107 to deny or to withdraw approval.
C.R.S. § 12-255-118.5 Approved nurse aide training programs
12-255-118.5. Approved nurse aide training programs. (1) Except for any medical facility or program that has been explicitly disapproved by the department of public health and environment, the board may approve any nurse aide training program offered by or held in a medical facility or offered and held outside a medical facility. Approval by the board is sufficient to authorize and permit the operation of the training program.
(2) The curriculum content for nurse aide training must include material that will provide a basic level of both knowledge and demonstrable skills for each individual completing the program and be presented in a manner that will take into consideration individuals with limited literacy skills. The curriculum content must include needs of populations that may be served by an individual medical facility.
(3) The curriculum must include the following topics:
(a) Communication and interpersonal skills;
(b) Infection control;
(c) Safety and emergency procedures;
(d) Promoting residents' and patients' independence;
(e) Respecting residents' and patients' rights.
(4) The training program shall be designed to enable participants to develop and demonstrate competency in the following areas:
(a) Basic nursing skills;
(b) Personal care skills;
(c) Recognition of mental health and social services needs;
(d) Basic restorative services;
(e) Resident or patient rights.
(5) The board or its designee shall inspect and survey each nurse aide training program it approves during the first year following approval and every two years thereafter. The inspection or survey may be made in conjunction with surveys of medical facilities conducted by the department of public health and environment.
(6) The board may require a nurse aide training program to include up to twenty-five percent more hours than the minimum requirements established in the federal "Omnibus Budget Reconciliation Act of 1987", as amended, Pub.L. 100-203, 101 Stat. 1330. Any additional training hours shall be within the subject areas required by federal law.
C.R.S. § 12-255-119 Disciplinary procedures of the board - inquiry and hearings panels - mental and physical examinations - definitions - rules
12-255-119. Disciplinary procedures of the board - inquiry and hearings panels - mental and physical examinations - definitions - rules. (1) (a) The president of the board shall divide the other members of the board into two panels of five members each. Members representing the different categories of membership (licensed practical nurses, professional nurses, certified midwives, and persons not licensed, employed, or in any way connected with, or with any financial interest in, any health-care facility, agency, or insurer) shall be divided between the two panels as equally as possible.
(b) Each panel shall act as both an inquiry and a hearings panel. Members of the board may be assigned from one panel to the other by the president. The president may be a member of both panels, but in no event shall the president or any other member who has considered a complaint as a member of a panel acting as an inquiry panel take any part in the consideration of a formal complaint involving the same matter.
(c) All matters referred to one panel for investigation shall be heard, if referred for formal hearing, by the other panel or a committee of the panel. However, in its discretion, either inquiry panel may elect to refer a case for formal hearing to a qualified administrative law judge, in lieu of a hearings panel of the board, for an initial decision pursuant to section 24-4-105.
(d) The initial decision of an administrative law judge may be reviewed pursuant to section 24-4-105 (14) and (15) by the filing of exceptions to the initial decision with the hearings panel that would have heard the case if it had not been referred to an administrative law judge or by review upon the motion of the hearings panel. The respondent or the board's counsel shall file the exceptions.
(2) Investigations shall be under the supervision of the panel to which they are assigned. The persons making the investigation shall report the results thereof to the assigning panel for appropriate action.
(3) (a) (I) As used in this section:
(A) "Grounds for discipline" includes grounds under sections 12-255-120 and 12-295-111.
(B) "License" includes licensure for a practical nurse or professional nurse, licensure for a certified midwife, and licensure for a psychiatric technician.
(C) "Nurse", "licensee", or "respondent" includes a practical nurse, a professional nurse, a certified midwife, and a psychiatric technician as described in section 12-295-103 (4).
(D) "Practice of nursing" includes the practice of practical nursing, the practice of professional nursing, and the practice as a psychiatric technician.
(II) Written complaints relating to the conduct of a nurse licensed or authorized to practice nursing in this state or relating to the conduct of a certified midwife licensed or authorized to practice as a certified midwife in this state may be made by any person or may be initiated by an inquiry panel of the board on its own motion. Unless the board determines the complaint to be without merit of investigation, the board shall give notice of the complaint to the nurse or certified midwife complained of, by first-class mail, and shall state in the notice the nature of the complaint and that the failure to respond in a materially factual and timely manner constitutes grounds for discipline. The nurse or certified midwife complained of shall be given thirty days to answer or explain in writing the matters described in the complaint. Upon receipt of the nurse's or certified midwife's answer or at the conclusion of thirty days, whichever occurs first, the inquiry panel may take further action as set forth in subsection (3)(a)(III) of this section.
ner constitutes grounds for discipline. The nurse or certified midwife complained of shall be given thirty days to answer or explain in writing the matters described in the complaint. Upon receipt of the nurse's or certified midwife's answer or at the conclusion of thirty days, whichever occurs first, the inquiry panel may take further action as set forth in subsection (3)(a)(III) of this section.
(III) Upon receipt of the nurse's or certified midwife's answer or the conclusion of thirty days, the inquiry panel may conduct a further investigation that may be made by one or more members of the inquiry panel; in the case of a complaint against a nurse, one or more nurses who are not members of the board; in the case of a complaint against a certified midwife, one or more certified midwives or certified nurse midwives who are not members of the board; a member of the staff of the board; a professional investigator; or any other person or organization as the inquiry panel directs. The investigation must be entirely informal.
(b) The board shall cause an investigation to be made when the board is informed of:
(I) Disciplinary action taken by an employer of a nurse or certified midwife against the nurse or certified midwife or resignation in lieu of a disciplinary action for conduct that constitutes grounds for discipline under section 12-255-120 or 12-295-111. The employer shall report the disciplinary action or resignation to the board.
(II) An instance of a malpractice settlement or judgment against a nurse or certified midwife;
(III) A nurse or certified midwife who has not timely renewed the nurse's or certified midwife's license and the nurse or certified midwife is actively engaged in the practice of nursing or as a certified midwife.
(c) On completion of an investigation, the inquiry panel shall make a finding that:
(I) The complaint is without merit and no further action need be taken;
(II) There is no reasonable cause to warrant further action on the complaint;
(III) An instance of conduct occurred that does not warrant formal action by the board and that should be dismissed, but that indications of possible conduct by the nurse or certified midwife were noted that could lead to serious consequences if not corrected. In such a case, the board shall send a confidential letter of concern in accordance with section 12-20-404 (5) to the nurse or certified midwife against whom the complaint was made.
(IV) An instance of misconduct occurred that, in the opinion of the board, does not warrant formal action by the board but that should not be dismissed as being without merit, in which case the board may issue and send a letter of admonition to the licensee in accordance with section 12-20-404 (4);
(V) Facts were disclosed that warrant further proceedings by formal complaint, as provided in subsection (4) of this section, and that the complaint should be referred to the attorney general for preparation and filing of a formal complaint.
(4) (a) All formal complaints shall be heard and determined in accordance with subsection (4)(b) of this section and section 24-4-105. Except as provided in subsection (1) of this section, all formal hearings shall be conducted by the hearings panel. The nurse or certified midwife may be present in person or represented by counsel, or both, if so desired, to offer evidence and be heard in the nurse's or certified midwife's own defense. At formal hearings, the witnesses shall be sworn and a complete record shall be made of all proceedings and testimony.
ubsection (1) of this section, all formal hearings shall be conducted by the hearings panel. The nurse or certified midwife may be present in person or represented by counsel, or both, if so desired, to offer evidence and be heard in the nurse's or certified midwife's own defense. At formal hearings, the witnesses shall be sworn and a complete record shall be made of all proceedings and testimony.
(b) Except as provided in subsection (1) of this section, an administrative law judge shall preside at the hearing and shall advise the hearings panel on all legal matters in connection with the hearing as the panel may request. The administrative law judge shall provide such advice or assistance as the hearings panel may request in connection with the preparation of its findings and recommendations or conclusions. The administrative law judge may act in accordance with section 12-20-403 and perform other duties as the hearings panel may authorize the administrative law judge to perform. The administrative law judge shall have the qualifications provided in section 24-30-1003 (2).
(c) (I) To warrant a finding of grounds for discipline, the charges shall be established as specified in section 24-4-105 (7). Except as provided in subsection (1) of this section, the hearings panel shall make a report of its findings and conclusions that, when approved by a majority of those members of the hearings panel who have conducted the hearing pursuant to subsections (4)(a) and (4)(b) of this section, shall be the action of the board.
(II) If it is found that the charges are unproven, the hearings panel, or an administrative law judge sitting in lieu of the hearings panel pursuant to subsection (1) of this section, shall enter an order dismissing the complaint.
(III) If the hearings panel finds the charges proven and orders that discipline be imposed, it shall also determine the extent of the discipline, which may be in the form of a letter of admonition regarding a license or suspension for a definite or indefinite period, revocation, or nonrenewal of a license to practice. In addition to any other discipline that may be imposed pursuant to this section, the hearings panel may impose a fine of no less than two hundred fifty dollars but no more than one thousand dollars per violation on any nurse or certified midwife who violates this part 1 or any rule adopted pursuant to this part 1. The board shall adopt rules establishing a fine structure and the circumstances under which fines may be imposed.
(IV) In determining appropriate disciplinary action, the hearings panel shall first consider sanctions that are necessary to protect the public. Only after the panel has considered such sanctions shall it consider and order requirements designed to rehabilitate the nurse or certified midwife. If discipline other than revocation of a license to practice is imposed, the hearings panel may also order that the nurse or certified midwife be granted probation and allowed to continue to practice during the period of the probation. The hearings panel may also include in any disciplinary order that allows the nurse or certified midwife to continue to practice such conditions as the panel may deem appropriate to assure that the nurse or certified midwife is physically, mentally, and otherwise qualified to practice nursing or as a certified midwife in accordance with generally accepted standards of practice, including any of the following:
(A) Submission by the respondent to such examinations as the hearings panel may order to determine the respondent's physical or mental condition or the respondent's professional qualifications;
(B) The taking by the respondent of such therapy or courses of training or education as may be needed to correct deficiencies found either in the hearing or by the examinations;
ding any of the following:
(A) Submission by the respondent to such examinations as the hearings panel may order to determine the respondent's physical or mental condition or the respondent's professional qualifications;
(B) The taking by the respondent of such therapy or courses of training or education as may be needed to correct deficiencies found either in the hearing or by the examinations;
(C) The review or supervision of the respondent's practice of nursing or as a certified midwife as may be necessary to determine the quality of the respondent's practice of nursing or as a certified midwife and to correct deficiencies in the respondent's practice; or
(D) The imposition of restrictions upon the nature of the respondent's practice to assure that the respondent does not practice beyond the limits of the respondent's capabilities.
(V) Upon the failure of the respondent to comply with any conditions imposed by the hearings panel pursuant to subsection (4)(c)(IV) of this section, the hearings panel may order revocation or suspension of the respondent's license to practice in this state until the respondent complies with the conditions.
(VI) In making any of the orders provided in subsections (4)(c)(IV) and (4)(c)(V) of this section, the hearings panel may take into consideration the respondent's prior disciplinary record. If the hearings panel does take into consideration any prior discipline of the respondent, its findings and recommendations shall so indicate.
(VII) In all cases of revocation, suspension, probation, or nonrenewal, the board shall enter in its records the facts of the revocation, suspension, probation, or nonrenewal and of any subsequent action of the board with respect thereto.
(d) The attorney general shall prosecute those charges that have been referred to the office of the attorney general by the inquiry panel pursuant to subsection (3)(c)(V) of this section. The board may direct the attorney general to perfect an appeal.
(e) The two-year waiting period specified in section 12-20-404 (3) applies to any person whose license to practice nursing, practice as a certified midwife, or practice any other health-care occupation is revoked by any other legally qualified board.
(5) A majority of the members of the board, three members of the inquiry panel, or three members of the hearings panel shall constitute a quorum. The action of a majority of those present comprising a quorum shall be the action of the board, the inquiry panel, or the hearings panel.
(6) Upon the expiration of any term of suspension, the license shall be reinstated by the board if the board is furnished with evidence that the nurse or certified midwife has complied with all terms of the suspension. If the evidence shows the nurse or certified midwife has not complied with all terms of the suspension, the board may revoke or continue the suspension of the license at a hearing, notice of which and the procedure at which shall be as provided in this section.
(7) In case any nurse or certified midwife is determined to be mentally incompetent or insane by a court of competent jurisdiction and a court enters, pursuant to part 3 or 4 of article 14 of title 15 or section 27-65-110 (4) or 27-65-127, an order specifically finding that the mental incompetency or insanity is of such a degree that the nurse or certified midwife is incapable of continuing the practice of nursing or as a certified midwife, the board shall automatically suspend the nurse's or certified midwife's license, and, notwithstanding any provision of this part 1 to the contrary, the suspension must continue until the nurse or certified midwife is found by the court to be competent to continue the practice of nursing or the practice as a certified midwife, as applicable.
nuing the practice of nursing or as a certified midwife, the board shall automatically suspend the nurse's or certified midwife's license, and, notwithstanding any provision of this part 1 to the contrary, the suspension must continue until the nurse or certified midwife is found by the court to be competent to continue the practice of nursing or the practice as a certified midwife, as applicable.
(8) (a) If the board has reasonable cause to believe that a nurse is unable to practice nursing, or a certified midwife is unable to practice as a certified midwife, with reasonable skill and safety to patients because of a condition described in section 12-255-120 (1)(i) or (1)(j) or section 12-295-111 (1)(i) or (1)(j), the board may require the nurse or certified midwife to submit to mental or physical examinations by a physician or other licensed health-care professional designated by the board. If a nurse or certified midwife fails to submit to the mental or physical examinations, the board may suspend the nurse's or certified midwife's license until the required examinations are conducted.
(b) (I) Every nurse or certified midwife shall be deemed, by so practicing or by applying for renewal registration of the nurse's or certified midwife's license, to have consented to submit to mental or physical examinations when directed in writing by the board. Further, the nurse or certified midwife shall be deemed to have waived all objections to the admissibility of the examining physician's or other licensed health-care professional's testimony or examination reports on the ground of privileged communication. Subject to applicable federal law, the nurse or certified midwife shall be deemed to have waived all objections to the production of medical records to the board from health-care providers that may be necessary for the evaluations described in subsection (8)(a) of this section.
(II) Nothing in this section prevents a nurse or certified midwife from submitting to the board testimony or examination reports of a physician or other licensed health-care professional designated by the nurse or certified midwife to a condition described in subsection (8)(a) of this section that may be considered by the board in conjunction with, but not in lieu of, testimony and examination reports of the physician or licensed health-care professional designated by the board.
(c) The results of any mental or physical examination ordered by the board shall not be used as evidence in any proceeding other than before the board and shall not be deemed a public record nor made available to the public.
(d) The board may require that a nurse or certified midwife submit medical records for review in conjunction with an examination made pursuant to subsection (8)(a) of this section; except that the records remain confidential, and the board may review the records only to the extent necessary to conduct an investigation.
(9) (a) Investigations, examinations, hearings, meetings, or any other proceedings of the board conducted pursuant to the provisions of this section shall be exempt from the open meetings provisions of the "Colorado Sunshine Act of 1972", part 4 of article 6 of title 24, requiring that proceedings of the board be conducted publicly, and the open records provisions of article 72 of title 24, requiring that the minutes or records of the board with respect to action of the board taken pursuant to the provisions of this section be open to public inspection.
xempt from the open meetings provisions of the "Colorado Sunshine Act of 1972", part 4 of article 6 of title 24, requiring that proceedings of the board be conducted publicly, and the open records provisions of article 72 of title 24, requiring that the minutes or records of the board with respect to action of the board taken pursuant to the provisions of this section be open to public inspection.
(b) Notwithstanding the exemptions in subsection (9)(a) of this section, records of disciplinary action taken by the board pursuant to this section shall be open to public inspection pursuant to the open records provisions of article 72 of title 24.
(10) A physician or other licensed health-care professional who, at the request of the board, examines a nurse or certified midwife is immune from suit for damages by the nurse or certified midwife examined if the examining physician or examining licensed health-care professional conducted the examination and made findings or a diagnosis in good faith.
(11) All actions taken and decisions rendered by the board prior to July 1, 1999, are hereby ratified.
(12) Final board action may be judicially reviewed in accordance with section 12-20-408. Judicial proceedings for the enforcement of a board order may be instituted in accordance with section 24-4-106.
(13) Upon certification of the custodian that copies of records subpoenaed pursuant to section 12-20-403 (2) are true and complete except for the patient's name, the copies shall be deemed authentic, subject to the right to inspect the originals for the limited purpose of ascertaining the accuracy of the copies. No privilege of confidentiality shall exist with respect to the copies, and no liability shall lie against the board or the custodian or the custodian's authorized employee for furnishing or using the copies in accordance with this subsection (13).
(14) The board may issue cease-and-desist orders under the circumstances and in accordance with the procedures specified in section 12-20-405.
C.R.S. § 12-255-120 Grounds for discipline - definitions
12-255-120. Grounds for discipline - definitions. (1) "Grounds for discipline", as used in this part 1, means any action by any person who:
(a) Has procured or attempted to procure a license by fraud, deceit, misrepresentation, misleading omission, or material misstatement of fact;
(b) (I) Has been convicted of a felony or any crime that would constitute a violation of this part 1.
(II) (A) For purposes of this subsection (1)(b), "convicted" includes entering a plea of guilty or nolo contendere or imposing a deferred sentence.
(B) A certified copy of the judgment of a court of competent jurisdiction of the conviction or plea shall be prima facie evidence of the conviction.
(c) Has acted in a manner inconsistent with the health or safety of persons under his or her care;
(d) Has had a license to practice nursing, practice as a certified midwife, or practice any other health-care occupation suspended or revoked in any jurisdiction. A certified copy of the order of suspension or revocation is prima facie evidence of the suspension or revocation.
(e) Has violated or has aided or knowingly permitted any person to violate any provision of this part 1 or an applicable provision of article 20 or 30 of this title 12;
(f) Has practiced nursing or as a certified midwife in a manner that fails to meet generally accepted standards for the practice of nursing or as a certified midwife, as applicable;
(g) Has violated any order or rule of the board pertaining to nursing practice, practice as a certified midwife, or licensure;
(h) Has falsified or in a negligent manner made incorrect entries or failed to make essential entries on patient records;
(i) Excessively or habitually uses or abuses or has engaged in excessive or habitual use or abuse of alcohol, a habit-forming drug, a controlled substance, as defined in section 18-18-102 (5), or any other drug having similar effects; except that the board has the discretion not to discipline the licensee if the licensee is participating in good faith in a program approved by the board designed to end the excessive or habitual use or abuse;
(j) Has failed to:
(I) Notify the board, as required by section 12-30-108 (1), of a physical illness, physical condition, or behavioral health, mental health, or substance use disorder that affects the person's ability to practice nursing or as a certified midwife with reasonable skill and safety to patients or that may endanger the health or safety of individuals under the person's care;
(II) Act within the limitations created by a physical illness, physical condition, or behavioral health, mental health, or substance use disorder that renders the person unable to practice nursing or as a certified midwife with reasonable skill and safety to patients or that may endanger the health or safety of individuals under the person's care; or
(III) Comply with the limitations agreed to under a confidential agreement entered into pursuant to section 12-30-108;
(k) Has violated the confidentiality of information or knowledge as prescribed by law concerning any patient;
(l) Has engaged in any conduct that would constitute a crime as defined in title 18 and that relates to the person's employment as a practical or professional nurse or as a certified midwife. In conjunction with any disciplinary proceeding pertaining to this subsection (1)(l), the board shall be governed by the provisions of sections 12-20-202 (5) and 24-5-101.
(m) (I) Has violated abuse of health insurance pursuant to section 18-13-119; or
(II) Has advertised through newspapers, magazines, circulars, direct mail, directories, radio, television, or otherwise that the licensee will perform any act prohibited by section 18-13-119 (3);
rtaining to this subsection (1)(l), the board shall be governed by the provisions of sections 12-20-202 (5) and 24-5-101.
(m) (I) Has violated abuse of health insurance pursuant to section 18-13-119; or
(II) Has advertised through newspapers, magazines, circulars, direct mail, directories, radio, television, or otherwise that the licensee will perform any act prohibited by section 18-13-119 (3);
(n) Has engaged in any of the following activities and practices:
(I) Willful and repeated ordering or performance, without clinical justification, of demonstrably unnecessary laboratory tests or studies;
(II) The administration, without clinical justification, of treatment that is demonstrably unnecessary;
(III) The failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or
(IV) Ordering or performing, without clinical justification, any service, X ray, or treatment that is contrary to recognized standards of the practice of nursing or as a certified midwife as interpreted by the board;
(o) Has committed a fraudulent insurance act, as defined in section 10-1-128;
(p) Has prescribed, distributed, or given to himself or herself or a family member any controlled substance as defined in part 2 of article 18 of title 18 or as contained in schedule II of 21 U.S.C. sec. 812, except for medical marijuana lawfully recommended and obtained pursuant to the laws of the state of Colorado;
(q) Has dispensed, injected, or prescribed an anabolic steroid, as defined in section 18-18-102 (3), for the purpose of hormonal manipulation that is intended to increase muscle mass, strength, or weight without a medical necessity to do so or for the intended purpose of improving performance in any form of exercise, sport, or game;
(r) Has dispensed or injected an anabolic steroid, as defined in section 18-18-102 (3), unless the anabolic steroid is dispensed from a pharmacy pursuant to a written prescription or is dispensed by any person licensed to practice medicine in the course of the person's professional practice;
(s) Has administered, dispensed, or prescribed any habit-forming drug or any controlled substance, as defined in section 18-18-102 (5), other than in the course of legitimate professional practice, which includes the recommendation, administration, or dispensation of medical marijuana;
(t) Has been disciplined by another state, territory, or country based upon an act or omission that is defined substantially the same as a ground for discipline pursuant to this subsection (1);
(u) Willfully fails to respond in a materially factual and timely manner to a complaint issued pursuant to section 12-255-119 (3);
(v) Has failed to accurately complete and submit to the board the designated questionnaire upon renewal of a license pursuant to section 12-255-110 (3), 12-255-111.5 (4), 12-255-114 (3), or 12-255-115 (7);
(w) (I) Represents oneself to an individual or to the general public by use of any word or abbreviation to indicate or induce others to believe that he or she is a licensed practical or professional nurse unless the person is actually licensed as a practical nurse or professional nurse, respectively;
(II) Uses the title "nurse", "registered nurse", "R.N.", "practical nurse", "trained practical nurse", "licensed vocational nurse", "licensed practical nurse", or "L.P.N." unless the person is licensed by the board as a professional or practical nurse, as applicable;
(III) Represents oneself to an individual or to the general public by use of any word or abbreviation to indicate or induce others to believe that the person is a certified midwife unless the person is actually licensed as a certified midwife; or
(IV) Uses the title "certified midwife" or the abbreviation "C.M." unless the person is licensed by the board as a certified midwife;
e, as applicable;
(III) Represents oneself to an individual or to the general public by use of any word or abbreviation to indicate or induce others to believe that the person is a certified midwife unless the person is actually licensed as a certified midwife; or
(IV) Uses the title "certified midwife" or the abbreviation "C.M." unless the person is licensed by the board as a certified midwife;
(x) Practices as a practical or professional nurse or as a certified midwife during a period when the person's license has been suspended, revoked, or placed on inactive status pursuant to section 12-255-122;
(y) Sells or fraudulently obtains or furnishes a license to practice as a nurse or certified midwife or aids or abets in such act;
(z) Has failed to report to the board, within thirty days after a final conviction, that the person has been convicted of a crime, as defined in title 18;
(aa) Fails to maintain professional liability insurance in accordance with section 12-255-113;
(bb) Repealed.
(cc) Engaged in a sexual act with a patient during the course of patient care or within six months immediately following the termination of the person's professional relationship with the patient. As used in this subsection (1)(cc), "sexual act" means sexual contact, sexual intrusion, or sexual penetration as defined in section 18-3-401.
(dd) Has failed to notify the board, in writing and within thirty days after a judgment or settlement is entered, of a final judgment by a court of competent jurisdiction against the licensee for malpractice of nursing or as a certified midwife or a settlement by the licensee in response to charges or allegations of malpractice of nursing or as a certified midwife and, in the case of a judgment, has failed to include in the notice the name of the court, the case number, and the names of all parties to the action;
(ee) Fails to report to the board, within thirty days after an adverse action, that an adverse action has been taken against the person by another licensing agency in another state or jurisdiction; a peer review body; a health-care institution; a professional, nursing, or certified midwife society or association; a governmental agency; a law enforcement agency; or a court for acts or conduct that would constitute grounds for disciplinary or adverse action as described in this article 255;
(ff) Fails to report to the board, within thirty days, the surrender of a license or other authorization to practice nursing or as a certified midwife in another state or jurisdiction or the surrender of membership on any nursing or certified midwife staff or in any nursing, certified midwife, or professional association or society while under investigation by any of those authorities or bodies for acts or conduct similar to acts or conduct that would constitute grounds for action as described in this article 255;
(gg) Is diverting or has diverted a controlled substance, as defined in section 18-18-102 (5), or any other drug having similar effects from the person's place of employment; or
(hh) Has been convicted of an offense under section 18-13-131. For purposes of this subsection (1)(hh), "convicted" includes the entry of a plea of guilty or nolo contendere or the imposition of a deferred sentence.
C.R.S. § 12-255-121 Withholding or denial of license - hearing - definitions
12-255-121. Withholding or denial of license - hearing - definitions. (1) (a) The board is empowered to determine summarily whether:
(I) An applicant for a license or a temporary license to practice as a nurse or as a certified midwife possesses the qualifications required by this part 1;
(II) There is probable cause to believe that an applicant for a license or temporary license has done any of the acts set forth in section 12-255-120 as grounds for discipline; or
(III) The applicant for a license or temporary license has had a license to practice nursing, practice as a certified midwife, or practice any other health-care occupation revoked by any legally authorized board.
(b) As used in this section:
(I) "Applicant" includes a nurse or certified midwife seeking reinstatement or reactivation of a license pursuant to section 12-255-122, but does not include a renewal applicant.
(II) "Legally authorized board" means a board created pursuant to the laws of this state or of another state for the purpose of licensing or otherwise authorizing a person to engage in a health-care occupation. The term includes any governmental entity charged with licensing or other oversight of persons engaged in a health-care occupation.
(2) (a) (I) If the board determines that an applicant does not possess the qualifications for licensure required by this part 1, that probable cause exists to believe that an applicant for a license or temporary license has done any of the acts set forth in section 12-255-120, or that an applicant for a license or temporary license has had a nursing, certified midwife, or other health-care occupation license revoked by another legally authorized board, the board may withhold or deny the applicant a license under this part 1.
(II) The board may deny a license or temporary license to practice as a nurse or as a certified midwife to any applicant during the time the applicant's license is under suspension in another state.
(III) The board may deny a license or may grant a license subject to terms of probation if the board determines that an applicant for a license has not actively practiced practical or professional nursing, has not actively practiced as a certified midwife, or has not otherwise maintained continued competency, as determined by the board, during the two years immediately preceding the application for licensure under this part 1.
(b) If the board denies a license to an applicant pursuant to subsection (2)(a) of this section, the provisions of section 24-4-104 (9) apply. Upon the denial, the board shall provide the applicant with a statement in writing setting forth the following:
(I) The basis of the board's determination that the applicant:
(A) Does not possess the qualifications required by this part 1;
(B) Has had a nursing, certified midwife, or other health-care occupation license revoked or suspended by another legally authorized board; or
(C) Has not actively practiced practical or professional nursing, has not actively practiced as a certified midwife, or has not maintained continued competency during the previous two years; or
(II) The factual basis for probable cause that the applicant has done any of the acts set forth in section 12-255-120.
-care occupation license revoked or suspended by another legally authorized board; or
(C) Has not actively practiced practical or professional nursing, has not actively practiced as a certified midwife, or has not maintained continued competency during the previous two years; or
(II) The factual basis for probable cause that the applicant has done any of the acts set forth in section 12-255-120.
(c) (I) If the board denies a nursing license to an applicant on the grounds that the applicant's nursing or other health-care occupation license was revoked by another legally authorized board, the board may require the applicant to pass a written examination as provided in section 12-255-109 as a prerequisite to licensure. The applicant shall not be allowed to take the written examination until at least two years after the revocation of the nursing or other health-care occupation license.
(II) If the board denies a certified midwife license to an applicant on the grounds that the applicant's certified midwife license was revoked by another legally authorized board, the board may require the applicant to obtain recertification from the American Midwifery Certification Board, or its successor entity, as a prerequisite to licensure. The applicant shall not be allowed to obtain licensure pursuant to this subsection (2)(c)(II) until at least two years after the applicant's certified midwife license was revoked.
(3) If the applicant requests a hearing pursuant to the provisions of section 24-4-104 (9) and fails to appear without good cause at the hearing, the board may affirm its prior action of withholding or denial without conducting a hearing.
(4) Following a hearing, the board shall affirm, modify, or reverse its prior action in accordance with its findings at the hearing.
(5) No action shall lie against the board for the withholding or denial of a license or temporary license without a hearing in accordance with the provisions of this section if the board acted reasonably and in good faith.
(6) (a) At the hearing, the applicant has the burden of proof to show that:
(I) The applicant possesses the qualifications required for licensure under this part 1;
(II) The applicant's nursing, certified midwife, or other health-care occupation license was not revoked by another legally authorized board; or
(III) The applicant has actively practiced practical or professional nursing, has actively practiced as a certified midwife, or has maintained continued competency during the two years prior to application for a license under this part 1.
(b) The board shall have the burden of proof to show commission of acts set forth in section 12-255-120.
C.R.S. § 12-255-122 Inactive license status - reactivation
12-255-122. Inactive license status - reactivation. (1) A nurse or certified midwife licensed pursuant to section 12-255-110, 12-255-111.5, or 12-255-114 may request that the board place the nurse's or certified midwife's license on inactive status. The request shall be made in the form and manner designated by the board.
(2) A nurse or certified midwife requesting inactive license status shall provide an affidavit or other document required by the board certifying that, immediately upon the conferral of inactive status, the nurse will not practice nursing, or the certified midwife will not practice as a certified midwife, in the state unless the nurse's or certified midwife's license is reactivated pursuant to subsection (6) of this section.
(3) Upon receiving the documentation pursuant to subsection (2) of this section, the board shall approve a request for inactive license status. However, the board may deny the request if the board has probable cause to believe that the requesting nurse or certified midwife has committed any of the acts set forth in section 12-255-120.
(4) A license on inactive status shall constitute a single state license issued by Colorado and without multistate licensure privilege pursuant to part 38 of article 60 of title 24.
(5) A nurse or certified midwife with a license on inactive status is not authorized to practice nursing or as a certified midwife, as applicable, in Colorado. Any nurse practicing nursing while the nurse's license is inactive, and any certified midwife practicing as a certified midwife while the certified midwife's license is inactive, is subject to disciplinary action pursuant to section 12-255-119 and criminal penalties pursuant to section 12-255-125.
(6) (a) A nurse or certified midwife with a license on inactive status who wishes to resume the practice of nursing or as a certified midwife, as applicable, shall file an application in the form and manner designated by the board and pay the license reactivation fees established pursuant to section 12-255-107. The board shall reactivate such license unless subsection (6)(b) of this section applies.
(b) The board shall deny an application for reactivation of an inactive license:
(I) Pursuant to section 12-255-121; or
(II) If the board determines that the nurse or certified midwife requesting reactivation has not actively practiced nursing or as a certified midwife in another state for the two-year period immediately preceding the filing of the request for reactivation or has not otherwise demonstrated continued competency to return to the active practice of nursing or as a certified midwife in a manner approved by the board.
C.R.S. § 12-255-123 Immunity in professional review
12-255-123. Immunity in professional review. (1) If a professional review committee is established pursuant to section 12-255-108 to investigate the quality of care being given by a person licensed pursuant to this part 1, the professional review committee must include in its membership at least three persons licensed in the same category as the licensee under review, but the committee may be authorized to act only by the board.
(2) In addition to the persons specified in section 12-20-402, any member of a professional review committee authorized by the board, any member of the committee's staff, any person acting as a witness or consultant to the committee, any witness testifying in a proceeding authorized under this part 1, and any person who lodges a complaint pursuant to this part 1 is granted the same immunity and is subject to the same conditions for immunity as specified in section 12-20-402.
C.R.S. § 12-255-124 Surrender of license
12-255-124. Surrender of license. (1) Prior to the initiation of an investigation or hearing, any licensee or temporary license holder may surrender the individual's license to practice nursing or as a certified midwife.
(2) Following the initiation of an investigation or hearing and upon a finding that to do so would be in the public interest, the board may allow a licensee or temporary license holder to surrender his or her license to practice.
(3) The board shall not issue a license or temporary license or permit to a former licensee or temporary license or permit holder whose license has been surrendered unless the licensee meets all of the requirements of this part 1 for a new applicant, including, for applicants for a license, temporary license, or permit to practice nursing, the passing of an examination.
(4) The surrender of a license in accordance with this section removes all rights and privileges to practice nursing or as a certified midwife, as applicable, including renewal of a license.
C.R.S. § 12-255-125 Unauthorized practice - penalties
12-255-125. Unauthorized practice - penalties. (1) It is unlawful for any person to practice as a practical or professional nurse or as a certified midwife unless licensed to practice that profession.
(2) Any person who practices or offers or attempts to practice practical or professional nursing or as a certified midwife without an active license issued under this part 1 is subject to penalties pursuant to section 12-20-407 (1)(a).
C.R.S. § 12-255-126 Injunctive proceedings
12-255-126. Injunctive proceedings. The board may seek injunctive relief in accordance with section 12-20-406, but only to enjoin any person who does not possess a currently valid or active practical or professional nurse license, certified midwife license, or nurse aide certification from committing any act declared to be unlawful or prohibited by this article 255.
C.R.S. § 12-255-127 Exclusions
12-255-127. Exclusions. (1) This part 1 does not prohibit:
(a) Gratuitous care of friends or members of the family;
(b) Domestic administration of family remedies or care of the sick by domestic servants, housekeepers, companions, or household aides of any type, whether employed regularly or because of an emergency of illness, but who shall not in any way assume to practice practical or professional nursing or as a certified midwife;
(c) Nursing or midwifery assistance in the case of an emergency;
(d) The practice of nursing or as a certified midwife in this state by any legally qualified nurse or certified midwife of another state whose engagement requires the nurse or certified midwife to accompany and care for a patient temporarily residing in this state during the period of one engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a practical or professional nurse or certified midwife licensed to practice in this state;
(e) The practice of any nurse or certified midwife licensed in this state or another state or a territory of the United States who is employed by the United States government or any bureau, division, or agency of the United States government while in the discharge of official duties;
(f) The practice of nursing or midwifery by students enrolled in an approved education program or midwifery education program when the practice is performed as part of the approved education program or midwifery education program prior to the graduation of the student;
(g) The practice of nursing or as a certified midwife by any nurse or midwife who is licensed in any other state, any territory of the United States, or any other country and is enrolled in a baccalaureate or graduate program, if the practice is performed as a part of the program;
(h) The administration and monitoring of medications in facilities pursuant to part 3 of article 1.5 of title 25;
(i) The administration of nutrition or fluids through gastrostomy tubes as provided in sections 25.5-10-204 (2)(j) and 27-10.5-103 (2)(i) as a part of residential or day program services provided through service agencies approved by the department of health care policy and financing pursuant to section 25.5-10-206;
(j) The administration of topical and aerosol medications within the scope of physical therapy practice as provided in section 12-285-116 (2);
(k) The practice of administration and monitoring as defined in section 25-1.5-301 (1) and (3);
(l) The administration of medications by child care providers to children cared for in family child care homes pursuant to section 26.5-5-325;
(m) A person who provides nonmedical support services from using the title "Christian Science nurse" when offering or providing services to a member of his or her own religious organization;
(n) (I) The administration of epinephrine auto-injectors by a licensee in a public school or nonpublic school pursuant to a policy adopted in accordance with section 22-1-119.5;
(II) The issuance by an advanced practice registered nurse with prescriptive authority of standing orders and protocols for the use of epinephrine auto-injectors for emergency use in a public school or nonpublic school pursuant to a policy adopted in accordance with section 22-1-119.5; or
(III) The training by a licensee of and the delegation to designated school personnel on the recognition of the symptoms of anaphylactic shock and on the administration of epinephrine auto-injectors in a public school or nonpublic school pursuant to a policy adopted in accordance with section 22-1-119.5;
(o) A prescription by an advanced practice registered nurse with prescriptive authority for the use of epinephrine auto-injectors by an authorized entity in accordance with article 47 of title 25;
n of the symptoms of anaphylactic shock and on the administration of epinephrine auto-injectors in a public school or nonpublic school pursuant to a policy adopted in accordance with section 22-1-119.5;
(o) A prescription by an advanced practice registered nurse with prescriptive authority for the use of epinephrine auto-injectors by an authorized entity in accordance with article 47 of title 25;
(p) The administration of medical marijuana in a nonsmokeable form by a licensed nurse in a public school or nonpublic school pursuant to a policy adopted pursuant to section 22-1-119.3 (3)(d.5);
(q) The training by a licensed nurse of school personnel or volunteers on the administration of medical marijuana in a nonsmokeable form in a public school or nonpublic school to a student with a valid medical marijuana recommendation pursuant to a policy adopted pursuant to section 22-1-119.3 (3)(d.5).
(2) This part 1 shall not be construed as applying to a person who nurses or cares for the sick in accordance with the practice or tenets of any church or religious denomination that teaches reliance upon spiritual means through prayer for healing and who does not hold himself or herself out to the public to be a licensed practical or professional nurse or a certified midwife.
(3) Nothing in this part 1:
(a) Prohibits any licensee from practicing practical or professional nursing or as a certified midwife independently for compensation upon a fee for services basis;
(b) Prohibits or requires the direct reimbursement for nursing or certified midwife services and care through qualified governmental and insurance programs to persons duly licensed in accordance with this part 1; or
(c) Conveys to the practice of nursing or the practice as a certified midwife the performance of medical practice as regulated by article 240 of this title 12, other than as permitted under section 12-240-107 (1)(f)(I).
(4) Repealed.
C.R.S. § 12-255-128 Prescribing opioid antagonists
12-255-128. Prescribing opioid antagonists. An advanced practice registered nurse or certified midwife with prescriptive authority pursuant to section 12-255-112 may prescribe or dispense an opioid antagonist in accordance with section 12-30-110.
C.R.S. § 12-255-129 Continuing education - rules
12-255-129. Continuing education - rules. In addition to any other authority conferred upon the board by this part 1, the board is authorized to require no more than twenty hours of continuing education every two years as a condition of renewal of licenses and to establish procedures and standards for the educational requirements. The board shall, to assure that the continuing education requirements imposed do not have the effect of restraining competition among providers of the education, recognize a variety of alternative means of compliance with the requirements. The board shall adopt rules that are necessary to carry out the provisions of this section in accordance with article 4 of title 24.
C.R.S. § 12-255-130 Peer health assistance or alternative to discipline program - fund - rules
12-255-130. Peer health assistance or alternative to discipline program - fund - rules. (1) As a condition of licensure and for the purpose of supporting a peer health assistance program for nurses or certified midwives or an alternative to discipline program for nurses or certified midwives, every applicant for an initial license or to reinstate a license and any person renewing a license issued pursuant to this part 1 shall pay to the administering entity designated pursuant to subsection (3)(c) of this section a fee in an amount set by the board, not to exceed twenty-five dollars per year; except that the board may adjust the amount each January 1 to reflect changes in the United States department of labor's bureau of labor statistics consumer price index, or its successor index, for Denver-Aurora-Lakewood for goods paid by urban consumers.
(2) (a) No later than June 30, 2008, the board shall transfer any remaining balance in the impaired professional diversion fund, as such fund existed prior to January 1, 2008, to the administering entity chosen by the board pursuant to subsection (3)(c) of this section.
(b) Money in the fund shall be used to support a peer health assistance program for nurses and certified midwives or an alternative to discipline program for nurses and certified midwives in providing assistance to licensees needing help in dealing with physical, emotional, psychiatric, or psychological problems or behavioral, mental health, or substance use disorders that may be detrimental to their ability to practice nursing or to practice as a certified midwife.
(3) (a) The board shall select one or more recognized peer health assistance organizations or alternative to discipline programs as designated providers. For purposes of selecting designated providers, the board shall use a competitive bidding process that encourages participation from interested vendors. To be eligible for designation by the board pursuant to this section, a peer health assistance organization or alternative to discipline program shall:
(I) Offer assistance and education to licensees concerning the recognition, identification, and prevention of physical, emotional, psychiatric, or psychological problems or behavioral, mental health, or substance use disorders and provide for intervention when necessary or under circumstances that may be established in rules promulgated by the board;
(II) Evaluate the extent of physical, emotional, psychiatric, or psychological problems or behavioral, mental health, or substance use disorders and refer the licensee for appropriate treatment;
(III) Monitor the status of a licensee who has been referred for treatment, including assessing continued public protection;
(IV) Provide counseling and support for a licensee and for the family of a licensee referred for treatment;
(V) Receive referrals from the board; and
(VI) Make services available to all licensees statewide.
(b) The board contract with the designated provider or providers selected pursuant to subsection (3)(a) of this section shall include specific deliverables, performance measures, and documentation of results.
(c) The board shall designate an administering entity for a program established pursuant to this section. The entity must be a nonprofit private entity that is qualified under 26 U.S.C. sec. 501 (c)(3) of the federal "Internal Revenue Code of 1986", as amended, and be dedicated to providing support for charitable, benevolent, educational, or scientific purposes that are related to nursing or midwifery, nursing or midwifery education, nursing or midwifery research and science, and other nursing or midwifery charitable purposes.
ofit private entity that is qualified under 26 U.S.C. sec. 501 (c)(3) of the federal "Internal Revenue Code of 1986", as amended, and be dedicated to providing support for charitable, benevolent, educational, or scientific purposes that are related to nursing or midwifery, nursing or midwifery education, nursing or midwifery research and science, and other nursing or midwifery charitable purposes.
(d) The administering entity shall:
(I) Collect the required annual payments, directly or through the board;
(II) Distribute the moneys collected, less expenses, to the approved designated provider, as directed by the board;
(III) Provide an annual accounting to the board of all amounts collected, expenses incurred, and amounts disbursed; and
(IV) Post a surety performance bond in an amount specified by the board to secure performance under this section.
(e) The administering entity may recover from the fee required by subsection (1) of this section the actual administrative costs incurred in performing its duties under this section. The recovery shall not exceed ten percent of the total amount collected.
(f) The board, at its discretion, may collect the required annual payments payable to the administering entity for the benefit of the administering entity and shall transfer the payments to the administering entity. All required annual payments collected or due to the board for each fiscal year shall be deemed custodial funds that are not subject to appropriation by the general assembly, and the funds shall not constitute state fiscal year spending for purposes of section 20 of article X of the state constitution.
(4) Notwithstanding sections 12-255-119 and 24-4-104, the board may immediately suspend the license of any licensee who is referred to a peer health assistance program or alternative to discipline program by the board and who fails to attend or to complete the program. If the licensee objects to the suspension, the licensee may submit a written request to the board for a formal hearing on the suspension within ten days after receiving notice of the suspension, and the board shall grant the request. In the hearing, the licensee shall bear the burden of proving that the individual's license should not be suspended.
(5) The records of a proceeding pertaining to the rehabilitation of a licensee under a program established pursuant to this section shall be confidential and shall not be subject to subpoena unless the licensee has been referred to the board for disciplinary action.
(6) Nothing in this section shall be construed to create any liability of the board, members of the board, or the state of Colorado for the actions of the board in making awards to peer health assistance organizations or alternative to discipline programs or in designating licensees to participate in the programs of such organizations. No civil action may be brought or maintained against the board, its members, or the state for an injury alleged to have been the result of an act or omission of a licensee participating in or referred to a program provided by a peer health assistance organization or to an alternative to discipline program. However, the state remains liable under the provisions of the "Colorado Governmental Immunity Act", article 10 of title 24, if an injury alleged to have been the result of an act or omission of a licensee participating in or referred to a peer health assistance program or alternative to discipline program occurred while such licensee was performing duties as an employee of the state.
(7) The board is authorized to promulgate rules necessary to implement this section.
C.R.S. § 12-255-131 Delegation of nursing or midwifery tasks - rules
12-255-131. Delegation of nursing or midwifery tasks - rules. (1) Any licensed practical nurse, registered nurse, advanced practice registered nurse, or certified midwife may delegate any task included in the nurse's or certified midwife's licensed scope of practice, subject to the requirements of this section. A licensed practical nurse, registered nurse, advanced practice registered nurse, or certified midwife may delegate nursing or certified midwife tasks to licensed, certified, registered, or unlicensed or unregulated assistive personnel. In no event may a registered nurse or certified midwife delegate to another person the authority to select medications if the person is not, independent of the delegation, authorized by law to select medications.
(2) Delegated tasks must be within the area of responsibility of the delegating nurse or certified midwife and must not require any delegatee to exercise the judgment required of a nurse or certified midwife.
(3) No delegation shall be made without the delegating nurse or certified midwife making a determination that, in the licensee's professional judgment, the delegated task can be properly and safely performed by the delegatee and that the delegation is commensurate with the patient's safety and welfare.
(4) The delegating nurse or certified midwife is solely responsible for determining the required degree of supervision the delegatee will need, after an evaluation of the appropriate factors, which include but are not limited to the following:
(a) The stability of the condition of the patient;
(b) The training and ability of the delegatee;
(c) The nature of the nursing or certified midwife task being delegated; and
(d) Whether the delegated task has a predictable outcome.
(5) An employer of a nurse or certified midwife may establish policies, procedures, protocols, or standards of care that limit or prohibit delegations by nurses or certified midwives in specified circumstances.
(6) The board may promulgate rules pursuant to this section, including but not limited to standards on the assessment of the proficiency of the delegatee to perform delegated tasks, and standards for accountability of any nurse or certified midwife who delegates nursing or certified midwife tasks. The rules shall be consistent with the provisions of part 3 of article 1.5 of title 25, section 25.5-10-204 (2)(j), and section 27-10.5-103 (2)(i).
C.R.S. § 12-255-132 School nurses - over-the-counter medication
12-255-132. School nurses - over-the-counter medication. (1) This part 1 does not prohibit a person who has been appropriately trained from dispensing an over-the-counter medication to a minor as long as the person has written instructions from the minor's parent or guardian and there is a physician's standing medical order.
(2) This section is not intended to affect the authority of a professional nurse to delegate nursing tasks.
C.R.S. § 12-255-133 Licensee duties relating to assistance animals - definitions
12-255-133. Licensee duties relating to assistance animals - definitions. (1) A licensee who is approached by a patient seeking an assistance animal as a reasonable accommodation in housing shall either:
(a) Make a written finding regarding whether the patient has a disability and, if a disability is found, a separate written finding regarding whether the need for the animal is related to that disability; or
(b) Make a written finding that there is insufficient information available to make a finding regarding disability or the disability-related need for the animal.
(2) This section does not:
(a) Change any laws or procedures related to a service animal under Title II and Title III of the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101 et seq., as amended;
(b) Affect in any way the right of pet ownership in public housing established in 42 U.S.C. sec. 1437z-3, as amended; or
(c) Limit the means by which a person with a disability may demonstrate, pursuant to state or federal law, that the person has a disability or that the person has a disability-related need for an assistance animal.
(3) A licensee shall not make a determination related to subsection (1) of this section unless the licensee:
(a) Has met with the patient in person;
(b) Is sufficiently familiar with the patient and the disability; and
(c) Is legally and professionally qualified to make the determination.
(4) For purposes of this section:
(a) "Assistance animal" means an animal that qualifies as a reasonable accommodation under the federal "Fair Housing Act", 42 U.S.C. sec. 3601 et seq., as amended, or section 504 of the federal "Rehabilitation Act of 1973", 29 U.S.C. sec. 794, as amended.
(b) "Disability" has the same meaning as set forth in the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101 et seq., and its related amendments and implementing regulations and includes a handicap as that term is defined in the federal "Fair Housing Act", 42 U.S.C. sec. 3601 et seq., as amended, and 24 CFR 100.201.
(c) "Service animal" has the same meaning as set forth in the implementing regulations of Title II and Title III of the federal "Americans with Disabilities Act of 1990", 42 U.S.C. sec. 12101 et seq., as amended.
C.R.S. § 12-255-133.5 Licensee duties related to medical forensic evidence
12-255-133.5. Licensee duties related to medical forensic evidence. (1) A licensee who performs a medical forensic examination as described in section 12-240-139 (1)(b)(I) shall inform the victim:
(a) Of the contact information for the nearest sexual assault victim advocate if the victim makes a law enforcement report pursuant to section 12-240-139 (1)(b)(I)(A);
(b) Of the contact information for the nearest community-based victim advocate pursuant to section 13-90-107 (1)(k)(II) if the victim makes a medical report pursuant to section 12-240-139 (1)(b)(I)(B) or an anonymous report pursuant to section 12-240-139 (1)(b)(I)(C); and
(c) That any forensic medical evidence collected must be maintained until after the assailant may no longer be prosecuted for the crime and that the victim must be notified prior to the destruction of such evidence.
C.R.S. § 12-255-134 Repeal of article - subject to review
12-255-134. Repeal of article - subject to review. This article 255 is repealed, effective September 1, 2027. Before the repeal, the board and its functions under this article 255, including the functions of the board related to the certification of nurse aides, are scheduled for review in accordance with section 24-34-104.
C.R.S. § 12-255-135 Confidential agreement to limit practice
12-255-135. Confidential agreement to limit practice. (1) Except as specified in subsection (2) of this section, section 12-30-108 concerning confidential agreements to limit practice applies to this article 255.
(2) This section and section 12-30-108 do not apply to a nurse or certified midwife subject to discipline under section 12-255-120 (1)(i).
C.R.S. § 12-255-136 Change of name - direction to revisor - repeal
12-255-136. Change of name - direction to revisor - repeal. (Repealed)
C.R.S. § 12-255-201 Nurse aide certification program - department of public health and environment to assist - funding
12-255-201. Nurse aide certification program - department of public health and environment to assist - funding. (1) The department of public health and environment, which is otherwise responsible for the regulation of certain medical facilities, shall, as necessary, assist the board in implementing the provisions of this part 2.
(2) Funding for the nurse aide certification program, as operated by the department of regulatory agencies, shall be provided by the federal medicaid and medicare programs. Medicaid funding shall be secured by the department of health care policy and financing and medicare funding shall be secured by the department of public health and environment. All the funding shall be forwarded to the department of regulatory agencies for its use in operating the nurse aide certification program. The departments of health care policy and financing and public health and environment shall take all reasonable and necessary steps to secure the funding from the federal medicaid and medicare programs.
C.R.S. § 12-255-202 Application for certification - fee
12-255-202. Application for certification - fee. (1) Every applicant for certification as a nurse aide, whether qualifying by competency evaluation or by endorsement, shall submit the application on forms provided by the board.
(2) (a) The applicant shall include with the application submitted pursuant to subsection (1) of this section an application fee established pursuant to section 12-20-105.
(b) The board may reduce the application fee if federal funds are available. The fee is not subject to the provisions of section 12-20-104.
C.R.S. § 12-255-203 Application for certification by competency evaluation
12-255-203. Application for certification by competency evaluation. (1) Every applicant for certification by competency evaluation shall pay the required application fee and shall submit written evidence that the applicant:
(a) Has not committed any act or omission that would be grounds for discipline or denial of certification under this article 255; and
(b) Has successfully completed an approved education program.
C.R.S. § 12-255-204 Certification by endorsement
12-255-204. Certification by endorsement. An applicant may obtain certification by endorsement if the applicant satisfies the requirements of the occupational credential portability program.
C.R.S. § 12-255-205 Certification by competency evaluation
12-255-205. Certification by competency evaluation. (1) All applicants except those certified by endorsement shall pass a clinical competency evaluation. The evaluation shall be in a written or oral form and shall include the following areas:
(a) Basic nursing skills;
(b) Personal care skills;
(c) Recognition of mental health and social services needs;
(d) Basic restorative services;
(e) Resident or patient rights.
(2) Competency evaluations shall be held at the times and places as the board determines but shall be held at least four times per year.
C.R.S. § 12-255-206 Scope of practice - rules
12-255-206. Scope of practice - rules. (1) In addition to any nursing tasks delegated to a certified nurse aide pursuant to section 12-255-131, a certified nurse aide who is deemed competent by a registered nurse licensed pursuant to part 1 of this article 255 may perform the following tasks:
(a) Digital stimulation, insertion of a suppository, or the use of an enema, or any other medically acceptable procedure to stimulate a bowel movement;
(b) Gastrostomy-tube and jejunostomy-tube feedings;
(c) Placement in a client's mouth of presorted medication that has been boxed or packaged by a registered nurse, a licensed practical nurse, or a pharmacist or, in the case of a client who is a minor, presorted medication that has been sorted by the minor's parent or guardian;
(d) Administration of oxygen to clients; and
(e) Changing ostomy bags.
(2) The board shall promulgate rules concerning the competency requirements for a certified nurse aide to perform the tasks listed in subsection (1) of this section.
(3) The duties performed by a certified nurse aide as specified in subsection (1) of this section are not considered a delegation of nursing tasks pursuant to section 12-255-131.
(4) A registered nurse who in good faith determines that a certified nurse aide is competent to perform the tasks listed in subsection (1) of this section is not liable for the actions of the certified nurse aide in the performance of the tasks.
C.R.S. § 12-255-207 Advisory committee
12-255-207. Advisory committee. To assist in the performance of its duties under this part 2, the board may designate an advisory committee, which shall report to the board. The committee consists of seven members who have expertise in an area under review. One member shall be a certified nurse aide; one member shall be a licensed professional nurse or a licensed practical nurse as defined in section 12-255-104 who supervises certified nurse aides; one member shall represent a home health agency; one member shall represent a nursing facility; one member shall be a department of public health and environment employee; and two members shall be members of the public. Committee members shall receive a per diem allowance pursuant to section 12-20-103 (6) for their services and shall be reimbursed for the actual and necessary expenses in the performance of their duties from the division of professions and occupations cash fund by the general assembly.
C.R.S. § 12-255-208 Medication aides - training - scope of duties - rules
12-255-208. Medication aides - training - scope of duties - rules. (1) Prior to a certified nurse aide obtaining authority as a medication aide to administer medications, the certified nurse aide shall meet all applicable requirements as established by rules of the board. The board shall promulgate rules regarding the scope of practice, education, experience, and certification requirements for a nurse aide to obtain authority to administer medications. The board shall consider, but not be limited to, reducing the number of required hours of education, expanding the allowable routes of administration, reducing or eliminating the required hours of work experience, and developing different scopes of practice depending on practice setting, if appropriate.
(2) The board shall promulgate rules regarding the supervision requirements for a medication aide, the requirements for a registered nurse to perform a patient assessment before a medication aide administers medications to the patient, and requirements for a registered nurse to review medications to be administered by a medication aide.
(3) The administration of medications by medication aides does not alter any requirement or limitation applicable to the delegation of nursing tasks pursuant to section 12-255-131.
C.R.S. § 12-255-209 Grounds for discipline
12-255-209. Grounds for discipline. (1) The board may suspend, revoke, or deny any person's certification to practice as a nurse aide or authority to practice as a medication aide in accordance with section 12-20-404 (1)(d) or may issue to the person a letter of admonition under the circumstances specified in and in accordance with section 12-20-404 (4), upon proof that a person:
(a) Has procured or attempted to procure a certificate by fraud, deceit, misrepresentation, misleading omission, or material misstatement of fact;
(b) Has been convicted of a felony or has had a court accept a plea of guilty or nolo contendere to a felony. A certified copy of the conviction or plea from a court of competent jurisdiction is prima facie evidence of the conviction or plea. In considering discipline based on the grounds specified in this subsection (1)(b), the board shall be governed by sections 12-20-202 (5) and 24-5-101.
(c) Has had a certification to practice as a nurse aide or to practice any other health-care occupation suspended or revoked in any jurisdiction. A certified copy of the order of suspension or revocation shall be prima facie evidence of the suspension or revocation.
(d) Has violated or has aided or knowingly permitted any person to violate any provision of this part 2 or an applicable provision of article 20 or 30 of this title 12;
(e) Has negligently or willfully violated any order or rule of the board pertaining to practice or certification as a nurse aide;
(f) Has verbally or physically abused a person under the care of the certified nurse aide;
(g) Excessively uses or abuses alcohol, any habit-forming drug, any controlled substance, as defined in section 18-18-102 (5), or other drugs having similar effects, or is diverting controlled substances, as defined in section 18-18-102 (5), or other drugs having similar effects from the person's place of employment;
(h) Has misused any drug or controlled substance, as defined in section 18-18-102 (5);
(i) Has a physical or mental disability that renders the person unable to practice as a certified nurse aide with reasonable skill and safety to the patients and that may endanger the health or safety of persons under the nurse aide's care;
(j) Has violated the confidentiality of information or knowledge as prescribed by law concerning any patient;
(k) Has misappropriated patient or facility property;
(l) Has engaged in any conduct that would constitute a crime as defined in title 18, if the conduct relates to the person's ability to practice as a nurse aide. In considering discipline based upon the grounds specified in this subsection (1)(l), the board shall be governed by the provisions of sections 12-20-202 (5) and 24-5-101.
(m) Has neglected a person under the care of the certified nurse aide;
(n) Has willfully or negligently acted in a manner inconsistent with the health or safety of persons under the nurse aide's care;
(o) Has willfully or negligently practiced as a medication aide in a manner that does not meet generally accepted standards for practice;
(p) Has willfully or negligently violated any order or rule of the board pertaining to the practice or authorization as a medication aide;
(q) Has practiced in a medical facility as a nurse aide except as provided in this part 2;
(r) Has practiced as a nurse aide during any period when his or her certificate has been suspended or revoked;
(s) Has sold or fraudulently obtained or furnished a certificate to practice as a nurse aide or has aided or abetted therein;
(t) Has failed to respond in a materially factual and timely manner to a complaint as grounds for discipline pursuant to section 12-255-212; or
in this part 2;
(r) Has practiced as a nurse aide during any period when his or her certificate has been suspended or revoked;
(s) Has sold or fraudulently obtained or furnished a certificate to practice as a nurse aide or has aided or abetted therein;
(t) Has failed to respond in a materially factual and timely manner to a complaint as grounds for discipline pursuant to section 12-255-212; or
(u) Has failed to report a criminal conviction to the board within forty-five days after the conviction.
(2) Except as otherwise provided in subsection (1) of this section, the board need not find that the actions that form the basis for the disciplinary action were willful. However, the board, in its discretion, may consider whether the action was willful in determining the sanctions it imposes on the nurse aide.
(3) An employer of a medication aide shall report conduct that constitutes grounds for discipline pursuant to this section to the board and any disciplinary action taken by the employer against a medication aide or the resignation of a medication aide in lieu of a disciplinary action resulting from the conduct.
C.R.S. § 12-255-210 Withholding or denial of certification
12-255-210. Withholding or denial of certification. (1) If the board determines that an applicant for an initial certificate to practice as a nurse aide does not possess the qualifications specified in section 12-255-203 or 12-255-204, that section 12-255-209 (1)(l) is applicable, or that there is reasonable cause to believe that the applicant has committed any of the acts set forth in section 12-255-209 as grounds for discipline, the board may deny the applicant a certificate. When the board denies a certificate, it shall comply with the following procedures:
(a) The provisions of section 24-4-104 shall apply, and the board shall provide the applicant with a written statement that sets forth the basis for the board's determination.
(b) If the applicant requests a hearing pursuant to section 24-4-104 (9), the following applies:
(I) An applicant whose certification has been denied on the basis of a lack of qualifications has the burden of proof to show that the applicant possesses the qualifications required under this part 2.
(II) For an applicant whose certification has been denied on the basis of reasonable cause to believe that grounds for discipline exist, the board has the burden of proof to show the commission of acts constituting grounds for discipline under this part 2.
(c) If a hearing is conducted, the board shall affirm, modify, or reverse its prior determination and action in accordance with the findings resulting from the hearing.
(d) If an applicant who has requested a hearing pursuant to section 24-4-104 (9) fails to appear at the hearing, absent a determination by the board that there was good cause for the failure to appear, the board may affirm its prior action of withholding certification without conducting a hearing on the matter.
(e) If the board withholds certification without a hearing in accordance with this section, the board is immune from suit concerning the withholding unless it has acted unreasonably or has failed to act in good faith.
C.R.S. § 12-255-211 Mental and physical competency of nurse aides
12-255-211. Mental and physical competency of nurse aides. (1) If a certified nurse aide is determined by a court of competent jurisdiction to have a mental health disorder, the board shall automatically suspend the certified nurse aide's certification, and the suspension must continue until the certified nurse aide is determined by the court to be restored to competency; duly discharged as restored to competency; or otherwise determined to be competent in any other manner provided by law.
(2) (a) If the board has reasonable cause to believe that a certified nurse aide's physical or mental health has resulted in the nurse aide being unable to practice with reasonable skill or that the practice of the nurse aide is a threat to the safety of the nurse aide's patients, the board may require the nurse aide to submit to a mental or physical examination by a physician or other licensed health-care provider designated by the board.
(b) If a nurse aide fails to submit to a mental or physical examination, the board may suspend the nurse aide's certification until the required examination or examinations are conducted.
(3) Every person who applies to the board for certification as a nurse aide is deemed by virtue of the application to have consented to undergo a physical or mental examination at any time if the board so requests. Any request by the board to a nurse aide to submit to the examination shall be in writing and shall contain the basis upon which the board determined that reasonable cause to believe the condition specified in subsection (2)(a) of this section exists.
(4) A certified nurse aide who has been requested to submit to a physical or mental examination may provide the board with information concerning the nurse aide's physical or mental health from a physician of the nurse aide's own choice. The board may consider the information in conjunction with, but not in lieu of, testimony and information provided by the physician designated by the board to examine the nurse aide.
(5) The results of any mental or physical examination requested by the board pursuant to this section shall not be used as evidence in any proceeding except a proceeding conducted pursuant to this part 2. The results of the examination shall not be deemed to be public records and shall not be made available to the public.
C.R.S. § 12-255-212 Disciplinary proceedings - hearing officers
12-255-212. Disciplinary proceedings - hearing officers. (1) The board may employ hearing officers as authorized in section 12-20-403 (3).
(2) A proceeding for discipline of a certified nurse aide may be commenced when the board has reasonable grounds to believe that a nurse aide certified by the board has committed acts that may violate the provisions of this part 2.
(3) The license of a person certified by the board as a nurse aide may be revoked or the person may otherwise be disciplined pursuant to section 12-20-404 upon written findings by the board that the licensee has committed acts that violate the provisions of this part 2.
(4) No later than thirty days after the date of the board's action, the board shall send a notice to a certified nurse aide disciplined under subsection (3) of this section, to the most recent address the certified nurse aide provided to the board, notifying the certified nurse aide of the action taken, the specific charges giving rise to the action, and the certified nurse aide's right to request a hearing on the action taken.
(5) Within thirty days after the board sends the notification, the certified nurse aide may file a written request with the board for a hearing on the action taken. Upon receipt of the request, the board shall grant a hearing to the certified nurse aide. If the certified nurse aide fails to file a written request for a hearing within thirty days, the action of the board shall be final on that date.
(6) Disciplinary proceedings shall be conducted in the manner prescribed by article 4 of title 24 and section 12-20-403.
(7) Failure of the certified nurse aide to appear at the hearing without good cause shall be deemed a withdrawal of the certified nurse aide's request for a hearing, and the board's action shall be final on that date. Failure, without good cause, of the board to appear at the hearing shall be deemed cause to dismiss the proceeding.
(8) (a) No previously issued certificate to engage in practice as a nurse aide shall be revoked or suspended except under the procedure set forth in this section, except in emergency situations as provided by section 24-4-104.
(b) The denial of an application to renew an existing certificate shall be treated in all respects as a revocation.
(9) A person providing documents subpoenaed pursuant to section 12-20-403 (2) shall prepare them from the original record and shall delete from the copy provided pursuant to the subpoena the name of the patient, but the patient shall be identified by a numbered code to be retained by the custodian of the records from which the copies were made. Upon certification of the custodian that the copies are true and complete except for the patient's name, the copies shall be deemed authentic, subject to the right to inspect the originals for the limited purpose of ascertaining the accuracy of the copies. A privilege of confidentiality does not exist with respect to the copies, and liability does not lie against the board or the custodian or the custodian's authorized employee for furnishing or using the copies in accordance with this subsection (9).
(10) The board may issue and send a confidential letter of concern to a certificate holder under the circumstances specified in section 12-20-404 (5).
(11) An employer of a nurse aide shall report to the board any disciplinary action taken against the nurse aide or any resignation in lieu of a disciplinary action for conduct that constitutes a violation of this part 2.
with this subsection (9).
(10) The board may issue and send a confidential letter of concern to a certificate holder under the circumstances specified in section 12-20-404 (5).
(11) An employer of a nurse aide shall report to the board any disciplinary action taken against the nurse aide or any resignation in lieu of a disciplinary action for conduct that constitutes a violation of this part 2.
(12) Except when a decision to proceed with a disciplinary action has been agreed upon by a majority of the board or its designee and notice of formal complaint is drafted and served on the licensee by first-class mail, any investigations, examinations, hearings, meetings, or any other proceedings of the board related to discipline that are conducted pursuant to this section are exempt from the open records provisions of article 72 of title 24 requiring that the proceedings of the board be conducted publicly or that the minutes or records of the board with respect to action of the board taken pursuant to this section be open to public inspection.
(13) The board may issue cease-and-desist orders under the circumstances and in accordance with the procedures specified in section 12-20-405.
C.R.S. § 12-255-213 Surrender of certificate
12-255-213. Surrender of certificate. (1) Prior to the initiation of an investigation or hearing, any certified nurse aide may surrender the aide's certificate to practice as a nurse aide to the board.
(2) Following the initiation of an investigation or hearing and upon a finding that to conduct the investigation or hearing would not be in the public interest, the board may allow a certified nurse aide to surrender the aide's certificate to practice.
(3) The surrender of a certificate in accordance with this section removes all rights and privileges to practice as a nurse aide, including the right to apply for renewal of a certificate.
C.R.S. § 12-255-214 Exclusions
12-255-214. Exclusions. (1) This part 2 does not affect or apply to:
(a) The gratuitous care of friends or family members;
(b) A person for hire who does not represent himself or herself as or hold himself or herself out to the public as a certified nurse aide. However, a person for hire who is not a nurse aide certified under this part 2 shall not perform the duties of or hold himself or herself out as being able to perform the full duties of a certified nurse aide.
(c) Nursing assistance in the case of an emergency;
(d) A person who is directly employed by a medical facility while acting within the scope and course of employment for the first four consecutive months of the person's employment at the medical facility if the employment is part of an approved training program prior to certification and the certification is not by endorsement pursuant to section 12-255-204. A person may utilize this exclusion only once in any twelve-month period. This exclusion does not apply to any person who has allowed the person's certification to lapse, had the person's certification as a nurse aide suspended or revoked, or had an application for certification denied.
(e) Any person licensed, certified, or registered by the state of Colorado who is acting within the scope of the license, certificate, or registration;
(f) Any person performing services pursuant to sections 12-255-131, 25.5-10-204 (2)(j), 27-10.5-103 (2)(i), and part 3 of article 1.5 of title 25.
C.R.S. § 12-255-215 Unauthorized practice - penalties
12-255-215. Unauthorized practice - penalties. Any person who practices or offers or attempts nursing aide practice or medication administration without an active certificate of authority issued under this part 2; practices in a medical facility as a nurse aide except as provided in this part 2; uses any designation in connection with the person's name that tends to imply that the person is a certified nurse aide unless the person is so certified under this part 2; practices as a nurse aide during any period when the person's certificate has been suspended or revoked; or sells or fraudulently obtains or furnishes a certificate to practice as a nurse aide or aids or abets therein commits a class 2 misdemeanor and shall be punished as provided in section 18-1.3-501.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-12.docxFetched: 10/6/2026