WILLIAM DONALD SCHAEFER, Governor Ch. 688

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 ESTABLISHMENT OF A NEW
MEDICAL SERVICE IN A health care facility THAT WOULD REQUIRE A
CERTIFICATE OF NEED UNDER SUBSECTION (I) OF THIS SECTION.

[(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)] (2) 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)] (3) 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)] (4) 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;

(iii) Acquisition of business or office
equipment that is not directly related to patient care;

(iv) Capital expenditures to the extent that
they are directly related to the acquisition and installation of
major medical equipment;

(v) A capital expenditure made as part of a
consolidation or merger of 2 or more health care facilities, or
conversion of a health care facility or part of a facility to a
nonhealth-related use if:

1. At least 45 days before an expenditure
is made, written notice of intent is filed with the Commission;

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