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 capital 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 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
hospital rates of more than $1,500,000 for the capital costs associated with the project
as determined by the Commission, after consultation with the Health Services Cost
Review Commission;

3. At least 45 days before the proposed expenditure is made,
the hospital notifies the Commission and within 45 days of receipt of the relevant
financial information, the Commission makes the financial determination required
under item 2 of this subparagraph; and

4. The relevant financial information to be submitted by the
hospital is defined in regulations [promulgated] ADOPTED by the Commission, after
consultation with the Health Services Cost Review Commission; or

(ix) A plant donated to a hospital as defined in § 19-301 of this title,
which does not require a cumulative increase in patient charges or hospital rates of