The CNA scope of practice in Colorado has two layers: routine personal care that any certified nurse aide can provide under RN oversight, and an expanded set of five clinical tasks a CNA may perform only after a supervising registered nurse individually finds them competent to do so. On top of those, a licensed nurse can delegate additional tasks case by case, but nothing that calls for nursing-level clinical judgment can ever be handed down.
Routine Care Every Colorado CNA Can Provide
At the baseline level, CNAs assist patients with the activities of daily living: bathing, dressing, feeding, mobility, taking vital signs, documenting observations, and reporting changes in a patient’s condition to the supervising nurse. These tasks come with initial certification. They don’t require any special sign-off beyond standard training and RN oversight.
This is the floor of the job. Everything below builds on it.
The Five Expanded-Scope Tasks
Section 12-255-206 of the Nurse Practice Act identifies clinical tasks a CNA may perform once a supervising RN has individually evaluated the aide and deemed them competent. The five tasks are:
- Bowel care, including digital stimulation, suppository insertion, enema administration, and other medically accepted procedures to stimulate a bowel movement
- Gastrostomy-tube and jejunostomy-tube feedings
- Placing presorted medication in a client’s mouth when the medication has been packaged by an RN, LPN, or pharmacist (if the client is a minor, medication sorted by a parent or guardian also qualifies)
- Administering oxygen to clients
- Changing ostomy bags1Justia. Colorado Code 12-255-206 – Scope of Practice – Rules
The RN’s competency determination is not a formality. Under the Board’s rules, the supervising nurse has to find that you can perform each task “with reasonable skill and safety” before you’re cleared to do it.2Legal Information Institute. 3 CCR 716-1.10 – Rules and Regulations for Certification as a Nurse Aide Competent at one task doesn’t mean competent at the others. Each is evaluated on its own.
The medication item trips people up. You can place pre-packaged, presorted medication in a patient’s mouth, but you play no role in selecting, sorting, or deciding dosages. The pills have to arrive already sorted by someone legally authorized to do that work.
Tasks a Nurse Can Delegate on Top of That
Section 12-255-131 gives licensed nurses broad authority to delegate additional nursing tasks to CNAs on a case-by-case basis. Before delegating, the nurse must determine that the task can be performed safely, that it doesn’t require nursing-level clinical judgment, and that the outcome is predictable. The nurse also sets the level of supervision based on the patient’s stability and the CNA’s demonstrated ability.3Justia. Colorado Code 12-255-131 – Delegation of Nursing or Midwifery Tasks
Tasks like catheter care and range-of-motion exercises live here. They aren’t in the expanded-scope statute, but a supervising nurse can delegate them if the CNA has the training and the patient’s condition allows it. The important distinction: expanded-scope tasks come from the statute itself, while delegated tasks come from the supervising nurse’s professional judgment.
Employers can also set their own policies that limit or prohibit certain delegations. What you’re authorized to do at one facility may not carry over to the next, even with the same certification in your pocket. Check the employer’s policy before you assume a task is on the table.
What a Colorado CNA Cannot Do
The delegation statute draws a hard line: no delegated task may require a CNA to exercise the clinical judgment of a nurse. In practice, CNAs cannot start intravenous lines, insert nasogastric tubes, independently select medications, make diagnostic assessments, or perform other procedures that require licensed-nurse training.3Justia. Colorado Code 12-255-131 – Delegation of Nursing or Midwifery Tasks
The medication limit is worth stating plainly. Even within the authority to place presorted medication, RNs cannot delegate the authority to select medications to anyone not independently authorized by law to do so. Experience doesn’t lift that ceiling. Neither does on-the-job training or a supervisor’s trust in your judgment. The authority simply isn’t the nurse’s to hand over.
A few things that fall outside the statute’s grant are worth naming because people assume otherwise. Sorting medications into a pill planner is not within scope, even if you’re the one who will later place them. Choosing which PRN medication a patient should receive is not within scope. Independent clinical assessments that drive treatment decisions are not within scope. If a task calls for the judgment of a licensed nurse, it stays with the licensed nurse.
Expanding Your Scope Through Medication Aide Authority
If you want to do more with medications than place presorted doses, Colorado offers a Medication Aide authority (CNA-M) built on top of CNA certification. Earning it requires completing a Board-approved Medication Aide training program covering theory, lab work, and clinical practice in medication administration, followed by passing a separate state-approved competency evaluation.4Legal Information Institute. 3 CCR 716-1.18 – Rules and Regulations for the Certified Nurse Aide in Relation to Medication Aide Authority
If you already hold Medication Aide certification from another state with substantially equivalent requirements, the Board may grant Colorado authority through endorsement instead of making you repeat the training.
What Happens if You Practice Outside Your Scope
Practicing outside your authorized scope is one of the specific grounds the Board of Nursing uses to open disciplinary proceedings. The Board can revoke or suspend your certificate, issue a confidential letter of concern, or enter a cease-and-desist order. Denial of a renewal application is treated the same as a revocation for procedural purposes, which means you get the same hearing rights.5FindLaw. Colorado Code 12-255-212 – Disciplinary Proceedings
Other common grounds for discipline include falsifying patient records and conduct that violates the standards in Part 2 of Article 255. Except in emergencies, the Board cannot revoke or suspend an existing certificate without following formal hearing procedures. You do get due process. But the consequences for substantiated scope violations are serious enough that the time to confirm a task is within your authority is before you perform it, not after.