CHOW is an acronym frequently used by those in the health care industry to describe the regulatory process that often must be followed when a licensed or certified health care provider undergoes a "change of ownership." Many businesses that operate in the health care industry will have at least one and maybe multiple "permits" or "provider numbers" issued by a governmental body. As a result, the CHOW process applicable to most, if not all, health care permits, licenses, certifications, and provider numbers is heavily regulated to ensure that any new owners satisfy the regulatory requirements that the "seller" met when it originally obtained the permit. This book is designed to give practitioners a general understanding of the CHOW process for operating licensure, certificate of need, and Medicare and Medicaid provider numbers. The book describes some general and specific elements of what can be, and in some cases is, required in a change of ownership process in these different contexts.