During the Department of Health Care Policy And Financing's re-validation process the Department of Public Health and Environment will be providing information to the Department of Health Care Policy and Financing.
This will include whether or not community clinics and community clinics and emergency centers have disclosed a common ownership or other affiliation with a licensed Colorado hospital.
As a hospital, community clinic or community clinic and emergency center provider, completing this form is an attestation of common ownership or other affiliation relating to the provider's enrollment with the Department of Health Care Policy and Financing that you would like the Department of Public Health and Environment to take notice of and transmit to the Department of Health Care Policy and Financing.
Completing this form is not a requirement for licensed facilities. There is no penalty for not completing the form.
FOR FURTHER INFORMATION: Please contact Greg Wright at (303) 692-2813 or email the branch at cdphe.healthfacilities@state.co.us
Declaration of Common Ownership or Affiliation
This blog publishes information typically sent to users of the Colorado Health Facilities Interactive (COHFI) system for health care entities regulated by the Colorado Department of Public Health and Environment. Please note that COHFI is the official medium for business communication between the Department and licensed and/or Medicare/Medicaid certified health care entities. Health care entities should continue to monitor their email accounts routinely.
