The Colorado Nurse Practice Act, codified at Title 12, Article 255 of the Colorado Revised Statutes, sets who may practice nursing in the state, what each license level allows, and what conduct can cost a nurse that license. It is enforced by the Colorado State Board of Nursing, which sits inside the Department of Regulatory Agencies and handles licensure, investigations, and discipline. If you hold or want a Colorado nursing license, the Act is the document that governs your career.
Who the Act Covers
Colorado licenses nurses at three levels, and the Act defines a different scope of practice for each.
Registered nurses (RNs) deliver independent and collaborative nursing care in any setting. That includes evaluating health status through data collection and assessment, health teaching and counseling, providing supportive and restorative therapy, executing delegated medical functions, and referring patients who need further evaluation.1Justia. Colorado Code 12-255-104 – Definitions The Board of Nursing treats RNs as independent practitioners bounded by two things only: the statutory scope, and the individual nurse’s own education and competency.
Licensed practical nurses (LPNs) work under the direction of an RN, physician, or other authorized provider and handle a narrower range of clinical tasks.
Advanced practice registered nurses (APRNs) hold the broadest scope. An APRN who has logged at least 3,000 hours of clinical practice under a collaborative agreement with a physician may apply to the board for full practice authority. Once granted, the APRN can practice independently, prescribe medications including controlled substances, and perform any act authorized for an APRN under the Act.2Colorado General Assembly. Senate Bill 19-242 Before that threshold, the APRN practices under the collaborative agreement. Controlled-substance prescribing also requires a federal DEA registration; the DEA classifies nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists as mid-level practitioners eligible for their own registration where state law authorizes prescribing.
Delegating to Other Staff
The Act lets RNs, LPNs, and APRNs delegate tasks within their licensed scope to other personnel, including unlicensed assistive staff. The delegating nurse must use professional judgment to decide that the task can be safely performed by the person receiving it and that the delegation fits the patient’s needs. The task cannot require the clinical judgment that only a licensed nurse should exercise.3Justia. Colorado Code 12-255-131 – Delegation of Nursing Tasks The nurse also decides the level of supervision, weighing patient stability, task complexity, and the training of the person doing the work. One hard limit: an RN cannot delegate authority to select medications to anyone not independently authorized by law to do so. Employers may impose stricter delegation policies on top of the statute.
Getting and Keeping a License
Every applicant, at any level, must graduate from a board-approved nursing education program and pass the appropriate National Council Licensure Examination — the NCLEX-PN for practical nurses or the NCLEX-RN for registered nurses.1Justia. Colorado Code 12-255-104 – Definitions A fingerprint-based criminal background check is required. A felony conviction or a nursing-related misdemeanor draws additional scrutiny and can result in denial depending on the circumstances.
APRNs must also earn a graduate-level degree and hold national certification in their specialty before applying to the board’s advanced practice registry. To obtain prescriptive authority, an APRN needs specific coursework in controlled substances and prescription drugs, professional liability insurance, and a signed attestation of at least three years of clinical experience as a professional nurse or APRN.4FindLaw. Colorado Code 12-255-112 – Prescriptive Authority
Foreign-educated nurses need a credential evaluation before sitting for the NCLEX. Most go through the CGFNS Certification Program, which reviews education and licensure records, administers a qualifying exam, and requires proof of English proficiency (waived for graduates of programs taught in English in a designated list of countries).5CGFNS International, Inc. CGFNS Certification Program
Colorado nursing licenses renew every two years. The current renewal fee is approximately $108 for RNs and LPNs, though the board adjusts fees periodically. One point that surprises nurses moving from other states: Colorado does not currently require a set number of continuing education hours for routine RN or LPN renewal, though the board has statutory authority to require up to 20 hours per cycle. Even without a mandate, staying current matters, because the Act requires nurses to practice in a manner consistent with generally accepted standards of the profession.6Justia. Colorado Code 12-255-120 – Grounds for Discipline – Definitions
Practicing Across State Lines
Colorado belongs to the Nurse Licensure Compact (NLC), which lets nurses with a multistate license practice in any of the 43 member jurisdictions without a separate license in each state. To hold a multistate license issued by Colorado, your primary residence must be in Colorado. Move to another compact state and you apply for a new license there; your Colorado multistate license deactivates. Move to a non-compact state and it converts to a single-state Colorado license.7Justia. Colorado Code 24-60-3802 – Compact Approved and Ratified
The compact matters most for telehealth. A Colorado nurse with a multistate license can care for patients in any other compact state remotely, but must follow the practice laws of the state where the patient is physically located. A scope violation in the patient’s state can trigger discipline there and in Colorado.
Not everyone qualifies for the multistate license. You need an active, unencumbered license (no current disciplinary restrictions), a federal fingerprint-based background check, no felony convictions, and you cannot be participating in an alternative-to-discipline program.
Reporting Duties You Cannot Ignore
The Act and related Colorado law create two separate reporting obligations, and mixing them up causes real problems.
Under Colorado’s Children’s Code, RNs and LPNs are mandatory reporters of child abuse and neglect. If you have reasonable cause to know or suspect a child has been abused or neglected, or you observe conditions that would reasonably result in abuse or neglect, you must report immediately to the county department of human services, local law enforcement, or the state’s child abuse reporting hotline.8Justia. Colorado Code 19-3-304 – Persons Required to Report Child Abuse or Neglect The duty is personal and immediate. Failing to report can result in criminal liability and professional discipline.
The Act itself creates reporting duties inside the profession. Nurses must notify the board of any physical illness, mental health condition, or substance use disorder that impairs their own ability to practice safely. Employers must report disciplinary actions taken against a nurse for conduct that would be grounds for board discipline, and malpractice settlements or judgments must also be reported.9Justia. Colorado Code 12-255-119 – Disciplinary Proceedings Each of these triggers a mandatory board investigation. Nurses who report a colleague’s unsafe practice or impairment in good faith are shielded from civil liability.
What Puts a License at Risk
The Act’s grounds for discipline are broad. They include obtaining a license through fraud, being convicted of a felony, acting in a manner inconsistent with patient safety, failing to meet generally accepted practice standards, falsifying patient records, and excessive use of alcohol or controlled substances.6Justia. Colorado Code 12-255-120 – Grounds for Discipline – Definitions Having a nursing license suspended or revoked in any other state is independently grounds for Colorado discipline.
When the board opens a complaint, the nurse is notified by mail and has 30 days to respond in writing. Failing to respond in a materially factual and timely manner is itself a separate ground for discipline. The board’s inquiry panel then decides whether to dismiss, resolve informally, or send the matter to a formal hearing before an administrative law judge, where the nurse can appear, be represented by counsel, present evidence, and cross-examine witnesses under oath.9Justia. Colorado Code 12-255-119 – Disciplinary Proceedings
Range of Penalties
The board can impose the following outcomes, from least to most severe:
- Confidential letter of concern, kept off the public record, for conduct that signals a pattern but does not warrant formal action.
- Letter of admonition, a formal written warning for real misconduct that does not justify suspension or revocation.
- Probation with conditions such as supervised practice, mandatory examinations, or required training.
- Suspension for a definite or indefinite period; indefinite suspensions require the nurse to petition for reinstatement.
- Revocation or nonrenewal, permanently ending the nurse’s authority to practice in Colorado.
- Fines from $250 to $1,000 per violation, imposed on top of any other discipline.9Justia. Colorado Code 12-255-119 – Disciplinary Proceedings
Disciplinary actions become part of the nurse’s permanent licensing record and are reported to national databases that other state boards can access.
An Alternative Path for Substance Use
The Act gives the board discretion not to discipline a nurse who is participating in good faith in a board-approved program designed to end excessive or habitual use of alcohol or controlled substances.6Justia. Colorado Code 12-255-120 – Grounds for Discipline – Definitions Colorado funds a Peer Health Assistance Program for nurses and certified midwives under Section 12-255-130.
These alternative-to-discipline programs generally require the nurse to acknowledge the problem, submit to random drug testing, comply with workplace restrictions, and complete a monitoring period commonly running two to five years. Participation is confidential and stays off the public disciplinary record so long as the nurse complies. Relapse or noncompliance typically sends the matter back to the formal disciplinary process. Note the compact consequence already mentioned: nurses actively participating in an alternative program are not eligible for a multistate license.
Federal Exposure Beyond the State Board
Losing a Colorado license is not the only career-ending risk. The federal Office of Inspector General maintains the List of Excluded Individuals and Entities (LEIE), and a nurse placed on it is barred from any role where federal healthcare dollars are involved. No Medicare, Medicaid, or other federal program payment may be made for items or services furnished, ordered, or prescribed by an excluded individual.10Office of Inspector General | U.S. Department of Health and Human Services. Exclusions Program Information
The reach extends past bedside care. Federal program payment cannot cover an excluded person’s salary, fringe benefits, or expenses even in an administrative or management role. An employer who hires an excluded individual and submits federal claims faces civil monetary penalties of up to $10,000 per item or service, plus an assessment of up to three times the amount claimed.11Office of Inspector General | U.S. Department of Health and Human Services. The Effect of Exclusion From Participation in Federal Health Care Programs Employers must check the LEIE before hiring, so exclusion effectively closes off employment across the industry. Checking your own status is free and worth doing after any disciplinary event.
Practicing on a Lapsed License
Section 12-255-125 makes it illegal to practice professional or practical nursing without an active license, and the prohibition reaches nurses whose licenses lapsed through missed renewal, not just people who never held a license. Continuing to work after your renewal deadline slips creates the same legal exposure as practicing with no license at all. If a renewal date is close, confirm it with the board before your next shift.