Registration of 50 to 100 Bed Hospital in Nepal

Registration of 50 to 100 Bed Hospital in Nepal. A 50 to 100 bed hospital must meet federal, provincial and local requirements before receiving an operation license in Nepal. The legal foundation comes from the Public Health Service Act 2075, Health Institution Operation Standards, Local Government Operation Act 2074, Environmental Protection Act 2076, Industrial Enterprise Act 2076 and related Ministry of Health guidelines. Hospitals in this bed category require a higher level of structural, clinical and environmental compliance due to expanded services such as surgery, intensive care, maternity, diagnostics and emergency care. Approval involves review by municipal offices, Provincial Health Directorate, Ministry of Health and Population and environmental authorities. Each stage demands supporting documents, technical designs, staffing proof and physical inspection. The process ensures that hospitals meet national standards for quality, safety, infection control and service capacity. Medha Law and Partners Is a leading law firm in Nepal.

1. Legal Framework for 50 to 100 Bed Hospital Registration

The Public Health Service Act 2075 makes licensing mandatory for all health institutions. It requires compliance with infrastructure standards, staffing norms and service delivery rules. The Health Institution Operation and Standards Guidelines set specifications for land area, building layout, service units, sanitation systems and biomedical equipment. The Environmental Protection Act 2076 requires an Environmental Impact Assessment for hospitals above 50 beds, making it a major legal step. The Local Government Operation Act 2074 authorizes municipalities to issue location and building-related approvals. The Industrial Enterprise Act 2076 applies when a hospital operates as a commercial service industry. Together, these instruments create a multi-layer regulatory process that all hospitals must follow.

2. Infrastructure and Building Requirements

A 50 to 100 bed hospital must follow the National Building Code, local building permit rules and the structural safety requirements set by municipal engineers. Hospitals in this category require emergency units, operation theatres, ICU or HDU, maternity services, diagnostics, laboratory, radiology, pharmacy and administrative areas. There must be waste management zones, water systems, ventilation, fire exit routes, firefighting equipment and earthquake-resistant design. The building must include accessible entry points, emergency ramps, backup power, water storage and effluent treatment structures. Approval for building completion and structural fitness is issued by the municipal authority after inspection.

3. Environmental Impact Assessment Requirement

Hospitals with more than 50 beds fall under the Environmental Impact Assessment requirement under Schedule-2 of the Environmental Protection Regulation 2077. The EIA studies solid waste volume, effluent discharge, air emissions, radiation, noise, infection risks and community impact. The report includes mitigation plans, waste segregation systems, wastewater treatment plant design, autoclave or incineration mechanism and long-term monitoring commitments. The provincial Ministry of Environment reviews and approves the EIA. A hospital cannot move forward with licensing until EIA approval is granted and all mitigation measures are incorporated.

4. Corporate Registration Structure

A hospital can register as a private limited company, public limited company, cooperative or non-profit institution. Most operators choose private limited companies under the Company Act 2063. Registration requires memorandum, articles, capital details, board resolution, objectives and PAN. Hospitals with foreign equity require approval under the Foreign Investment and Technology Transfer Act 2075 and registration at the Department of Industry. Corporate registration is required before applying for municipal or provincial approvals. The corporate structure must match the ownership model, service scope and financial plan of the hospital.

5. Local Government Approvals

Municipalities issue land-use approval, building permit, environmental compliance letters, waste management coordination confirmation, fire safety review and location recommendation. They check road connection, surrounding settlements, zoning and site suitability under the Local Government Operation Act 2074. For hospitals in dense areas, municipalities often require traffic plans and wastewater management details. The local government review also confirms the building layout meets standards for hospital corridors, service zones and emergency access routes. Without municipal clearance, higher authorities will not process licensing.

6. Provincial Health Directorate Review

The Provincial Health Directorate evaluates technical capacity before recommending the institution to the Ministry of Health. It reviews bed count, service departments, staffing charts, biomedical equipment lists, quality assurance plans, emergency service capacity and infection prevention systems. They conduct site inspection to verify readiness. This step ensures that hospital departments such as ICU, maternity ward, operation theatre and radiology are adequately staffed and equipped. The Directorate’s recommendation letter is a mandatory document for the final licensing stage.

7. Ministry of Health Licensing Procedure

The Ministry of Health and Population issues the final license for 50 to 100 bed hospitals. This is governed by the Public Health Service Act 2075 and related directives. The Ministry reviews all documents, EIA approval, staffing details, equipment lists and structural safety certification. An expert committee conducts on-site inspection to confirm compliance with patient safety standards, emergency care readiness, biomedical waste systems and availability of essential medicine. After successful evaluation, the Ministry provides the Hospital Operation License, which authorizes service commencement. The license must be renewed according to Ministry requirements.

Documents Required

Corporate Documents

• Company registration certificate

• Memorandum and Articles

• PAN registration

• Shareholders list

• Board resolution for hospital establishment

Land and Building Documents

• Land ownership or lease agreement

• Cadastral map and land tax receipt

• Building permit

• Structural safety certificate

• Fire safety approval

• Building completion certificate

Environmental Documents

• Environmental Impact Assessment report

• Approval from Provincial Environment Ministry

• Waste management plan

• Radiation safety plan

Hospital Operation Documents

• Staffing plan

• Equipment list

• Service department layout

• Infection prevention and control plan

• Quality assurance policy

• Biomedical waste treatment plan

• Emergency service readiness plan

Local Level Documents

• Location recommendation letter

• Sanitation and wastewater approval

• Public utility connection letters

Step-by-Step Process

1. Secure land and prepare building design

2. Apply for building permit at municipality

3. Construct hospital according to approved drawings

4. Prepare EIA and submit to provincial environment ministry

5. Register company and obtain PAN

6. Prepare staffing and equipment documentation

7. Obtain location recommendation from municipality

8. Submit application to Provincial Health Directorate

9. Undergo technical inspection by Directorate

10. Apply to Ministry of Health with full documents

11. Undergo final inspection and compliance check

12. Receive Hospital Operation License

Renewal and Compliance

Hospitals must renew their licenses periodically under the Public Health Service Act 2075. Renewal requires updated staffing lists, annual service statistics, waste management details, radiation compliance and environmental monitoring reports. Hospitals must maintain emergency care capacity, quality assurance systems and infection control standards. Annual reporting to the Provincial Health Directorate is required. Radiology and pharmacy services also require separate renewal from relevant authorities.

Common Practical Issues

Many institutions face delays during EIA approval, structural safety certification and staffing verification. Hospitals often submit drawings that do not meet hospital layout standards such as corridor width, fire exits or ventilation requirements. Inadequate waste treatment design is another common cause of rejection. Completing technical documents, preparing accurate drawings and ensuring compliance before inspection helps reduce these delays. Coordination between corporate, engineering and medical teams is necessary to meet all requirements.

FAQs

1. Does a 50 to 100 bed hospital require an EIA?

Yes. The Environmental Protection Act 2076 requires an Environmental Impact Assessment for hospitals above 50 beds. The EIA must include waste treatment plans, effluent control systems, environmental mitigation measures and monitoring commitments. Approval is mandatory before applying for the Ministry of Health license.

2. How long does the registration process take?

The timeline varies from six to twelve months depending on EIA processing, building completion, staffing readiness and document accuracy. Environmental approval often takes the longest. Municipal approvals and inspections may also extend the timeline if drawings or technical plans require corrections.

3. Can a foreign company establish a 100 bed hospital in Nepal?

Yes. Foreign investment is allowed under the Foreign Investment and Technology Transfer Act 2075. The investor must apply through the Department of Industry and provide financial plans, engineering drawings, staffing models and compliance documents. The hospital must follow the same licensing requirements as domestic institutions.

4. Who issues the operation license for a 100 bed hospital?

The Ministry of Health and Population issues the final operational license after reviewing documents, conducting inspection and verifying compliance with the Public Health Service Act 2075. Provincial and municipal recommendations are mandatory for this stage.