Minimum Standard for Hospital with 51-100 beds

1. Definition:

Hospital

A hospital is a clinical establishment providing patient treatment by qualified and trained staff and through
registered Ayurveda/Unani / Siddha / Sowa Rigpa /Homoeopathy practitioner(s)/ duly certified Yoga &
Naturopathy practitioner(s) as per the relevant statute of the concerned State/UT or one or more of any of
these systems or along with Allopathy where the patients are 'admitted' and stay overnight or more and they
are referred as 'inpatients'; while some patients may go to a hospital just for diagnosis, treatment, or therapy
and then leave, they are referred as 'outpatients' without staying overnight.

Hospitals have facility to admit and care for inpatients whilst the other clinical establishments are described
as clinics or polyclinics or dispensary. There are other exceptions too like Hospice etc.

The hospital may have multiple departments taking care of many kinds of disease. Some hospitals are
affiliated with universities for medical research and the training of medical personnel such as physicians and
nurses, often called teaching hospitals. Guidelines laid down by NCISM and NCH or other legal bodies shall
be applicable to such hospitals.

A hospital can be situated in rural or urban setting. It can be run by Public Sector (Central government or
State government or Local government or Public Sector undertaking or Registered Society etc) or by Private
Sector (Individual Proprietorship or Registered Partnership or Registered Company or Co-operative Society
or Trust or Charitable etc).

2. Scope:

The scope of services that may be provided at a Hospital with 51-100 beds practicing Ayurveda, Unani,
Siddha & Sowa Rigpa, Yoga & Naturopathy or one or more of any of these systems or along with Allopathy
may include patient-care services in any or all of the specialties of that concerned system, for example:

a. Panchkarma / Marma Therapy / Kshar Sutra/Agni Karma in Ayurveda System of Medicine

etc.
b. Ilaj Bit Tadbeer in Unani System of Medicine etc.
c. Varmam and PuraMaruthuvamin Siddha System of Medicine etc.
d. Las-Na in Sowa-Rigpa System of Medicine etc.
e. Nauli, Dhauti, Neti, Fasting, Mud therapy etc. in Yoga & Naturopathy

3. Infrastructure:

3.1 Signage:

a. The Hospital shall display appropriate signage which shall be in at least two languages.
b. The building shall have a board displaying the name of the hospital at a prominent location.
c. Directional signage shall be placed within the facility to guide the patient(s).

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3.2 Following informative signage shall be displayed:

a. Name of the doctor with degree.

b. Registration number of the doctor.
c. Registration details of the hospitals as applicable.
d. Fee - (both for OPD & IPD-daily IPD charges of hospital)
e. Timings of the hospital.
f. Facilities provided
g. Certificate of registration under CE Act.

3.3 Other requirement:

a. Access to the hospital shall be comfortable for the patients or attendants or visitors.
b. The hospital shall be developed and maintained to provide safe, clean and hygienic environment for
patients, their attendants, staff and visitors.
c. The hospital shall have 24 hr provision of potable water for drinking & hand hygiene. It shall also
have 24 hr supply of electricity, either through direct supply or from other sources.
d. The hospital shall have clean public toilet(s) separately for male and female.
e. The hospital shall have mechanism for timely maintenance of the hospital building and equipment.
f. Furniture and fixtures shall be available in accordance with the activities and workload of the
hospital. They shall be functional and properly maintained.

The minimum space and other requirements shall be as per Appendix 1.

Indicative list of furniture and fixtures is as per Appendix 2.

4. Equipment and Instruments:

a. The hospital shall have adequate medical equipments and instruments commensurate to the scope
of service and number of beds.
b. There shall be established system for maintenance of equipments.
c. Equipment shall be kept in good working condition through a process of periodic inspection,
cleaning and maintenance.

For indicative list of equipment, Please refer to Appendix 3

5. Drugs and Consumables:

a. The hospital shall have adequate drugs and consumables commensurate to its scope of services and
number of beds.
b. Drug storage shall be in a clean, well lit, and safe environment and shall be in consonance with
applicable laws and regulations.
c. The facility shall have defined procedures for storage, inventory management and dispensing of drugs
in pharmacy and patient care areas.
d. Emergency drugs and consumables shall be available at all times. (if applicable)

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6. Human Resource Requirement:

a. The hospital shall have qualified, trained and registered medical doctor and staff as per the scope of
service provided. In case of Yoga & Naturopathy practitioners, they shall be duly certified as per the
relevant statute of the concerned State/UT.
b. For every staff there shall be personal record containing the appointment order, documentary
evidence of qualification and or training (and professional registration where applicable).

For human resource requirements, please refer to Appendix 4

7. Support Services:

7.1 Registration or Help Desk and Billing:

a. The hospital shall have a Registration or Help-desk & Billing counter and the scope of this shall also
include provision of patient guidance in matters like services available, cost estimation etc.

7.2 Diagnostic Services:

a. The diagnostic services, whether in house or outsourced, shall be commensurate with the scope of
service of the hospital.
b. Whether in house or outsourced, the services shall fulfill the requirements of safe and timely patient
care.

7.3. Pharmacy Services:

a. Pharmacy survives in a hospital can be in-house or outsourced.

b. All applicable legal requirements shall be complied with.
c. Medicine storage shall be in a clean, well lit, and safe environment, and as per manufacturer’s
requirement.

7.4 Sterilization area:

a. Provision for instrument and linen sterilization and storage of sterile items shall be made available
as per scope of services.
b. Validation of sterilization shall be done for ensuring the effectiveness of sterilization process.

7.5 Linen management:

a. Soiled linen shall be collected, transported and washed separately in clean and hygienic environment.
b. Where linen is contaminated, appropriate decontamination shall be carried prior to dispatch for
washing

7.6 Waste Management Services:

a. Segregation, collection, transportation, storage and disposal of general waste shall be done as per
applicable local laws
b. Segregation, collection, transportation, storage and disposal of biomedical waste from generated in
the laboratories shall be done as per Biomedical Waste Management Rules, 2018 amended from

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 time to time as applicable to various departments of Ayurveda / Unani / Siddha / Sowa-Rigpa /
Homeopathy/ Yoga & Naturopathy clinical establishments

7.7 Ambulance services (Own or Outsourced) (as per applicability):

a. The hospital shall have provision of transporting patients for transfer or referral or investigations etc.
in safe manner.
b. Ambulance Services may be in-house or outsourced. The Ambulance services shall comply with the
applicable local laws, even if they are outsourced.

8. Legal or Statutory Requirements

a. Compliance with local regulations and law. (as per applicability)

Indicative list of legal requirement is as per Appendix 5.

9. Record Maintenance and reporting:

a. Medical Records shall be maintained in physical or digital format.

b. The hospital shall ensure confidentiality, security and integrity of records at all times.
c. The medical records of IPD patients shall be maintained in consonance with National or local law or
guidelines, if any.
d. Every Clinical Establishment shall maintain medical records of patients treated by it and health
information and statistics in respect of national programmes and furnish the same to the district
authorities as and when required.
e. All clinical establishments shall be responsible for submission of information and statistics in time
of emergency or disaster or epidemic situation or as required from time to time by National Council,
Clinical establishment Act 2010.

For content of medical record refer to Appendix 6

10. Basic Processes

10.1 Registration or help desk and billing services:

a. The hospital shall register all patients preferably by ABHA number who visit the hospital except if
the required service is not available in the facility, in which case the patient is guided to the
appropriate nearest facility.
b. Once registered, depending on the clinical need, patient is guided to appropriate service area.
c. Patient shall be guided and informed regarding Patients’ rights & responsibilities, cost estimates,
third party services (e.g. Insurance) etc. Appendix 7.
d. The billing shall be as per the therapy centre/day care centre/hospital tariff list, which shall be
available to patients in a suitable format.

10.2 Assessment and Plan of Care:

a. Each patient shall undergo an initial assessment by qualified and or trained personnel.

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 b. Further management of patient shall be done by a registered practitioner on the basis of findings of
initial assessment; for example, OPD treatment, admission, transfer or referral, investigation etc.
c. At the time of admission of patient, general consent for admission shall be taken.
d. In case of non-availability of beds or where clinical need warrants, the patient shall be referred to
another facility along with the required clinical information or notes.
e. Reassessments of the admitted patients shall be done at least once in a day and or according to the
clinical needs and these shall be documented.
f. Any examination, treatment or management of female patient shall be done in the presence of an
employed female attendant or female nursing staff, if conducted by male personnel inside the hospital
and vice versa.

10.3. Informed Consent and Procedure:

Informed consent shall be obtained from the patient or next of kin or legal guardian as and when required as
per the prevailing Guidelines or Rules and regulations in the language patient can understand (for e.g., before
Surgical / Invasive procedures etc). Please refer to Appendix 8.

10.4. Care of Patient:

a. The Hospital shall provide care of patient as per Standard Treatment Guidelines that may be notified
by the Central or State Government
b. Patient and or families shall be educated on preventive, curative, promotive and rehabilitative aspects
of care either verbally, or through printed materials.
c. All the relevant documents pertaining to any surgical/invasive procedures performed shall be
maintained in the record.
d. Monitoring of patient shall be done during and after all the procedures and same shall be documented.

10.5. Medical Prescription, Administration and Monitoring:

a. Prescription shall include name of the patient, date, name of medication/therapy, dosage, route,
frequency, duration, name, signature and registration number of the medical practitioner in legible
writing.
b. Drug allergies shall be ascertained before prescribing and administration; if any allergy is discovered,
the same shall be communicated to the patient and recorded in the case sheet as well.
c. Patient identity, medication, dose, route, timing, expiry date shall be verified prior to administration
of medication.
d. Patients shall be monitored after medication administration and adverse drug reaction or events if
any shall be recorded and reported

10.6 Infection control:

a. The hospital shall follow standard precautions like practicing hand hygiene, use of personal
protection equipment, etc to reduce the risk of healthcare associated infections.
b. The hospital shall ensure adequate and proper spacing in the patient care area so as to prevent
transmission of infections.
c. Regular cleaning of all areas with disinfectant shall be done.

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 d. Prescribed & documented Infection Control Practices shall be followed in High risk areas like
Operation theatre, Labor room, Procedure Room etc. as per good clinical practice guidelines. (as per
applicability)
e. Housekeeping or sanitary services shall ensure appropriate hygiene and sanitation in the
establishment

10.7 Safety of the patient, staff, visitors and relative in a hospital

Security and safety of patients, staff, visitors and relatives shall be ensured by provision of
appropriate safety installations and adoption of appropriate safety measures.

10.8. Patient Information and Education:

a. The patient and or family members are explained about the disease condition, proposed care,
including the risks, alternatives and benefits. They shall be informed on the expected cost of the
treatment. They shall also be informed about the progress and any change of condition.

b. Patient andor family are educated about the safe and effective use of medication, diet, and disease
prevention strategies.

10.9. Discharge:

a. A Discharge summary shall be given to all patients discharged from the hospital.
b. Discharge or Death summary shall also be given to patient and or attendant in case of transfer or
Leaving Against Medical Advice or Discharge Against Medical Advice or death
c. The discharge summary shall include the points as mentioned in the Appendix in an understandable
language and format. For content of discharge summary refer to Appendix 9

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 Appendix 1

Minimum space requirements in a Hospital with 51-100 beds:

Sr. No.
1. Minimum space requirement for OPD in Hospital 100 sq. ft. (per OPD)

2. Minimum space requirement for IPD in Hospital 50 sq. ft. per bed

3. Minor Operation Theater / Procedure or Therapy 150 sq. ft.

room (where applicable)
4. Labour Room (where applicable) 150 sq. ft.
5. Neonatal care room (where applicable) 150 sq. ft.
6. Operation Theater (where applicable) 263.71 sq. ft. per operating room

*Other functional areas (waiting area, administrative area, laboratory, diagnostics, pharmacy, front
office or reception, etc.) should be appropriately sized as per the scope of service and patient load of
the hospital

Other requirements:

1. The ward shall also have designated areas for doctor’s duty room, nursing station, , store, clean and
dirty utility, janitor room, toilets and this shall be provided from circulation area

2. Area per bed must be 50 sq. ft. per bed with the minimum distance between two beds is 3.5 ft.
3. Minimum distance between two rows of bed must be 5 ft.
4. As a general guideline, in the case of Ayurveda/Unani/Siddha/Sowa-Rigpa/Homeopathy/Yoga &
Naturopathy specialty hospitals the facilities available should be commensurate and appropriate with
the nature of services provided.
5. The services provided at the hospital shall be consistent with the principles of concerned system of
medicine. In particular, diet lifestyle and basic treatment of diseases.

Labour room: (wherever applicable)

1. The obstetrical unit shall provide privacy, prevent unrelated traffic through the unit and provide
reasonable protection of mothers from infection and from cross-infection.
2. Measures shall be in place to ensure safety and security of neonates.
3. Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to
the delivery room.

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 4. The labour room shall contain facilities for medication, hand washing, charting, and storage for
supplies and equipment.
5. The labour room shall be equipped with oxygen and suction

Operation Theater: (wherever applicable)

1. The operation theatre complex shall have appropriate zoning.

2. The operation theatre complex shall provide appropriate space for other areas nursing station, doctors’
duty room, scrub station, sterile store, Clean and dirty utility, Dress change room, Toilets.

a. Sterile area – consists of operating room sterile store and anesthesia room

b. Clean zone- consists of equipment or medical store, scrub area, pre and post-operative area and
linen bay

c. Protective zone- consists of change room, doctors room and toilets

d. Dirty area

e. Due considerations are to be given to achieve highest degree of asepsis to provide appropriate
environment for staff and patients.

3. Doors of pre-operative and recovery room are to be 1.5 m clear widths

4. Air Conditioning to be provided in all areas. Window AC and split units should preferably be
avoided as they are pure re circulating units and become a source of infection.

5. Appropriate arrangements for air filtration to be made.

6. Temperature and humidity in the OT shall be monitored.

7. Oxygen, Nitrous Oxide, suction and compressed air supply should be provided in all OTs.

8. All necessary equipment such as shadow-less light, Boyle’s apparatus shall be available and in
working condition.

9. Uninterrupted power supply to be provided.

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 Appendix 2

Furniture and Fixtures

Sr. No. Articles

1. Doctor’s Chair
2. Doctor’s Table
3. Patient’s stool
4. Examination table
5. Foot Step
6. Chair for attendants
7. IPD beds
8. Bedside lockers
9. Stretcher
10. Wheelchair
*This is an indicative list and the items shall be provided as per the size of the
hospital and scope of service to be provided by different systems i.e.
Ayurveda/Unani/Siddha/Sowa Rigpa/Homoeopathy/Yoga & Naturopathy

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 Appendix 3

Equipment

Sr. No.
1. Equipment required for Stethoscope
OPD of Hospital B.P apparatus
Torch
Thermometer
Tongue Depressor
Weighing Machine
X-Ray view box

* Above and other equipment specific to each

system of Ayurveda/Unani/Siddha/Sowa-
Rigpa/Homoeopathy/Yoga & Naturopathy shall
be provided as per the nature and scope of
therapy and service of Hospital
2. Equipment required for Stethoscope
IPD of Hospital B.P apparatus
Torch
Thermometer
Tongue Depressor
Weighing Machine
X-Ray view box
Enema Pot
Urine Pot

* Above and other equipment specific to each

system of Ayurveda/Unani/Siddha/Sowa-
Rigpa/Homoeopathy/Yoga & Naturopathy shall
be provided as per the nature and scope of
therapy and service of Hospital

Equipment required for specific therapies of concerned system of Ayurveda/Unani/Siddha/Sowa-Rigpa/

Yoga & Naturopathy:

Sr. No. System of Equipment as per the therapy

Medicine
1. Ayurveda For Poorva Karma (Snehana/Sweadana): Complete bedding/cot one for
male& one for female,Abhyanga (Massage)Table/Droni, Gas/Stove/heater
with fittings, Lighter/Matchbox, Plastic aprons, Towels, Dusters ,
Measuring glasses, Swedan Yantra

For Vamana: Measuring glasses (50 ml, 100ml, 200ml, 1litre),

Gas/Stove/heater with fittings, Buckets/Plastic tubs/Basin(with provision of
measuring scale), Kharala/Mortar, Swedan Yantra, Vamanpeetha
(Adjustable chair), Dhumapana Yantra Plastic Aprons, Big steel pateela
(bowl) 5 litre, Table spoons, Steel glasses

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 For Basti:
Kharala/Mortar, NiruhabastiYantra (Enema pot), AnuvasanabastiYantra,
Swedan Yantra, Urinary catheters (Rubber and metallic) of different, nos.,
Gloves, Plastic Aprons
For Uttarbasti (Females):Gynaecological Table with attachment for
Lithotomic position , UttarabastiYantras (Douche can fitted with rubber tube
and nozzle of various sizes), Sponge holding Forceps, Sim’s speculum,
Cusco’s Speculum , Anterior Vaginal wall retractor ,Vulsellum, Uterine
sound,Kharala/Mortar,BastiNetra (Metallic), Bowls, Rubber Sheets, Focus
lamp/Torch, Plastic aprons, Plastic syringes, Cotton, Gauze pieces
Gudavarti, Gloves
For Shirodhara: Shirodhara yantra, Stand, Dharapatra

For Shirobasti: Plastic Caps/Leather caps: Small/Medium/Large

For Nasya:Nasyapeetha (Chairs), Adjustable Tables, Dropper/Dropper
bottles,PradhamanaNasyaYantra, DhumaYantra, Steamer (Facial Steamer)
For Rakthamokshana:
(i) Siravedha: Needle/Scalp vein set, Tourniquet, bandages, SwedanYantra
(ii) Jaloukaavcharana: Jalooka, kidney tray, bandages, turmeric powder &
salt, cotton pads
(iii) Pracchana: Surgical blade, cotton pads, tourniquet, SwedanYantra
2. Unani For HijamabilaShart: Treatment table, Foot Stool, Mahjama (Glass cups
of different sizes), Bunsen burner, Sponge holder, patient gown, aprons,
gloves
For HijamabilShart: Treatment table, Foot Stool, Mahjama (disposable
Hijama cups of different sizes), Vacuum cupping pump, surgical blades,
Sponge holder, Tissue forceps, Cheatle forceps, Scissors, Kidney trays &
drums, Analytical balance, autoclave, patient gown, aprons, gloves
For HijamaMuzliqa&Dalk: Traditional massage table, Foot Stool,
Mahjama (glass & plastic cups of different sizes), Vacuum cupping pump,
Bunsen burner, Sponge holder, patient gown, aprons, gloves
For Taleeq: Treatment table, Foot Stool, Leeches, Leech aquarium, Glass
container of different sizes, Sponge holder, Tissue forceps, Cheatle forceps,
Scissors, Kidney trays& drums, autoclave, patient gown, aprons, gloves
For Fasd: Syringes, surgical blades, Blood pressure manometer or
tourniquet, Sponge holder, Tissue forceps, Scissors, Gauze/cotton wool,
Tape, Kidney trays & drums, Cleaning agent and local anesthetics, Blood
collection bags and weighing device, Blood sample bottles, Blood disposal
bin, autoclave, aprons, gloves,
For Nutool:Nutul Tables (massage table with Shirodhra stand), Nutul Pot
(Shirodhra pot), patient gown, aprons, gloves, towels, medicated oils
For Inkibab:AalaeMubakhiraUmoomi {Sarvangvashpaswedanyantra (with
steam generator & trolley)}, NadiSwedanYantra (Steam generator), Steam
cabinet with steam generator (sitting type), bath gown, towels
For Takmid: Treatment table, gas/stove, canning kettles, hot and cold
packs, compress cloths, towels, patient gown,

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 For Bukhur: Treatment table / chair, Bukhur burners, patient gown, chips
of aromatic drugs
For Abzan: Sitz bath tub
For Pashoya: Foot bath tub
For Qai’: Complete Qae set (Vamanpeeth set) comprising of tubular steel
Vaman table and a chair with reclining back, Vaman table is fitted with one
stainless steel bucket, 2 glass holders & one utility bar, Measuring jars of
different sizes are provided for Vamankriya (vomiting).
For Huqna: Complete Huqna (enema) kit
3. Siddha Thokkanam:ThokkanamesaiorThokkanapalagai with adjustable stand,
Hanging robe with handle, Foot rest, Electric/Gas stove, Towels, Vessels
(for heating, serving and storing of oil),Gloves.
Vedhu: Steam chamber, Steam generator, Steam controller, Temperature
sensor, Sitting stool, Foot rest, Towels, Apron, Gloves
Kattu, Seelai, Kalimbu, Neer, Pasai, Podi, Uthal: Stone mortar and
pestle, Stove or oven, Knife, Nail cutter, Sponge cloths, Sterile cloth roll,
Gauze, Cotton, Gloves, Scissors, Forceps, Clips, Different size of Syringes,
Kidney tray, Wood and steel spoons.
Pugai: Cotton towel, Charcoal, Steel funnel, Cardboard, Steel hose, Flame
lamb, Fumigator, Tissue paper, Temperature control.
Kaaranool:Kaaranool, Kaarathiri, Silver Curved needle with eagles eye,
Silver straight needles, Malleable silver probes, Knifes, Surgical blades of
different size, Sponge cloths, Sterile cloth roll, Gauze roll, Cotton roll,
Gloves, Scissors, Forceps, Clips, Different size of Syringes, Kidney tray,
Wood and steel spoons, Marker, Scale, Formalin, Biopsy container
Attaividal: Bench, Stool, Sponge cloths, Sterile cloth roll, Gauze, Cotton,
Gloves, Scissors, Forceps, Clips, Different size of Syringes, Kidney tray,
Wood and steel spoons, Glass bottles of different sizes, Stone mortar and
pestle, Stove or oven, Knife, Nail cutter, Sharp needles.
Nasiyam, Nasikaparanam, Mai, Kalikkam: Sliding chair, Flame lamb,
Filter paper, Sieve filter, Dropper,Eye wash basin, Stone mortar, Pestle,
Flame lamb, Charcoal, Coconut shell, Conch shell, Gloves, Cotton balls,
Cotton towel
Vamanam: Water Jug, Stone mortar,Measuring cup, Chair, Electric stove,
Sieve filter, Cupboard, Wash basin
Kazhicchal, Varthi, Peetchu: Water Jug, Stone mortar, Measuring cup,
Toilet cum Chair, Electric stove, Sieve filter, Tissue paper, Toilet, Towel,
Inner wears
Chuttigai: Panchaloga or Silver cauterizers (like Pottusoottukoel,
Kurukkusoottukoel, Kavattaisoottukoel, piraisottukoel,sangilikaal, pulladi,
aazhisoottukoel, pottugai, pullisoottukoel, uusisootukoel, udukkusootukoel,
mukkavar, kalappaisoottukoel, irukavarsoottukoel, piraisoottukoel,
kutthusoottukoel, vettusoottukoel), Marker, Scale,Cotton roll, Gauze roll,
Formalin, Biopsy container, Stool, Nursing trolley, Cupboard, Apron,
Towel

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 Aruvai, Salagai, Keeral, Kuruthivaangal, Urinjal, Kombukattal,
Murichal: Knifes, Surgical blades of different size, Sponge cloths, Sterile
cloth roll, Gauze roll, Cotton
roll, Gloves, Scissors, Forceps, Clips, Different size of Syringes,Kidney
tray, Wood and steel spoons, Splints, Supports, Crepe bandage, Butterfly
needle, IV set, Suction apparatus, Marker, Needle cutter, Electro cauterizer,
Kaaranool sterilizer, Scale, Formalin,Biopsy container, Stool, Nursing
trolley, Apron, Towel, Wall clock, X Ray lobby.

4. Sowa-Rigpa Num-chos (Snehana): Massage table, Appropriate stand to fix

massage table, Gas/Stove/heater with fittings, Lighter/Matchbox, Plastic
aprons,
Jam-rTsi (basti): Jam-rTsi (basti): Yantra, Enenma Pot, Plastic Aprons,
Gloves
Kyug (Vamana): Buckets/Plastic tubs/ Wasin with the provision of
measuring scale, Kyugpeeth (adjustable chair)
Na-sMan (Nasyakarma) : Na-sMan Set, Plastic aprons, Gloves
Tarka (Raktamokshana): Storage aquarium for fresh leeches: 20-25 liters
capacity (may be with partitions),Glass containers (1 litercapacity) for
storing usedleeches:5-10 (for each patientrequires separate containerand the
number may varyaccording to the number of patients), Leeches :As per the
requirement, usually 3-5 leeches per patient/ treatment period), Different
types of Forceps, Scissors, Needles, Suturing material etc. (as per
requirement), Turmeric, Saindhavalavana, Jatyadighrita, honey, Dressing
tray with gloves, bandage cloth, bandages etc. , Plastic aprons, Gloves

5. Yoga & Yoga Department

Naturopathy Yoga Accessories : Yoga Mats, Jalneti Pots, Sutra Neti, Vastra Dhauti,
Trataka Stands, Water Jugs, Yoga props such as Cushions, Wooden Blocks,
Planks, Ropes,
Naturopathy Department
Hydrotherapy (with necessary hot & cold water provision) :
Treatment couches (1 per procedure room),Steam bath Chamber (1 nos.),
Spinal bath /Spinal Spray (1 nos.), Hip bath tub (1 nos.), Infra-Red Lamps (1
per 50 patient), Foot & Arm Bath Tub (1 nos).
Massage Therapy: Massage Couch – 1 per procedure room.
Acupressure/Acupuncture/Reflexology : Acupressure Accessories,
Acupuncture needle, Acupuncture stimulator, Acupuncture Needle Disposer
(1 per ward), Reflexology equipment.
Other Equipments :
Hot Water Bags, Ice Bags, Packs, Jet Bath, Colored Bottles, Buckets, Mugs,
Jugs, Eye wash cups, Enema cans, Woolen Blanket, Muslin cloth, Mud
storage unit, Mud Packs& Mud Pack Tray.
Optional Equipment :
Sauna Bath, Vibro-massager, Cold Irrigation, Deluxe Hydro massage,
Jacuzzi, Hot and Cold-water Douches, Effusions, Whirlpool Bath, Under
Water Exercise, Electro therapy equipment, Exercise therapyequipment,
Mud bath beds, Thermoleum (1 per service room), Sun Recliners, Plantain

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 Leaf Bath, PEMF, Magnetic belt, General magnet, Magneto Therapy couch,
Immersion Bath, Colon Hydrotherapy, Ozone therapy unit.

*This is an indicative list and the items shall be provided as per the size of and scope of service to be
provided by different systems i.e. Ayurveda /Unani /Siddha /Sowa Rigpa /Yoga & Naturopathy

Appendix 4
Human Resource

The Human Resource requirement for any clinical establishment depends on the scope of services provided,
bed strength and workload of the hospital by that clinical establishment.

However, on the basis of level of care provided the minimum staffing requirements for a therapy centre/ day
care centre/ hospital shall be as follows:

Sr. No. Human Resource

1. Doctor One Registered Ayurveda/ Unani /Siddha /Sowa-
Rigpa/ Homoeopathy practitioner/ duly certified
Yoga & Naturopathy practitioner as per the relevant
statute of the concerned state/ UT for every 20 beds
above 50 beds and upto 100 beds.
2. Nurse in a hospital 1 Registered nurse for every 10 beds
3. Therapist 4 Male and 4 female therapist.
4. Pharmacist in hospital Three (in case of in-house pharmacy)
5. Attendant / Multipurpose Ten
Worker for Hospital
Requirement of other (Support and administrative) or more staff will depend on the scope of the
Hospital

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 APPENDIX 5

Listof Legal& statutory requirements -

Below is the list of legal requirements to be complied with by a hospital as applicable by the local or state
health authority (all may not be applicable)

Sl. Name of Document Valid Valid Send for Remark

From Till renewal by (Expired or
valid orNA )

1. Registration under Nursing Home

Actor Medical Establishment Act

2. Bio-medical Waste
Management Licenses

Authorization of HCO by PCB

MOU with Vendor

3. AERB Licenses

Type approval

Layout Approval

License for CT-interventional or

Registration for other machines

4. NOC from Fire Department

5. Ambulance

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 Commercial Vehicle Permit

Commercial Driver License

Pollution Control Licenses

6. Building Completion Licenses

7. Lift licenses for each lift

8. DG Set Approval for commissioning

9. Diesel Storage Licenses

10. Food Safety Licenses

11. Narcotic Drug Licenses

12. Medical Gases Licenses or

Explosives Act

13. Clinical Establishments and

Registration

14. Blood Bank Licenses

15. MoU or agreement with outsourced

human resource agencies as per labor
laws

16. Spirit Licenses

17. Electricity rules

18. Provident fund or ESI Act

19. MTP Act

20. PNDT Act

21. Transplantation of Human organs Act

22. Sales Tax registration

23. PAN

24. No objection certificate under

Pollution Control Act (Air or Water)

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25. Wireless operation certificate from
Indian P & T

26. Arms Act, 1950 (if guards have

weapons)

APPENDIX 6

CONTENT OF MEDICAL RECORD

Medical record shall contain, at the least, the following information:

Sr. No. Content

1. Name & Registration number of treating doctor
2. Name, demographic details & contact number of patient
3. Outpatient Register
4. Inpatient Register
5. Operation Theater Register (Wherever applicable)
6. Labour Room Register(Wherever applicable)
7. Birth Register (Wherever applicable)
8. Case sheets including relevant clinical history, assessment and re-assessment findings,
nursing notes and diagnosis
9. Investigation reports
10. Details of treatment/therapy/surgical procedures and other care provided
11. Applicable consents
12. Discharge summary
13. Cause-of-death certificate & Death Summary (where applicable)

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 APPENDIX 7

Patients’ rights and responsibilities:

Patients’ Rights

A patient and his or her representative has the following rights with respect to the clinical establishment:

1. To have adequate relevant information about the nature, cause of illness, proposed investigations and
care, expected results of treatment, possible complications and expected costs.
2. Rate of services provided by the clinical establishment would be displayed prominently.
3. To access a copy of case papers, patient records, investigations reports and detailed bill.
4. To informed consent prior to specific tests or treatment or therapy.
5. To seek second opinion from an appropriate clinician of patient’s choice, with records and
information being provided by treating hospital.
6. To have confidentiality, human dignity and privacy during treatment.
7. To have ensured presence of a female person, during physical examination of a female patient by a
male practitioner.
8. To have non-discrimination about treatment and behavior on the basis of HIV status
9. To choose alternative treatment if options are available
10. Rate of services provided by the clinical establishment would be displayed prominently

Patients’ Responsibilities

1. Provide all health related information.

2. Cooperate with Doctors during examination, treatment.
3. Follow all instructions · Pay hospitals agreed fees on time.
4. Respect dignity of doctors and other hospital staff.
5. Never resort to violence.

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 APPENDIX 8

INFORMED CONSENT or CONSENT GUIDELINES

The informed consent shall at the least contain the following information in an understandable
language and format (desirably which a lay person can easily understand)

Sr. No. Content

1. Name of the patient or guardian (in case of minor or mentally disabled).
2. Registration number of patient
3. Date of admission
4. Name & Registration number of treating doctor
5. Name of therapy/surgical/investigation and potential complications should be
explained
6. Signature of patient or guardian with date and time

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 APPENDIX 9

DISCHARGE SUMMARY

The discharge summary shall at the least contain the following information in any understandable
language and format:

Sr. no. Content

1. Name & Registration number of treating doctor
2. Name, demographic details & contact number of patient, if available
3. Date of admission and discharge
4. Relevant clinical history, assessment findings and diagnosis
5. Investigation results
6. Details of medical treatment /therapy/surgical procedures and other care provided
7. Discharge advice (medications and other instructions).
8. Instruction about when and how to obtain urgent care

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