The director of the establishment is required to make an amending decision when :
1° One of the titles or chapters on the list mentioned in article R. 6145-14 is insufficiently funded;
2° Expenditure incurred on an account that may not have been allocated sufficient funds or may have been allocated insufficient funds in the approved budget is such as to upset the general structure of the budget;
3° Changes in the institution’s revenue or expenditure levels are manifestly incompatible with compliance with its budget;
4° The Director General of the Regional Health Agency applies the provisions of I and II of Article L. 6145-4;
5° The Director General of the Regional Health Agency notifies the institution for the first time in the calendar year of the decisions referred to in Article R. 162-42-4 of the Social Security Code and Article R. 6145-26 and that the institution is subject to a recovery plan in application of Article L. 6143-3.
In the circumstances provided for in 4° and 5°, the amending decision that the director of the establishment is required to take is presented within thirty days of notification of the request or decision by the Director General of the Regional Health Agency.