HARRY HUGHES, Governor

1293

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

1.  The expenditure is made as part
of an acquisition, improvement, or expansion, and, after
adjustment for inflation as provided in the rules and
regulations of the State agency, the total expenditure,
including the cost of each study, survey, design, plan,
working drawing, specification, and other essential
activity, is more than $150,000;

2.  The expenditure is made as part
of a replacement of any plant and equipment of the health
care facility and is more than $150,000;

3.  The expenditure results in a
substantial change in the bed capacity of the health care
facility; or

4.  The expenditure results in a
substantial change in the services of the health care
facility; or

(ii) Any expenditure that is made to lease
or, by comparable arrangement, obtain any plant or equipment
for the health care facility, if:

1.  The expenditure is made as part
of an acquisition, improvement, or expansion, and, after
adjustment for inflation as provided in the rules and
regulations of the State agency, the total expenditure,
including the cost of each study, survey, design, plan,
working drawing, specification, and other essential
activity, is more than $150,000;

2.  The expenditure is made as part
of a replacement of any plant and equipment and is more than
$150,000;

3.  The expenditure results in a
substantial change in the bed capacity of the health care
facility; or

4.  The expenditure results in a
substantial change in the services of the health care
facility.

(2) A certificate of need is required before any
equipment or plant is donated to a health care facility, if
a certificate of need would be required under paragraph (1)
of this subsection for an expenditure by the health care
facility to acquire the equipment or plant directly.