How to start Hospital in India is a crucial question, and I am Major Paresh Singhal (ex), a Healthcare Infrastructure specialist here to guide you. With over 10 years of experience in the hospital industry, I have built 15+ hospitals and designed 25+ more. Today, I am sharing essential information about the legal points and norms that you must be aware of when starting a hospital in India. It is crucial to obtain various licenses under different Acts to operate a hospital legally. A sound understanding of these requirements will help you avoid many potential pitfalls as you embark on this journey.

Healthcare is a state subject, which means most of the laws which govern hospitals are State-specific and hence vary as per the state you want to set up your hospital. There are few norms Like NABH, AERB which are the same across states. The difference in Law and norm can be simplified is that under the law you get permissions and Licences and under norms you get Accredited. 

The Licences, permissions and Accreditations can broadly be grouped under Infrastructure related and Operations related. Though at some points they can overlap also. This grouping is done to understand what is required during the project Phase and what during hospital operations. There can be another grouping for better tracking. I am detailing out some of these as under

1. Land Related:  
   1. Land registry
   2. Land Conversion: see my article “The land required to build a Hospital” for more details on this.
   3. Land Mutation. 
   4. Land Revenue Payment and its receipt: 

Kindly consult a good lawyer before buying land to keep you out of trouble.

1. Building-Related: The following permissions and Licences are required before and after building completion. 
   1. Before the start of Construction:
      1. Building Plan Sanction from Relevant Authority: Please read my article “The land required to build a Hospital” to understand Building By-law. Building By-law knowledge is a must if you want your hospital plans sanctioned by the relevant authority. 
      2. Pollution Control Board (PCB) NOC:
      3. Fire NOC
      4. NH Entry Permission: if the hospital is on National Highway
      5. NOC from any Special Area Development Authority: if Land falls under any such area.
      6. Environment Clearance MOEF: if the building is bigger than 2 Lakh Sqft.
      7. Linear Accelerator Site Approval AERB: if you are planning for a radiotherapy Bunker.
      8. Registration in BOCWA & Payment of Tax. Labour Cess
   2. After Building completion & before the start of hospital services  
      1. Fire licenses: 
      2. Building Occupancy Certificate: 
      3. Certificate of Structural Engineer and Architect
      4. Consent to operate PCB (Pollution Control Board) 
      5. Electricity Connection Application: though not a license, bit kept here as it takes time to get it at some places. 
2. General Business Requirement
   1. Trade licenses
   2. Local Body Taxes (property)
   3. GST registration
   4. Import / Export License (IE): if you want to import some items.
3. The requirement for Hospital Operations
   1. Clinical Establishment (CE)licenses
   2. PC PNDT (if you want to use USG)
   3. AERB Registration for All X-ray equipment, LINAC
   4. MTP (medical termination of pregnancy)
   5. Biomedical Waste (BMW) Authorisation
   6. Pharmacy licenses
   7. License to handle Narcotic drugs
   8. Lift license
   9. Registration of DG set
   10. Explosive Licence for Medical gas tank
4. HR Related
   1. PF
   2. ESI
   3. Professional Tax
5. Norms you should follow: During the Design phase and operations these norms are a must for you.
   1. NABH: National Board of Hospital Accreditation. Being made mandatory for providing cashless insurance services. After hospital start you should get your self accredited under NABH. 
   2. AERB: For any Radioactive equipment.
   3. National Building Code 2016: especially Fire norms for Hospital is critical.
   4. Green Building norms: if you are looking to get your certified under the green building.
   5. NABL: for the laboratory.
   6. JCI: If you are planning to cater to medical tourism clients from the USA and Europe.

 

Here I have tried to cover most of the Legal and Accreditation aspects related to India. I hope this article will help you to plan your hospital. For an end to end support in planning, designing and building your hospital pl approach us. We are an expert Hospital planner and builder, Kindly contact me at 9874637777; 9348954200 or write to me at paresh.Lt@gmail.com and visit my web site www.eywa.pro. If you are looking to build a hospital I and my team of experts are there, we guarantee a saving of 5 % on your project. Following norms and keeping your licenses updated is an integral part of Risk management. Knowing is power…..