3. Within 45 days of receiving notice under item 1 of this
subparagraph, 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:

(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;

(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 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 $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 $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 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