(1) [Editor's note: This version of subsection (1) is effective until July 1, 2026.] It is unlawful for any person, partnership, association, or corporation to open, conduct, or maintain any general hospital; hospital unit; freestanding emergency department as defined in section 25-1.5-114; psychiatric hospital; community clinic; rehabilitation hospital; convalescent center; facility for persons with developmental disabilities, as defined in section 25-1.5-103 (2)(c); nursing care facility; hospice care; assisted living residence, except an assisted living residence shall be assessed a license fee as set forth in section 25-27-107; dialysis treatment clinic; ambulatory surgical center; birthing center; home care agency; or other facility of a like nature, except those wholly owned and operated by any governmental unit or agency, without first having obtained a license from the department.
(1) [Editor's note: This version of subsection (1) is effective July 1, 2026.] It is unlawful for any person, partnership, association, or corporation to open, conduct, or maintain any general hospital; hospital unit; freestanding emergency department as defined in section 25-1.5-114; critical access hospital as defined in section 25-1.5-114.5; psychiatric hospital; community clinic; rehabilitation hospital; convalescent center; facility for persons with developmental disabilities as defined in section 25-1.5-103 (2)(c); nursing care facility; hospice care; assisted living residence, except an assisted living residence shall be assessed a license fee as set forth in section 25-27-107; dialysis treatment clinic; ambulatory surgical center; birthing center; home care agency; or other facility of a like nature, except those wholly owned and operated by a governmental unit or agency, without first having obtained a license from the department.
(2) As used in this section, unless the context otherwise requires:
(a) (I) Community clinic means a health-care facility that provides health-care services on an ambulatory basis, is neither licensed as an on-campus department or service of a hospital nor listed as an off-campus location under a hospital's license, and meets at least one of the following criteria:
(A) Operates inpatient beds at the facility for the provision of extended observation and other related services for not more than seventy-two hours;
(B) Provides emergency services at the facility and is not otherwise required to obtain licensure as a freestanding emergency department in accordance with section 25-1.5-114; or
(C) Is not otherwise subject to health facility licensure under this section or section 25-1.5-103 but opts to obtain licensure as a community clinic in order to receive private donations, grants, government funds, or other public or private reimbursement for services rendered.
(II) Community clinic includes a prison clinic operated by the department of corrections.
(III) Community clinic does not include:
(A) A federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4);
(B) A rural health clinic, as defined in section 1861 (aa)(2) of the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(2);
(C) A facility that functions only as an office for the practice of medicine or the delivery of primary care services by other licensed or certified practitioners; or
(D) A freestanding emergency department, as defined in and required to be licensed under section 25-1.5-114.
(b) Hospital unit means a physical portion of a licensed or certified general hospital, psychiatric hospital, maternity hospital, or rehabilitation hospital that is leased or otherwise occupied pursuant to a contractual agreement by a person other than the licensee of the host facility for the purpose of providing outpatient or inpatient services.
(3) Nothing in this section shall be construed to require the licensing of individual services provided by a licensed or certified provider on its own premises.
(4) A health-care facility is not required to be licensed as a community clinic solely due to the facility's ownership status, corporate structure, or engagement of outside vendors to perform nonclinical management services. This section permits regulation of a physician's office only to the extent the office is a community clinic as defined in this section.
Source: L. 09: p. 411, � 1. C.L. � 1053. CSA: C. 78, � 133. CRS 53: � 66-4-1. C.R.S. 1963: � 66-4-1. L. 71: p. 631, � 1. L. 78: Entire section amended, p. 440, � 3, effective May 18. L. 83: Entire section amended, p. 1051, � 1, effective May 25. L. 84: (1) amended, p. 338, � 4, effective April 25. L. 94: (1) amended, p. 2750, � 404, effective July 1. L. 95: Entire section amended, p. 1023, � 2, effective July 1. L. 2002: (1) amended, p. 1329, � 16, effective July 1. L. 2006: (1) amended, p. 1391, � 23, effective August 7. L. 2008: (1) amended, p. 2233, � 2, effective August 5. L. 2011: (1) and (2) amended, (HB 11-1101), ch. 94, p. 277, � 2, effective April 8; (2)(a) amended, (HB 11-1323), ch. 265, p. 1198, � 2, effective June 2. L. 2012: (1) and (2)(a) amended and (4) added, (HB 12-1294), ch. 252, p. 1253, � 3, effective June 4. L. 2019: (1), (2)(a)(I)(B), and (2)(a)(III)(C) amended and (2)(a)(III)(D) added, (HB 19-1010), ch. 324, p. 2998, � 3, effective August 2; (1) amended, (HB 19-1237), ch. 413, p. 3641, � 12, effective July 1, 2022. L. 2020: (2)(a)(III)(A) amended, (SB 20-136), ch. 70, p. 287, � 22, effective September 14. L. 2022: (1) amended, (HB 22-1278), ch. 222, p. 1592, � 228, effective July 1, 2024. L. 2024: (1) amended, (SB 24-121), ch. 439, p. 3066, � 3, effective July 1, 2026.
Editor's note: Amendments to subsection (1) by HB 19-1010 and HB 19-1237 were harmonized, effective July 1, 2022.
Cross references: For the legislative declaration contained in the 1994 act amending subsection (1), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration in the 2012 act amending subsections (1) and (2)(a) and adding subsection (4), see section 1 of chapter 252, Session Laws of Colorado 2012. For the legislative declaration in SB 20-136, see section 1 of chapter 70, Session Laws of Colorado 2020.
25-3-102. License - application - issuance - certificate of compliance required - rules. (1) (a) An applicant for a license described in section 25-3-101 shall apply to the department of public health and environment annually upon such form and in such manner as prescribed by the department; except that a community residential home shall make application for a license pursuant to section 25.5-10-214, C.R.S.
(b) The department has authority to administer oaths, subpoena witnesses or documents, and take testimony in all matters relating to issuing, denying, limiting, suspending, or revoking a license.
(c) The department shall issue licenses to applicants furnishing satisfactory evidence of fitness to conduct and maintain a health facility described in section 25-3-101 in accordance with this part 1 and the rules adopted by the department. The department shall not require, as satisfactory evidence of fitness, evidence as to whether an applicant has provided self declarations, affidavits, or other attestations as to its general compliance with statutory or regulatory licensing requirements. The department shall determine an applicant's fitness solely based on the specific fitness information or documentation submitted by the applicant upon the department's request or as otherwise acquired by the department through its own review or investigation of the applicant. The department may require the applicant to attest to the accuracy of the information provided as long as the attestation does not require the applicant's affirmation of its general compliance with statutory or regulatory licensing requirements. CAPS check information pursuant to section 26-3.1-111 (6)(a)(III) may be considered part of an applicant's evidence of fitness. The board may promulgate rules as necessary to implement this subsection (1)(c).
(d) The license expires one year after the date of issuance.
(e) (I) For a change of ownership, the department shall conduct a fitness review of a new owner based upon information compiled within the five years preceding the date of the application; except that the new owner shall disclose whether, within the ten years preceding the date of an application, the new owner:
(A) Has been convicted of a felony or misdemeanor involving moral turpitude;
(B) Had a state license or federal certification denied, revoked, or suspended by another jurisdiction;
(C) Had a civil judgment or criminal conviction against the new owner in a case brought by the federal, state, or local authorities that resulted from the operation, management, or ownership of a health facility or other entity related to substandard patient care or health-care fraud.
(II) The new owner shall provide the information specified in subparagraph (I) of this paragraph (e) to the department regardless of whether action has been stayed during a judicial appeal or otherwise settled between the parties.
(III) The department may review an existing owner of a licensed health facility or entity only when the department has new information not previously available or disclosed that bears on the fitness of the existing owner to operate or maintain a licensed health facility or entity.
(IV) A conversion of the health facility's or entity's legal structure, or the legal structure of an entity that has a direct or indirect ownership interest in the health facility or entity, is not a change of ownership unless the conversion also includes a transfer of at least fifty percent of the licensed facility's direct or indirect ownership interest to one or more new owners.
(2) Repealed.
(3) (a) Notwithstanding any provision of law to the contrary, the department of public health and environment shall not issue or renew any license described in section 25-3-101 for a facility covered by section 25-1.5-103 (5) unless the department receives a certificate of compliance for the applicant's building or structure from the division of fire prevention and control in the department of public safety in accordance with part 12 of article 33.5 of title 24, C.R.S.
(b) The department of public health and environment shall take action on an application for licensure within thirty days after the date that the department receives from the applicant all of the necessary information and documentation required for licensure, including a certificate of compliance from the division of fire prevention and control.
Source: L. 09: p. 412, � 2. C.L. � 1054. CSA: C. 78, � 134. C.R.S. 53: � 66-4-2. C.R.S. 1963: � 66-4-2. L. 71: p. 631, � 2. L. 79: Entire section amended, p. 1094, � 3, effective July 1. L. 94: (1) amended, p. 2750, � 405, effective July 1. L. 95: (1) amended, p. 1023, � 3, effective July 1. L. 2006: (2) amended, p. 1391, � 24, effective August 7. L. 2010: (2) amended, (SB 10-175), ch. 188, p. 799, � 61, effective April 29. L. 2012: (1) amended, (HB 12-1294), ch. 252, p. 1254, � 4, effective June 4; (1) amended and (3) added, (HB 12-1268), ch. 234, p. 1025, � 2, effective July 1, 2013. L. 2013: (3)(a) amended, (HB 13-1300), ch. 316, p. 1688, � 75, effective August 7; (1)(a) amended, (HB 13-1314), ch. 323, p. 1807, � 39, effective March 1, 2014. L. 2019: (2) amended, (HB 19-1237), ch. 413, p. 3638, � 3, effective August 2. L. 2020: (1)(c) amended, (HB 20-1302), ch. 265, p. 1274, � 9, effective September 14; (1)(d) amended, (SB 20-113), ch. 19, p. 75, � 2, effective September 14.
Editor's note: (1) Amendments to subsection (1) by House Bill 12-1268 and House Bill 12-1294 were harmonized, effective July 1, 2013.
(2) Subsection (2)(b) provided for the repeal of subsection (2), effective July 1, 2021. (See L. 2019, p. 3638.)
Cross references: For the legislative declaration contained in the 1994 act amending subsection (1), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration in the 2012 act amending subsection (1), see section 1 of chapter 252, Session Laws of Colorado 2012. For the legislative declaration in SB 20-113, see section 1 of chapter 19, Session Laws of Colorado 2020.