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;

2. Within 45 days of receiving notice, the Commission in its
sole discretion finds that the proposed consolidation, merger, or conversion:

A. Is not inconsistent with the State health plan or the
institution-specific plan developed by the Commission as appropriate;

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

C. Is in the public interest; and

3. Within 45 days of receiving notice, the Commission shall
notify the health care facility of its finding;

(vi) A capital expenditure by a nursing home for equipment,
construction, or renovation that:

1. Is not directly related to patient care; and

2. Is not directly related to any change in patient charges or

other rates;

(vii) A capita! expenditure by a hospital, as defined in §19-301 of
this title, for equipment, construction, or renovation that:

1. Is not directly related to patient care; and

2. Does not increase patient charges or hospital rates;

(viii) A capital expenditure by a hospital as defined in § 19-301 of
this title, for a project in excess of $1,250,000 $2,500,000 $1,250,000 for construction or
renovation that:

1. May be related to patient care;

2. Does not require, over the entire period or schedule of debt
service associated with the project, a total cumulative increase in patient charges or.