Beyond the provisions of Article 21, paragraph (1) (excluding items (i) and (ix)), an advanced treatment hospital is to have the following personnel and facilities and must prepare the following records, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare:

Beyond the provisions of Article 21, paragraph (1) (excluding items (i) and (ix)), a core hospital for clinical research is to have the following personnel and facilities and must prepare the following records, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare:

①Beyond the provisions of Article 21 through the preceding Article, the necessary standards for ensuring satisfactory ventilation, lighting, illumination, damp proofing, security, emergency evacuation, cleanliness, and other sanitary conditions with regard to the buildings and equipment of a hospital, clinic or birthing center, is to be prescribed by an Order of the Ministry of Health, Labour and Welfare.

②Regulations may be established by Cabinet Order to sentence persons who have violated the provisions of the Order of the Ministry of Health, Labour and Welfare as set forth in the provisions of the preceding paragraph to a fine of up to 200,000 yen.

When the distribution of personnel in a hospital or in a clinic with long-term care beds is significantly lacking in terms of the standards prescribed by the Order of the Ministry of Health, Labour and Welfare or prefectural ordinances set forth in Article 21, paragraph (1) (limited to the parts pertaining to item (i)) or paragraph (2) (limited to the part pertaining to item (i)), and falls under cases prescribed by an Order of the Ministry of Health, Labour and Welfare as cases that cause a significant impediment to the suitable provision of medical care, the prefectural governor may order the establisher to increase the number of personnel by a set deadline, or may suspend all or a part of its operations for a period that the governor prescribes.

①When a hospital, clinic, or birthing center is lacking in cleanliness, or when its buildings and equipment violate the provisions of Article 21, paragraph (1) or (2), or Article 22, or violate the provisions of an Order of the Ministry of Health, Labour and Welfare that is based on the provisions set forth in Article 23, paragraph (1), or are found to be a sanitation hazard or safety risk, the prefectural governor may prescribe a period of time and order the establisher to fully or partially limit or prohibit the use thereof, or may order repairs or reconstruction to be carried out by a set deadline.

②When the buildings and equipment of an advanced treatment hospital or core hospital for clinical research (hereinafter referred to as "advanced treatment hospital, etc." in this Section) violate the provisions of Article 22-2 or Article 22-3, the Minister of Health, Labour and Welfare may order their repair or reconstruction to be carried out by the establisher of the relevant advanced treatment hospital, etc. by a set deadline.

①When a prefectural governor finds that the business of a hospital, clinic, birthing center or facility for receiving online medical care violates laws and regulations or dispositions under laws and regulations, or that the operation thereof is extremely inappropriate (excluding the cases prescribed in Article 23-2 or paragraph (1) of the preceding Article), the governor may, to the extent necessary for the enforcement of this Act, order the establisher of the relevant hospital, clinic or birthing center or the founder of the relevant facility for receiving online medical care to take necessary measures by a set deadline.

②In the event that the establisher or founder set forth in the preceding paragraph does not comply with the order as prescribed in the same paragraph, the prefectural governor may order the relevant establisher or founder to suspend all or part of the business of the hospital, clinic, birthing center or facility for receiving online medical care that they establish, for a specified period of time.

①When a prefectural governor, the mayor of a city with a public health center, or the mayor of a special ward of Tokyo finds it necessary, the governor or mayor may order the establisher or administrator of a hospital, clinic, or birthing center, or the founder of a facility for receiving online medical care, to report as necessary, and may have the relevant officials enter the relevant hospital, clinic, birthing center or facility for receiving online medical care and inspect the personnel or the state of cleanliness, its buildings, and equipment, its medical records, birth records, books and documents, and other articles.

②When a prefectural governor, the mayor of a city with a public health center, or the mayor of a special ward of Tokyo suspects that the operation of a hospital, clinic, birthing center or facility for receiving online medical care is in violation of laws and regulations or a disposition based on laws and regulations, or suspects that the management thereof is significantly unsuitable, the governor or mayor may order the establisher or administrator of the relevant hospital, clinic, or birthing center, or the founder of the relevant facility for receiving online medical care, to submit medical records, birth records, books and documents, and other articles, or have the relevant officials enter the office of the establisher of the relevant hospital, clinic or birthing center or of the founder of the relevant facility for receiving online medical care, or other places related to the operation of the relevant hospital, clinic, birthing center or facility for receiving online medical care, and inspect books and documents, and other articles to the extent necessary for the enforcement of this Act.

③When the Minister of Health, Labour and Welfare finds it necessary, the minister may order the establisher or administrator of an advanced treatment hospital, etc. to report as necessary, and may have the relevant officials enter the advanced treatment hospital, etc. and inspect the personnel or the state of cleanliness, its buildings and equipment, medical records, birth records, books and documents, and other articles.

④When the Minister of Health, Labour and Welfare suspects that the operation of an advanced treatment hospital, etc. is in violation of laws and regulations or a disposition based on laws and regulations, or suspects that the management thereof is significantly unsuitable, the minister may order the establisher or administrator of the relevant advanced treatment hospital, etc. to submit medical records, birth records, books and documents, or other articles.

⑤The provisions set forth in Article 6-8, paragraph (3) apply mutatis mutandis pursuant to entry and inspection as set forth in paragraph (1) through paragraph (3), and the provisions set forth in paragraph (4) of the same Article apply mutatis mutandis pursuant to the authority set forth in each of the preceding paragraphs.

The mayors of cities with a public health center and the mayors of special wards of Tokyo must, as provided by Order of the Ministry of Health, Labour and Welfare, give notice to the prefectural governor of the particulars specified by Order of the Ministry of Health, Labour and Welfare concerning clinics, birthing centers and facilities for receiving online medical care.

①The Minister of Health, Labour and Welfare, prefectural governors, mayors of cities with public health centers, and mayors of special wards of Tokyo are to appoint medical care inspectors from among the officials of the Ministry of Health, Labour and Welfare, prefecture, city with the public health center, or special ward of Tokyo, to be entrusted with the authority of the relevant officials provided for in Article 25, paragraphs (1) and (3).

②Beyond the provisions of the preceding paragraph, necessary particulars concerning medical care inspectors are to be as prescribed by an Order of the Ministry of Health, Labour and Welfare.

A hospital, clinic with in-patient facilities, or birthing center with admission facilities must not use its buildings and equipment without first undergoing inspection by the prefectural governor with jurisdiction over their location and receiving a license.