Introduction: the social role of nurses in 1997 is defined, nursing care management being established via the general administrative regulation Nº 19. The implementation of assistant directorships for nursing care management becomes relevant in the results for both the patients and the nursing team. Goal: describe the degree of implementation of the general administrative regulation Nº 19 for close care at Chile’s medium-and-high-complexity public health establishments. Methods: a quantitative, descriptive, cross-sectional study was developed. With a convenience-intended sample of 56 centers, using an instrument to gather evidence of characteristics of Regulation Nº 19. Results: 75,0 % have an Assistant Directorship for Care Management and 3,57 % do not have any. High-complexity hospitals averaged 6,83 characteristics and medium complexity averaged 6,69 characteristics. The characteristics with the highest degree of fulfillment were those related to powers to grant safe care, the definition of job profiles corresponding to the structure, policies on communication with other offices, and having a set of care indicators for decision-making. Conclusion: there is a disparity in implementation, a National Nursing Directorship dependent on the Ministry of Health with a supervising role and generating standardized policies, protocols, and guidelines to support the implementation is required to achieve care with a sense of social and universal justice.