Ch. 767

LAWS OF MARYLAND

(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[.]; OR

(IV) BEFORE THE EXPANSION OF A HOME HEALTH
SERVICE OR PROGRAM BY A HEALTH CARE FACILITY THAT:

1.  ESTABLISHED THE HOME HEALTH SERVICE OR.
PROGRAM WITHOUT A CERTIFICATE OF NEED BETWEEN JANUARY 1, 1984 AND
JULY 1, 1984; AND

2.  DURING A 1-YEAR PERIOD, THE ANNUAL
OPERATING REVENUE THAT WOULD RESULT FROM THE EXPANSION OF THE
HOME HEALTH SERVICE OR PROGRAM WOULD BE GREATER THAN $333,000
AFTER AN ANNUAL ADJUSTMENT FOR INFLATION, BASED ON AN APPROPRIATE
INDEX SPECIFIED BY THE COMMISSION.

(j) (1) A certificate of need is required before any of the
following capital expenditures are made by or on behalf of a
health care facility:

(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 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] $1,250,000;

2.  The expenditure is made as part of a
replacement of any plant and equipment of the health care
facility and is more than [$600,000] $1,250,000 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;

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