HARRY HUGHES, Governor                                     3267

(2) This subsection does not apply if:

(i) The Commission adopts limits for changes in
health care services and the proposed change would not exceed
those limits;

(ii) The proposed change would add a new health
care service and, during a 1 year period, the annual operating
revenue that would result from the addition is less than $250,000
after an annual adjustment for inflation, based on an appropriate
index specified by the Commission; or

(iii) The proposed change would increase or
decrease the volume of one patient service and, during a 2 year
period, the change is less than 25 percent of that volume.

(3)(I) THIS PARAGRAPH SUBSECTION (J)(1) OF THIS
SECTION DOES NOT REQUIRE AN EXISTING HOME HEALTH AGENCY OR HOME
HEALTH SERVICE HEALTH CARE FACILITY THAT PROVIDES HOME HEALTH
CARE SERVICES TO OBTAIN A CERTIFICATE OF NEED FOR EXPANSION INTO
NEW HOME HEALTH CARE SERVICES AT A LOCATION ALLOWED UNDER A
PREVIOUS CERTIFICATE OF NEED OR LICENSE.

(II) (3) NOTWITHSTANDING THE PROVISIONS OF
PARAGRAPH (2) OF THIS SUBSECTION, A CERTIFICATE OF NEED IS
REQUIRED:

1. (I) BEFORE THE ESTABLISHMENT OF ANY AN
ADDITIONAL HOME HEALTH AGENCY, BRANCH OFFICE, OR HOME HEALTH
SERVICE CARE SERVICE IS ESTABLISHED BY AN EXISTING HEALTH CARE
AGENCY OR FACILITY;

2. (II) BEFORE THE EXPANSION OF AN

EXISTING HOME HEALTH AGENCY OR HOME HEALTH SERVICE BY THE
ESTABLISHMENT OF HEALTH CARE FACILITY ESTABLISHES A HOME HEALTH
AGENCY OR HOME HEALTH CARE SERVICE AT A LOCATION OTHER THAN THE
LOCATION ALLOWED IN THE SERVICE AREA NOT INCLUDED UNDER A
PREVIOUS CERTIFICATE OF NEED OR LICENSE; AND OR

3. (III) BEFORE A TRANSFER OF OWNERSHIP
OF ANY BRANCH OFFICE OF A HOME HEALTH AGENCY OR HOME HEALTH
SERVICE CARE SERVICE OF AN EXISTING HEALTH CARE FACILITY THAT
SEPARATES THE OWNERSHIP OF THE BRANCH OFFICE FROM THE HOME HEALTH
AGENCY OR HOME HEALTH SERVICE CARE SERVICE OF AN EXISTING HEALTH
CARE FACILITY WHICH ESTABLISHED THE BRANCH OFFICE.

(k) (1) A certificate of need is required before any of the
following capital expenditures are made by or on behalf of a
health care facility:

(i) Any expenditure that, under generally
accepted accounting principles, is not properly chargeable as an
operating or maintenance expense, if: