Chapter III: Health centres.

I. - Where it is found that there has been a breach that compromises the quality or safety of care, a breach by the legal representative of the managing body of the obligation to transmit the undertaking to comply, or a breach of the legislative and regulatory provisions relating to health centres, or in the case of abuse or fraud committed with regard to social security bodies or insured persons, the Director General of the Regional Health Agency will notify the managing body of the health centre and ask it to make known, within a period of not less than eight days, its observations in response and the corrective measures adopted or envisaged. The Director General of the Regional Health Agency will also inform the relevant professional bodies of any shortcomings that compromise the quality or safety of care.

If there is no response within this period, or if the response is insufficient, the Director General of the Regional Health Agency will issue an injunction to the manager of the health centre to take all necessary measures and to put a definitive end to the shortcomings within a specified period. It will record that this has been done.

If one of the breaches mentioned in the first paragraph of this I is found to have occurred, and if there is no response within the period set by the injunction, or if the response is inadequate, the Director General of the Regional Health Agency may impose an administrative fine on the managing body or its legal representative. The amount of the administrative fine may not exceed 500,000 euros. The Director General of the Regional Health Agency may add a daily penalty to this fine if the health centre manager has not complied with the instructions issued to him/her by the end of the period set by formal notice. The amount of the fine may not exceed 5,000 euros per day. The respective amounts of the fine and the daily penalty are set according to the seriousness of the breaches observed, by applying a scale established by decree.

The proceeds of the financial penalty provided for in this I shall be allocated to the Caisse nationale de l'assurance maladie.

The Director General of the Regional Health Agency publishes the financial penalties imposed under this I on the Regional Health Agency's website. He will publish the financial penalty decisions on the website of the appropriate health authorities and will give formal notice to the managing body or its legal representative to publish these decisions on the website, where it exists, of the health centre for which the breaches have been observed and, where applicable, to include them in the information concerning this centre made available to the public via an electronic contact platform.

II. - In the event of an emergency relating to patient safety or where the injunction provided for in I has not been complied with within the time limit set, the Director General of the Regional Health Agency may order the immediate suspension, in whole or in part, of the activity of the centre and, where they exist, of its branches.

The decision is notified to the legal representative of the health centre's managing body, together with the observations made and a formal notice to remedy the shortcomings within a specified period.

If, at the end of this period, it is found that the formal notice has been complied with, the Director General of the Regional Health Agency, after a compliance visit if necessary, ends the suspension.

If this is not the case, the Director General of the Regional Health Agency will decide either whether to maintain the suspension until the implementation of the planned measures has been completed, or to close the health centre and its branches, if any.

III. - Decisions to suspend or close a health centre pursuant to II shall be communicated without delay to the Caisse nationale de l'assurance maladie and to the councils of the relevant professional associations. In the event of permanent closure, the Regional Health Agency will also ensure that all patients receiving treatment in the health centre affected by the decision are informed.

IV. - The suspension of a centre's activity or the closure of a centre or one of its branches entails, until the suspension is lifted or for a period of eight years in the case of closure, the refusal by the Director General of the Regional Health Agency to issue a receipt for the undertaking to comply or the approval requested for the opening of a new health centre or branch, by the same legal representative, by the same managing body or by a member of its governing body.

V. - A national register records the measures taken to suspend and close health centres in application of this article. The information contained in this register and the procedures for its implementation shall be specified by decree. The register will be made available to all government departments and social security bodies.