If the institution fails to transmit the information referred to in Article L. 6113-8 under the conditions defined in application of the provisions of Article R. 6113-27, the Director General of the Regional Health Agency will send it, by any means that enables the date of receipt to be determined, a formal notice to comply within a period of fifteen days. If, at the end of this period, the establishment has not complied with the formal notice, the Director of the Regional Agency may impose the penalty provided for in Article L. 6113-8. The proposed sanction and the reasons for it are notified to the establishment by any means that enables the date of receipt to be determined. The establishment has one month to submit its observations. At the end of this period, the director of the regional agency decides on the penalty, notifies it to the establishment by any means that enables the date of receipt to be determined and indicates the time limit and procedures for payment of the sums in question. The penalty is entered in the accounts and recovered in accordance with the conditions set out in article R. 162-35-5 of the Social Security Code.