25 to 50 Bed Hospital Registration in Nepal

Establishing a 25 to 50 bed hospital in Nepal requires compliance with several federal, provincial and local laws. The process is shaped by the Public Health Service Act 2075, Health Institution Operation Standards, Local Government Operation Act 2074, Environmental Protection Act 2076, Industrial Enterprise Act 2076, and several technical directives issued by the Ministry of Health and Population. A hospital in this bed range falls under the category of a medium-scale health institution that must secure approvals from local government, provincial Health Directorate, Ministry of Health and Population, and environmental authorities. Each stage requires factual evidence of land ownership or lease, physical infrastructure, human resources, biomedical equipment and management systems. The registration process aims to ensure patient safety, infection control, clinical quality, and lawful operation. Medha Law and Partners Is a leading law firm in Nepal.

1. Legal Framework for Hospital Registration in Nepal

The legal basis for establishing a 25 to 50 bed hospital comes from multiple statutes. The Public Health Service Act 2075 sets the obligations for service providers and requires that institutions obtain licenses before operation. The Health Institution Operation and Standards Guidelines issued by the Ministry of Health outline minimum standards related to land area, building layout, sanitation, equipment and clinical staffing. The Local Government Operation Act 2074 authorizes municipalities to grant recommendation letters for building, location and local-level compliance. The Environmental Protection Act 2076 and Regulation 2077 require Environmental Impact Assessment or Initial Environmental Examination depending on bed capacity. The Industrial Enterprise Act 2076 categorizes hospitals as service industries requiring industry registration if operating commercially. Together, these frameworks create a layered approval system.

2. Land and Infrastructure Requirements

A 25 to 50 bed hospital must show that the land meets zoning, ownership and structural safety standards. Municipalities require proof of land ownership or lease with clear boundaries. Building codes under the National Building Code must be met, including fire exits, earthquake resistance, accessible entry, wastewater disposal, ventilation and segregation of clinical and non-clinical areas. Infrastructure must include wards, operating theatre, emergency room, laboratory, radiology room, pharmacy, administrative block, waste management zone and staff facilities. The Health Institution Operation Standards prescribe the layout to avoid infection transmission. Clearance from the municipal engineer is required to confirm building integrity and safety.

3. Environmental Compliance Requirements

For a 25 to 50 bed hospital, environmental compliance is determined by the Environmental Protection Act 2076. Hospitals above 25 beds require an Initial Environmental Examination, while hospitals above 50 beds require a full Environmental Impact Assessment. The IEE assesses waste generation, effluent treatment, air quality, radiation risk, noise levels, water use and community impact. The report must be approved by the respective provincial Ministry of Industry, Tourism and Environment. The hospital must commit to biomedical waste segregation, wastewater treatment, incineration or autoclaving of infectious waste and safe disposal under the Solid Waste Management Act 2068. Environmental approval is required before any final license is issued.

4. Corporate Registration Options

Hospitals in Nepal can be established as private limited companies, public limited companies, partnership firms, cooperatives or as not-for-profit entities under the Social Welfare Council. The Company Act 2063 governs corporate registration. For hospitals targeting commercial service, a private limited company is commonly used. Registration requires memorandum of association, articles of association, board decisions, capital structure and shareholding details. If the hospital seeks foreign investment, the Foreign Investment and Technology Transfer Act 2075 applies, requiring approval from the Department of Industry. Once incorporated, the hospital must register for PAN and VAT as required.

5. Pre-registration Approvals from Local Government

Local level governments issue several key documents. These include a location recommendation confirming suitability of the site, a building completion certificate if construction is finished, and a waste management coordination letter. Municipalities also verify road access, water connection and sanitation systems. The Local Government Operation Act 2074 gives municipalities authority to ensure that health institutions do not pose public risks. They also examine traffic flow, neighboring use, and whether the facility conflicts with zoning plans. Without local approval, provincial and federal authorities will not issue operational licenses.

6. Provincial Health Directorate Approval

Each province has a Health Directorate responsible for evaluating compliance with provincial health guidelines. The Directorate reviews bed capacity, staffing plans, equipment lists, organizational structure, financial capacity and building layout. They inspect the hospital site before granting recommendation. The basis for this review comes from the federal Health Institution Operation Guidelines. The Directorate ensures that staffing includes specialists, medical officers, nurses, anesthetists, lab technologists, radiology technicians and pharmacists. A positive recommendation is mandatory before final licensing by the Ministry of Health and Population.

7. Ministry of Health Licensing Procedure

The Ministry of Health and Population grants the final operation license for hospitals under Schedule-2 of the Public Health Service Act 2075. The applicant must submit all technical, infrastructure and environmental documents. The Ministry reviews the application through an expert committee. The committee conducts a physical inspection to verify bed count, infection control systems, availability of essential drugs, emergency care capacity and biomedical equipment. After compliance verification, the Ministry issues the Hospital Operation License. This license must be renewed periodically under conditions specified by the Ministry.

Documents Required

Corporate Documents

• Registration certificate

• Memorandum and Articles

• PAN certificate

• Shareholder list

Land and Infrastructure Documents

• Land ownership or lease agreement

• Land tax receipt

• Building drawings

• Engineer’s structural safety certificate

• Fire safety approval

• Building completion certificate

Environmental Documents

• IEE report

• Approval letter from provincial environment ministry

• Waste management plan

Health Sector Documents

• Staffing plan

• Equipment list

• Service schedule

• Infection control plan

• Quality assurance plan

• Biomedical waste plan

Local Government Documents

• Location recommendation

• Utility confirmation letters

8. Step-by-Step Process

1. Secure land and finalize building design

2. Obtain municipal building permit

3. Construct hospital structure as per standards

4. Prepare IEE and secure environmental approval

5. Register company and obtain PAN

6. Prepare staffing and equipment plan

7. Apply to Local Government for location recommendation

8. Apply to Provincial Health Directorate for technical review

9. Submit full application to Ministry of Health

10. Undergo inspection and meet compliance

11. Receive hospital operation license

12. Begin service registration such as drugs, radiology and waste system

9. Renewal and Compliance Obligations

A hospital with 25 to 50 beds must renew its operational license periodically. Renewal requires updated proof of staffing, infrastructure, sanitation and biomedical waste management. The Public Health Service Act 2075 authorizes suspension of licenses if facilities fail to meet standards. Hospitals must submit annual reports to the Health Directorate detailing bed occupancy, patient numbers, mortality statistics and service expansion. Radiation services require renewal from the Ministry of Health Radiation Unit. Pharmacy services require renewal from the Department of Drug Administration.

10. Common Practical Challenges

Common issues include delays in environmental approval, difficulty meeting structural standards and challenges in recruiting specialist doctors. Some hospitals face delays due to incomplete drawings or insufficient waste management plans. Local governments may require revisions if surrounding communities raise concerns about traffic or waste disposal. Applicants often misinterpret bed capacity rules, especially regarding emergency and maternity beds. Preparing complete documentation helps reduce delays during inspection and approval.

Frequently Asked Questions

1. How long does it take to register a 25 to 50 bed hospital in Nepal?
Most applications require four to ten months depending on environmental approval, construction progress and document quality. Delays occur when drawings or staffing plans are incomplete or when local-level review takes longer than expected. A well-prepared submission helps reduce waiting time.

2. Does a 25 to 50 bed hospital require an IEE?
Yes. The Environmental Protection Act 2076 requires an Initial Environmental Examination for facilities above 25 beds. The report must include waste, effluent and community impact assessments. Approval must be obtained before the hospital seeks operational licensing from the Ministry of Health.

3. Can a foreign investor establish a hospital in Nepal?
Yes, foreign investment is permitted under the Foreign Investment and Technology Transfer Act 2075. Approval is required from the Department of Industry. The investor must show financial capacity, technical plans and compliance with health sector standards.

4. Is company registration mandatory for a hospital?
If the hospital operates commercially, it must register under the Company Act 2063. Non-profit institutions may register under the Social Welfare Council. Most medium-scale hospitals operate as private limited companies.

5. Who issues the final hospital operation license?
The Ministry of Health and Population issues the final license after reviewing documents and conducting inspection. Provincial Health Directorate recommendations and local-level approvals must be secured before submitting the application.