Delaware Code § 16-9304

Activities subject to review [Effective until July 1, 2026]
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(a) Any person must obtain a Certificate of Public Review prior to undertaking any of the following activities:
(1) The construction, development or other establishment of a health-care facility or the acquisition of a nonprofit health-care facility;
(2) Any expenditure by or on behalf of a health-care facility in excess of $5.8 million, or some greater amount which has been
designated by the Board following an annual adjustment for inflation using an annual inflation index determined by the United States
Department of Labor, Bureau of Labor Statistics, is a capital expenditure. A capital expenditure for purposes of constructing, developing
or otherwise establishing a medical office building shall not be subject to review under this chapter. When a person makes an acquisition
by or on behalf of a health-care facility under lease or comparable arrangement, or through donation which would have required review

if the acquisition had been by purchase, such acquisition shall be deemed a capital expenditure subject to review. The Board may
exempt from review capital expenditures when determined to be necessary for maintaining the physical structure of a facility and not
related to direct patient care. A notice of intent filed pursuant to § 9305 of this title, along with any other information deemed necessary
by the Board, shall provide the basis for exempting such capital expenditures from review;
(3) A change in bed capacity of a health-care facility which increases the total number of beds (or distributes beds among various
categories, or relocates such beds from 1 physical facility or site to another) by more than 10 beds or more than 10 percent of total
licensed bed capacity, whichever is less, over a 2-year period;
(4) The acquisition of major medical equipment, whether or not by a health-care facility and whether or not the acquisition is through
a capital expenditure, an operating expense or a donation. The replacement of major medical equipment with similar equipment shall
not be subject to review under this chapter. In the case of major medical equipment acquired by an entity outside of Delaware, the use
of that major medical equipment within Delaware, whether or not on a mobile basis, is subject to review under this chapter. Major
medical equipment which is acquired for use in a freestanding acute inpatient rehabilitation hospital, as defined in § 9302(4) of this
title, a dispensary or first aid station located within a business or industrial establishment maintained solely for the use of employees or
in a first aid station, dispensary or infirmary offering services exclusively for use by students and employees of a school or university
or by inmates and employees of a prison is not subject to review.
(5) [Expired].
(b) [Expired].

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