The correct option is E eliminate unneeded beds, consolidate expensive services, and use space in other hospitals
In this, the use of 'recommend' makes 'should' redundant.' Recommend' implies that the person should do whats been advised, so 'should' becomes superfluous. This eliminates A, B, and C. Now, all the three recommendations should be in parallel as the sentence is a parallel structure one. The use of 'eliminate' at the beginning of all three options implies that the rest of the sentence should follow the same form. But 'services should be' in A, B and C, which is a passive construct, does not reflect the active construct of 'eliminate'. This is another reason why the first three options are incorrect. The '...space used' in D is not parallel with 'eliminate and 'consolidate' of the same sentence (D).This eliminates D. E is the only grammatically correct, parallel structure-confirming option. Thus, E is the correct answer.