HARRY HUGHES, Governor                                     1499

(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]

1.  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

2. THE CHANGE WOULD RESULT FROM THE

LEASE, ACQUISITION, OR USE OF MEDICAL EQUIPMENT; OR

2. THE ANNUAL OPERATING REVENUE THAT
WOULD RESULT FROM THE ADDITION IS ENTIRELY ASSOCIATED WITH THE
USE OF MEDICAL EQUIPMENT; 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) Notwithstanding the provisions of paragraph (2)
of this subsection, a certificate of need is required:

(i) Before an additional home health agency,
branch office, or home health care service is established by an
existing health care agency or facility;

(ii) Before an existing home health agency or
health care facility establishes a home health agency or home
health care service at a location in the service area not
included under a previous certificate of need or license; or

(iii) Before a transfer of ownership of any
branch office of a home health agency or home health care service
of an existing health care facility that separates the ownership
of the branch office from the home health agency or home health
care service of an existing health care facility which
established the branch office.

(k) (5) This subsection does not apply to:

(i) Site acquisition; [or]

(ii) Acquisition of a health care facility if,
at least 30 days before making the contractual arrangement to
acquire the facility, written notice of the intent to make the
arrangement is filed with the Commission and the Commission does
not find, within 30 days after the Commission receives notice,
that the health services or bed capacity of the facility will be
changed;