(a) If the physical plant was a Medicare/Medicaid certified hospital within twenty-four months prior to opening as a medical assistance facility and no renovation has been done, then the physical plant will be grandfathered.
(b) If there has been:
(c) All plans and specifications for construction and/or remodeling shall be approved by the Office of Health Quality prior to construction.
048-14 Wyo. Code R. § 14-18