Craig Hospital

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We’re here to help

COHFA serves to educate and assist public and nonprofit health institutions in acquiring lower cost capital necessary to the development and maintenance of public health, hospitals, long term care facilities, physical and mental health care, and related facilities.


COHFA was created by the Colorado Legislature in 1977 as a financing vehicle to enable public and nonprofit healthcare institutions to access the tax-exempt market when financing or refinancing healthcare related facilities. COHFA does not receive any State funds and is not a state agency. Its operations are funded through fees charged to borrowers.

As of September 30, 2023, COHFA had completed 414 financings, of which approximately $9.5 billion in aggregate principal amount remain outstanding. These financings have ranged in size from several hundred thousand to over one billion.

COHFA’s statute does not provide that the moral authority of the State can be pledged. To the contrary, it explicitly provides that any obligations issued by COHFA are not an indebtedness, a debt or a liability of the State or any political subdivision of the State. All bond documents, bonds and offering circulars of COHFA distributed to potential or actual purchases state that the bonds are not the obligations of the State or COHFA but are the financial obligations of the borrowing healthcare institutions.

COHFA serves healthcare providers located both throughout the State and throughout the country and ranging in size and type from small residential treatment to facilities for the mentally ill and developmentally disabled to facilities for the elderly and acute-care hospitals.


Bond Issues

Bond issues, both tax-exempt and taxable, are the primary types of COHFA financings. Such bonds can be publicly sold or privately placed, rated or unrated, credit enhanced or not, bear interest at fixed or variable interest rates, and have a maturity of not greater than forty years.

Tax-Exempt Leases

COHFA has a tax-exempt leasing program primarily, but not exclusively, for equipment. COHFA works with the lessors and vendors of the borrowers choosing. While typically structured as capital leases, they can also be structured as operating leases under certain circumstances. These leases have a lower fee schedule than bond issues.

Pooled Financings

Though less frequently issued than other obligations, COHFA has completed pooled or composite financings for a variety of borrowers.

waterfall in front of Mercy Medical Center

Mercy Medical Center

Who Qualifies?

COHFA may finance or refinance a wide variety of healthcare and elderly housing facilities, as further described in its statute. COHFA can provide financing for both governmental and nonprofit 501(c)3 healthcare related entities but may not finance for-profit entities.

Additionally, COHFA can finance or refinance any other structure or facility useful for the operation of a health facility, including equipment.

COHFA may also finance facilities located outside of the State of Colorado if the health institution or an affiliate of such institution also operates or manages a healthcare facility within the State.

The types of facilities COHFA can finance or refinance include, but are not limited, to the following:

  • Hospitals
  • Independent living facilities
  • Training facilities for the developmentally disabled
  • Mental health clinics
  • Dental or vision facilities
  • Pharmacies
  • Nursing schools
  • Nursing homes
  • Medical teaching and research facilities
  • Group homes for the developmentally disabled, mentally ill, or substance abusers
  • Outpatient facilities
  • Medical residences
  • Rehabilitation centers
  • Parking facilities
  • Assisted living facilities
  • Health clinics
  • Bone, tissue and blood banks
  • Laboratories
  • Hospices
  • Administration buildings


  • Colorado Hospital Association
  • Colorado chapter of the Healthcare Financial Management Association
  • Leading Age (formerly CAHSA)