WILLIAM DONALD SCHAEFER, Governor Ch. 767

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; 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] $1,250,000;

2.  The expenditure is made as part of a
replacement of any plant and equipment 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; 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

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