WILLIAM DONALD SCHAEFER, Governor                   Ch. 767

(III) THE PROPOSED CHANGE WOULD ESTABLISH,
INCREASE, OR DECREASE A HEALTH CARE SERVICE AND THE CHANGE WOULD
NOT RESULT IN THE:

1.  ESTABLISHMENT OF A NEW MEDICAL SERVICE
OR ELIMINATION OF AN EXISTING MEDICAL SERVICE;

2.  ESTABLISHMENT OF AN OPEN HEART
SURGERY, ORGAN TRANSPLANT SURGERY, BURN OR NEONATAL INTENSIVE
HEALTH CARE SERVICE;

3.  ESTABLISHMENT OF A HOME HEALTH
PROGRAM, HOSPICE PROGRAM, OR FREESTANDING AMBULATORY SURGICAL
CENTER OR FACILITY PROGRAM; OR

4.  EXPANSION OF A COMPREHENSIVE CARE

PROGRAM, INCLUDING AN INTERMEDIATE CARE OR EXTENDED CARE

PROGRAM;, EXTENDED CARE, INTERMEDIATE CARE, RESIDENTIAL
TREATMENT, PSYCHIATRY, OR REHABILITATION MEDICAL SERVICE, EXCEPT
FOR AN EXPANSION RELATED TO AN INCREASE IN TOTAL BED CAPACITY IN
ACCORDANCE WITH SUBSECTION (H)(2)(I) OF THIS SECTION; OR

(iv) 1. At least 45 days before increasing or
decreasing the volume of 1 or more [patient] HEALTH CARE
services, written notice of intent to change the volume of
[patient] HEALTH CARE services is filed with the Commission;

2.  The Commission in its sole discretion
finds that the proposed change:

A.  Is pursuant to the 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;

B.  Is not inconsistent with the State
health plan or the institution-specific plan developed and
adopted by the Commission;

C.  Will result in the delivery of more
efficient and effective health care services; and

D.  Is in the public interest; and

3.  Within 45 days of receiving notice
under item 1. of this paragraph, the Commission shall notify the
health care facility of its finding.

(3) Notwithstanding the provisions of paragraph (2)
of this subsection, a certificate of need is required:

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