Maharashtra to overhaul Nursing Home registration rules amid industry concerns
The Maharashtra government is preparing to amend the Mumbai Nursing Homes Registration Rules 1949 and the Maharashtra Nursing Homes Registration (Amendment) Rules 2021 in response to mounting concerns over compliance and practical implementation. Health Minister Prakash Abitkar initiated the process with a meeting with the Indian Medical Association (IMA), a key body representing healthcare professionals, to address issues raised by the recent changes to the regulatory framework. The amendments, aimed at ensuring higher standards for nursing homes across the state, have stirred debates about their feasibility, particularly for smaller institutions.
In January, health officials conducted a month-long inspection campaign across the state to enforce compliance with the existing nursing home rules. A total of 19,388 nursing homes were scrutinised, with nearly 3,000 failing to meet critical standards, including the fire no-objection certificate (NOC), treatment tariffs, and patients’ rights. These establishments have been granted a one-month window to make necessary adjustments. However, the new regulations are seen by many in the healthcare sector as impractical for older, smaller hospitals. Among the most contested amendments are infrastructure requirements, such as a mandatory 140-square-foot waiting room and examination room per nursing home, as well as staffing regulations for smaller facilities.
The Indian Medical Association (IMA) has voiced concerns from the outset of the amendment process, arguing that many of the proposed changes would be unfeasible for nursing homes with limited resources, particularly those operating in older buildings. According to IMA officials, the new staffing rules, which mandate the presence of a duty medical officer, two qualified midwives, and one qualified nurse in three shifts for nursing homes with 10 beds, would put an undue financial strain on smaller establishments. Furthermore, infrastructural requirements like maintaining six feet of space between beds and ensuring a nursing station for every five beds are seen as unrealistic for facilities that have been operating for decades without such standards.
Dr Sanjay Patil, National Secretary of the Hospital Board of India, emphasised the difficulty many hospitals face in adapting to these new norms. “We have engaged with the government for the past two years and have consistently sought relaxation in these rules. The new norms are impractical for most hospitals, especially those that have been serving the community for years,” he said. The government has been under pressure to balance stringent regulations aimed at improving healthcare standards with the need to support smaller hospitals that form the backbone of healthcare delivery in rural and semi-urban areas.
From a sustainability angle, the challenge presented by the proposed amendments to the nursing home rules lies in finding a balance between improving healthcare quality and ensuring that small, locally-focused hospitals continue to function effectively. Maharashtra’s healthcare infrastructure, particularly in smaller towns and suburban areas, has always faced challenges due to limited resources. While the new regulations seek to standardise care and improve patient safety, there is a significant risk that stringent compliance requirements could drive smaller, essential healthcare providers out of business. Sustainable healthcare development must involve a nuanced approach, where regulations foster improvement without putting undue pressure on the most vulnerable healthcare facilities. The government must consider easing certain provisions to ensure that these vital community healthcare services remain operational while still upholding high standards of patient care.
