①The administrator of a hospital or clinic must endeavor, for the time being, to ensure a continuous rest period, pursuant to an Order of the Ministry of Health, Labour and Welfare, for those physicians working at the hospital or clinic whose scheduled working hours status (limited to that for a period of one year; the same applies in Article 123, paragraph (1) of the Supplementary Provisions) falls under the requirements specified by an Order of the Ministry of Health, Labour and Welfare (excluding a specified target physician prescribed in that paragraph; hereinafter in this Article referred to as the "target physician"), by the time a period specified by an Order of the Ministry of Health, Labour and Welfare has elapsed from the start of the work specified by an Order of the Ministry of Health, Labour and Welfare for each target physician. However, this does not apply where the target physician is made to engage in night or day duty (limited to that which conforms to the standards established by the Minister of Health, Labour and Welfare; the same applies in paragraph (3) and Article 123, paragraphs (1) and (3) of the Supplementary Provisions), pursuant to an Order of the Ministry of Health, Labour and Welfare, by the time a period specified by an Order of the Ministry of Health, Labour and Welfare has elapsed from the start of that work.

②The administrator of a hospital or clinic must endeavor, where the rest period prescribed in the preceding paragraph has not been ensured for a target physician, to ensure an equivalent rest period afterwards, pursuant to an Order of the Ministry of Health, Labour and Welfare.

③In the case referred to in the proviso to paragraph (1), where the administrator of the hospital or clinic has had the target physician work during that night or day duty, the administrator must endeavor to ensure the necessary rest period for the target physician after that night or day duty, pursuant to an Order of the Ministry of Health, Labour and Welfare.

In the case where the prefectural governor finds that the administrator of a hospital or clinic has, without justifiable grounds, not established the necessary system prescribed in Article 107 of the Supplementary Provisions, has not conducted the face-to-face guidance under Article 108, paragraph (1) of the Supplementary Provisions (excluding the case where the document prescribed in the proviso to paragraph (2) of that Article has been submitted and the case prescribed in paragraph (8) of that Article), or has not taken the necessary measures prescribed in paragraph (6) of that Article, the prefectural governor may order the establisher of the hospital or clinic to take the measures necessary for the improvement, specifying a time limit.

In addition to what is prescribed in Articles 108 through 110 of the Supplementary Provisions, matters necessary for the conduct of face-to-face guidance under Article 108, paragraph (1) of the Supplementary Provisions or the securing of rest periods under the main clause of Article 110, paragraph (1), or paragraph (2) or (3) of the Supplementary Provisions are specified by an Order of the Ministry of Health, Labour and Welfare.

①The prefectural governor may, for the time being, upon application by the establisher of the hospital or clinic, designate as a specified regional medical care provision institution a hospital or clinic (limited to one situated in the area of the relevant prefecture) that is found to have operations specified by an Order of the Ministry of Health, Labour and Welfare for which it is unavoidably necessary to have physicians engage in work for long hours in order to provide any of the following medical care:

②An application for designation under the preceding paragraph must be made by attaching a draft of a plan relating to the shortening of working hours of the physicians engaged in the operations prescribed in that paragraph (hereinafter referred to as the "plan for shortening working hours") to a written application stating the particulars specified by an Order of the Ministry of Health, Labour and Welfare.

③When the prefectural governor finds that the hospital or clinic pertaining to the application under paragraph (1) falls under the following requirements, the prefectural governor may make the designation under that paragraph:

④In making the designation under paragraph (1), the prefectural governor must take into account the result of the evaluation of the hospital or clinic pertaining to the application under that paragraph, of which notice has been received pursuant to Article 132 of the Supplementary Provisions.

⑤In making the designation under paragraph (1), the prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance.

⑥When the prefectural governor has made the designation under paragraph (1), the prefectural governor must give public notice to that effect, pursuant to an Order of the Ministry of Health, Labour and Welfare.

⑦The prefectural governor may, to the extent necessary for the enforcement of the provisions of this Article, request a report on necessary matters from the medical institution work environment evaluation center referred to in Article 130, paragraph (1) of the Supplementary Provisions (referred to simply as the "medical institution work environment evaluation center" in Article 116, paragraph (1) of the Supplementary Provisions).

The administrator of a specified regional medical care provision institution must, without delay after receiving the designation under paragraph (1) of the preceding Article, establish a plan for shortening working hours.

①The designation under Article 113, paragraph (1) of the Supplementary Provisions loses its effect upon the lapse of the period unless it is renewed every three years.

②In the case where an application for renewal under the preceding paragraph has been filed, if no disposition on the application has been made by the date of expiry of the period referred to in that paragraph (hereinafter referred to as the "period of validity of designation" in this Article), the previous designation remains in force, even after the expiry of the period of validity of designation, until the disposition is made.

③In the case referred to in the preceding paragraph, when the designation has been renewed, the period of validity of designation is to be counted from the day following the date of expiry of the previous period of validity of designation.

④The provisions of the preceding two Articles apply mutatis mutandis to the renewal of designation under paragraph (1).

①When the establisher of a specified regional medical care provision institution intends to change the operations prescribed in Article 113, paragraph (1) of the Supplementary Provisions (excluding minor changes specified by an Order of the Ministry of Health, Labour and Welfare), the establisher must obtain the approval of the prefectural governor who made the designation of the relevant specified regional medical care provision institution, pursuant to an Order of the Ministry of Health, Labour and Welfare. In this case, the administrator of the relevant specified regional medical care provision institution must, in advance, after hearing the opinions of the physicians working at the relevant specified regional medical care provision institution and other related parties, conduct a review for revising the plan for shortening working hours and make the necessary changes, and must receive the evaluation under Article 131, paragraph (1), item (i) of the Supplementary Provisions by the medical institution work environment evaluation center, pursuant to an Order of the Ministry of Health, Labour and Welfare.

②The provisions of Article 113, paragraphs (2) through (7) of the Supplementary Provisions apply mutatis mutandis to the approval under the preceding paragraph. In this case, the term "that paragraph" in paragraph (2) of that Article is deemed to be replaced with "Article 113, paragraph (1)", and the term "a draft of" in that paragraph is deemed to be replaced with "a draft of a change to", and the term "the draft of" in paragraph (3), item (i) of that Article is deemed to be replaced with "the draft of a change to".

①The prefectural governor may rescind the designation under Article 113, paragraph (1) of the Supplementary Provisions (hereinafter referred to as "designation" in this Article) if a specified regional medical care provision institution falls under any of the following items:

②In rescinding a designation pursuant to the preceding paragraph, the prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance.

③When the prefectural governor has rescinded a designation pursuant to paragraph (1), the prefectural governor must give public notice to that effect, pursuant to an Order of the Ministry of Health, Labour and Welfare.

①The prefectural governor may, for the time being, upon application by the establisher of the hospital or clinic, designate as a collaborative specified regional medical care provision institution a hospital or clinic (limited to one situated in the area of the relevant prefecture) whose physicians' working hours unavoidably become long as a result of the staffing of physicians at another hospital or clinic (limited to staffing found necessary to ensure the medical care delivery system), pursuant to an Order of the Ministry of Health, Labour and Welfare.

②The provisions of Article 113, paragraphs (2) through (7), Article 114 and Article 115 of the Supplementary Provisions apply mutatis mutandis to the designation of a collaborative specified regional medical care provision institution under the preceding paragraph, the provisions of Article 116 of the Supplementary Provisions apply mutatis mutandis to a change in the operations of the physicians staffed under that paragraph by a collaborative specified regional medical care provision institution, and the provisions of the preceding Article apply mutatis mutandis to the rescission of the designation of a collaborative specified regional medical care provision institution under that paragraph. In this case, the term "physicians engaged in the operations prescribed in that paragraph" in Article 113, paragraph (2) is deemed to be replaced with "physicians staffed at another hospital or clinic (limited to those pertaining to the staffing prescribed in Article 118, paragraph (1))", the term "this Article" in paragraph (7) of that Article is deemed to be replaced with "Article 118", the term "the operations prescribed in Article 113, paragraph (1) no longer exist" in item (i) of paragraph (1) of the preceding Article is deemed to be replaced with "the staffing of physicians prescribed in paragraph (1) of the following Article is no longer carried out", and the term "each item of Article 113, paragraph (3)" in item (ii) of that paragraph is deemed to be replaced with "each item of Article 113, paragraph (3) as applied mutatis mutandis pursuant to paragraph (2) of the following Article".