What License Required To Open a Nursing Home and Their Procedure

Health care is the basic requirement and right of every citizen of the country. Nursing homes form the platform for this healthcare delivery, aided by doctors, nurses as well as other medical staff. 

Necessary Licenses required opening a nursing home In India

Registration in accordance with the clinical establishment act (Registration and Regulation) Act, 2017 

This act was enacted by the central government and is being adopted by states of India. It needs a one-time registration for a premise towards being operated as a nursing home. The registration is required to be done through the respective state government that has implemented this act. For registration, nursing homes should fulfill the minimum requirement under the category in which it falls. Each state has described the procedure of registration of the nursing homes that fall within their territory.

 Registration of nursing home

Each state has its own Nursing Home Registration Act. The Act provides a minimum requirement for the building, employees, equipment and certain guidelines to be fulfilled by the nursing home.

The licenses that are required to start a nursing home in India are:

Permits

•    Land and construction

A nursing home could be set up only on a Non-Agriculture land that could be used. The numerous approval, as well as permissions required from the local authority and the government, should be obtained before starting any nursing home.

•    Electricity and water

A nursing home needs approximately 100 liters of water per bed each day but it varies from different nursing homes. The permission from the concerned municipal authority is required to be obtained for making available the facilities of water as well as electricity.

•    Sewage

Well planned sanitary measures for disposal of waste as well as drainage system which includes tanks, pipelines, etc. and the permission from the local authorities should be obtained.

•    Biomedical Waste

The nursing homes must have an incinerator for disposal of bio-disposal waste, for instance, body parts or tissues. A nursing home is not able to afford such cost and it needs minimum space and additional machinery installations which are expensive for a nursing home set up. The permission from the Municipal Corporation shall be required for such removal of waste and it should not be injurious towards the individuals living at a neighboring location.

•    Fire and Health License

Approval of the Fire Department is required for a nursing home as well as a health certificate from the local authority after the installation of all the beds and equipment within the nursing home. A NOC from the Fire department shall also be required for nursing home and it would be the responsibility of the nursing home management to prove that the nursing home shall not cause any damage or loss of life and requires being received from the local municipal council.

•    Regulations relating to Employment of Staff

    Employment of employees (Doctors, Nurses, Pharmacists) only after proper credentialing

    Prevention of sexual harassment of women employee at the workplace

    Responsibility of employer for the safety of workforces

    Rules governing the employment of staff

    Immunization / other measures for the protection of staff from Occupational Health hazards.

•    Sign Boards

Rules for the size, contents as well as the correct place for signboards (IMC Regulations 2002)

•    Information that requires be displayed at the nursing home are; 

    Certificate of registration of nursing home with the municipal authorities

    IMC/SMC registration certificate (IMC Regulations, 2002)

    Charges for consultation as well as other procedures/services (IMC Regulations 2002)

    Clinic timings, closed days

•    FSSAI license for operating a kitchen

This comes under the Food Safety and Standards Authority of India under the Ministry of Health and Family Welfare, Government of India. The license is necessary if the nursing home runs an in house kitchen for the patients as well as attendants.

•    Permit to store LPG cylinder 

If the nursing home stores a large quantity of LPG cylinder for usage in nursing home’s kitchen or any other purpose, it must take a permit from the Controller of Explosives under the Petroleum act, 1934.

•    Pharmacy registration for medical shop 

 This comes under the Office of the Drug Controller. There are different licenses for medical shops attached to nursing homes (IP) and standalone medical shops. There are minimum requirements for the registration like the minimum size of the shop ( 250 – 300 ft) as well as requirements of Air conditioner and Refrigerator. This license is valid for a period of 5 years.

•    Trademark registration

 Indian Trademarks Act 1999 is not a mandatory activity and is essential only if the nursing home wants to trademark its logo or name

•    Vehicle registration for ambulances 

The ambulance bought by the nursing home must be registered under RTO, Transport Department, and state government. 

•    Arms licenses under arms act 1959 

If arms are possessed by a nursing home or its employees (for example by security guards), a license for the same should be available.

•    Waste disposal

Provisions are required to be made for the appropriate disposal of biomedical waste in order to avoid pollution. The compulsory permissions should be received from the State Pollution Board and arrangements made for eco-friendly removal of biomedical waste as directed through the board.

Planning the nursing home Infrastructure

One must take care of these things;

•    Qualifications of Doctors as well as their registration numbers

•    Working hours for Nurses as well as their shift timings

•    Medical equipment as well as instruments purchased

•    Computers as well as other hardware devices set up

•    Engineers as well as staffs required for maintenance, plumbing, medical gas pipelines, air conditioning, etc. set

The other important license required is:

•    Licenses and regulations relating to Building Permit obtained from the Municipality) 

•    No objection certificate obtained from the Chief Fire Officer

•    License under Bio-Medical Management and Handling Rules, 1998 (You are required to check whether the external agency is accredited towards disposing all biomedical wastes of the nursing home, a copy of their license shall be available with the nursing home, also one must check whether an MOU amid the agency and the nursing home is available. 

•    No objection certificate under the Pollution Control Act. 

•    Radiation Protection Certificate regarding all X-rays as well as CT Scanners from BARC. 

•    Excise permit towards storing spirit 

•    License to operate lifts under the Lifts and Escalators Act. (if applicable) 

•    Narcotics and Psychotropic substances Act, 1985

•    Vehicle Registration Certificates (For all nursing home vehicles.)

•    Atomic energy regulatory body approvals (For the structural facility of the radiology department, TLD badges, etc)

•    Boilers Act, 1923(If applicable)

•    Medical termination of pregnancy Act, 1971

•    License for the Blood Bank (To be displayed in the Blood Bank)

•    Transplantation of Human Organs Act 1994(If applicable) 

•    PNDT Act, 1996 (PNDT stands for Prenatal diagnostics test. To be displayed in the Radiology department that this is followed. )

•    Dentist Regulations, 1976 

•    Drugs & Cosmetics Act, 1940 

•    Electricity Act, 1998 

•    ESI Act, 1948 (For contract employees) 

•    Environment Protection Act, 1986 

•    Fatal Accidents Act 1855 

•    Guardians and Wards Act, 1890

•    Indian Lunacy Act, 1912 (Applicable only if a Psychiatry department is there in the nursing home).

•    Indian Nursing Council Act 1947 (which has provisioned that whether the nurses are registered with NCI). 

•    Also, you are required to check whether pharmacists are registered with Pharmacy Council of India.

•    Insecticides Act, 1968 

•    Lepers Act Maternity Benefit Act, 1961 

•    Indian Medical Council Act and the Code of Medical Ethics, 1956

•    Minimum wages act, 1948 (For contract employees) 

•    National Building Code Persons with Disability Act, 1995 

•    Pharmacy Act, 1948 

•    Protection of Human Rights Act, 1993

•    Registration of Births and Deaths Act, 1969 

•    SC and ST Act, 1989 

•    Urban Land Act, 1976

•    Right to Information Act 2005 

•    Registration for transplantation of human organ Act, 1994 (in case the nursing home varies out human organ transplantation or organ harvesting, it shall be registered under this Act)

•     License for provision of Psychiatric services( if the nursing home is providing a certain type of services like de-addiction, treatment of psychiatric disorders, child/adolescent psychiatric clinic, etc, then they must register with their state government).

•    Excise permit to store spirit( in order to store spirit beyond a certain quantity, the nursing home must obtain a permit from state excise department)

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Author:

eStartIndia Team