The Compliance Trap: Regulatory Burden, Accreditation, and the Shrinking Small Healthcare Sector in Maharashtra – An Empirical Study

Regulatory Framework is key to legal Governance of nay society, and to keep updating such a regulatory framework according to changing and ever emerging new needs of the man manifestative of a welfare democratic state. Healthcare has always been one of priority areas that has always kept nations, world over, engaged to set a goalpost and to keep moving it forward, for the general well-being of the society. Through this research paper I attempt to analyse such a forward-looking attempt of the regulators of Indian healthcare system through the establishment of NABH . The board was established in 2005 and started functioning in 2006, participation of state governments being voluntary, to begin with. Maharashtra government participated in the programme in 2021, updating its rule book through 'Maharashtra Nursing Homes Registration (amendment) rules, 2021 . Purpose of this study is to highlight the overall impact on the healthcare system of the state, given teething problems faced by ground level healthcare providers, these being the burden of compliance, infrastructure challenges and resulting implementation. Small level players in the system, particularly nursing homes with bed capacity of less than 50 beds, who otherwise cater to healthcare needs of majority of the populace, feel the pinch a lot more, given paucity of available resources to immediately meet out financial and infrastructure burden in implementing amended rules. Study reveals that during last two years i.e from 2022 to 2024, 70 to 80 small and medium level nursing homes closed down only in Pune . Averaging out this number for the state as a whole, the picture would certainly be alarming. The research is aimed to find a meeting place between the need to implement well-intentional amendment to the rules governing healthcare of the society and viability and feasibility of the same at the ground level.