2776

LAWS OF MARYLAND

Ch. 730

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
Commission, the total expenditure, including the cost of each
study, survey, design, plan, working drawing, specification, and
other essential activity, is more than $600,000;

2.  The expenditure is made as part of a
replacement of any plant and equipment and is more than $600,000
after adjustment for inflation as provided in the regulations of
the Commission;

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.

(3)  A certificate of need is required before any
equipment or plant is transferred to a health care facility at
less than fair market value if a certificate of need would be
required under paragraph (1) of this subsection for the transfer
at fair market value.

(4)  A certificate of need is required before a person
acquires a health care facility if a certificate of need would
be required under paragraph (1) of this subsection for the
acquisition by or on behalf of the health care facility.

(5)  This subsection does not apply to:

(i) Site acquisition;

(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;