Nursing Homes (Regulations) Act, No. 16 of 1949
An Act to provide for the registration of nursing homes and generally for the regulation, supervision and inspection of nursing homes so registered. Enacted 26 March 1949, this is one of the earliest pieces of healthcare regulation in Sri Lanka, predating independence-era health legislation.
Consolidated text available at lankalaw.net (PDF, extracted via OCR). Amended twice in 1988: No. 62 (fee increase) and No. 63 (redefined "Director").
Act Structure
The Act has a flat section structure (no chapter or part divisions) with 11 sections:
| Section | Topic | Summary |
|---|---|---|
| 1 | Short title | Citation |
| 2(1-2) | Registration requirement | Premises cannot be used as nursing home unless registered; offence for non-compliance |
| 3(1-5) | Registration procedure | Application to Director in prescribed form with Rs.100 fee; Director registers and issues certificate; 12-month registration renewable (Rs.50 fee); certificate must be displayed conspicuously |
| 4(1-3) | Refusal/cancellation | Director may refuse registration (unfit person, unsuitable premises, inadequate staffing); may cancel registration; cancellation requires written notice and opportunity to remedy |
| 5(1-3) | Appeal | Appeal to Magistrate's Court within 14 days; court decision is final; Director must register if appeal succeeds |
| 6(1-4) | Powers of entry/inspection | Director or authorised medical practitioner/nurse may inspect at reasonable time; can inspect unregistered premises suspected of operating as nursing home; cannot inspect patient medical records; obstruction is an offence |
| 7(1-4) | Regulations | Minister makes regulations for proper maintenance, staffing, standards; detailed list of regulation topics; regulations must be approved by Parliament; contravention of regulations is offence |
| 8(1-2) | Penalties | Fine up to Rs.50, plus Rs.20/day for continuing offence; corporate officers deemed guilty unless they prove no knowledge |
| 9(1-6) | Nursing Homes Advisory Board | 7 members: Director (chairman) + 6 appointed by Minister; 2-year term; Board sets own procedure |
| 10 | Approved nurses (transitional) | Director may recognise nurses until a nursing registration law is enacted |
| 11 | Interpretation | Definitions: Director, maternity home, nursing home, registered midwife, registered nurse, regulation |
Statutory Bodies
Nursing Homes Advisory Board — Composition Detail
The Board consists of 7 members: 1 ex-officio chairman and 6 appointed by the Minister.
Chairman (ex-officio):
| # | Role | Note |
|---|---|---|
| 1 | Director-General of Teaching Hospitals | Chairman (S.9(1)); originally Director of Health Services, amended by No. 63 of 1988. Deputy Director presides when Director absent (S.9(5)) |
Appointed by Minister (6):
| # | Category | Count | Note |
|---|---|---|---|
| 1 | Persons recommended by the Independent Medical Practitioners' Association | 3 | Chosen from persons recommended by the Association |
| 2 | At Minister's discretion | 3 | No specific qualification requirement |
- Term: 2 years; eligible for reappointment (S.9(2))
- Removal: Minister may remove any appointed member (S.9(3))
- Procedure: Board may regulate its own procedure, unless regulations prescribe otherwise (S.9(6))
- Function: Advise the Minister and the Director upon matters affecting the administration of the Act and the exercise of powers and functions conferred by the Act
Registration Requirements
Mandatory Registration
No premises shall be used as a nursing home unless registered under the Act (S.2). Operating an unregistered nursing home is an offence.
Registration Process
| Step | Details |
|---|---|
| Application | To the Director-General of Teaching Hospitals (originally Director of Health Services; amended 1988) in prescribed form |
| Initial fee | Rs. 10,000 (originally Rs. 100; amended by No. 62 of 1988) |
| Outcome | Director registers the nursing home and issues a certificate |
| Certificate | Must be displayed conspicuously on the premises |
| Validity | 12 months from date of registration |
| Renewal fee | Increased by No. 62 of 1988 (originally Rs. 50) |
Refusal and Cancellation Grounds
The Director may refuse or cancel registration on the following grounds (S.4):
- The applicant/proprietor is not a fit and proper person
- The premises are not suitable for use as a nursing home
- The nursing home is not, or will not be, under adequate staffing
Safeguard: Before cancellation, the Director must give written notice specifying the grounds and allow the proprietor a reasonable opportunity to remedy the issue (S.4(3)).
Staffing Requirements
The Act distinguishes between two types of nursing homes with different staffing requirements:
| Type | Superintendent Requirement |
|---|---|
| Maternity home | Must be a registered nurse or registered midwife (S.3(4)(b)) |
| General nursing home | Must be under a qualified medical practitioner or a registered nurse resident on the premises (S.3(4)(a)) |
Regulation-Making Powers
Section 7(2) gives the Minister broad power to make regulations on the following matters:
| Topic | Description |
|---|---|
| Construction standards | Building construction and maintenance of nursing homes |
| Ward size | Number of patients per ward or room |
| Staffing | Number and qualifications of nursing and other staff |
| Infectious disease | Precautions against spread of infectious disease |
| Immunization | Immunization requirements |
| Fees/charges | Rates, fees, and charges at nursing homes |
| Records | Keeping of records and registers |
| Inspection | Conduct of inspections |
| General | Any other matter for the proper maintenance and running of nursing homes |
Parliamentary approval: All regulations must be approved by Parliament (S.7(3)).
Inspection Powers and Privacy Protection
The Act balances inspection powers with patient privacy (S.6):
Powers of entry:
- Director of Health Services or any authorised medical practitioner or nurse may enter and inspect any registered nursing home at any reasonable time
- May also inspect any unregistered premises suspected of being used as a nursing home
Privacy safeguard:
- Inspectors cannot inspect individual patient medical records (S.6(3))
Obstruction: Obstructing an inspector is an offence (S.6(4)).
Penalties
| Offence | Penalty |
|---|---|
| Operating unregistered nursing home | Fine up to Rs.50 |
| Continuing offence | Rs.20 per day |
| Contravention of regulations | Fine up to Rs.50 + Rs.20/day continuing |
| Corporate liability | Directors/officers deemed guilty unless they prove no knowledge (S.8(2)) |
The penalty amounts (Rs. 50 fine, Rs. 20/day) reflect 1949 values. Unlike the registration fees (updated by Amendment No. 62 of 1988), the penalty amounts have not been amended and are negligible in modern terms.
Cross-References
Private Medical Institutions (Registration) Act, No. 21 of 2006
The 2006 Act established a modern regulatory framework for private healthcare institutions, including the Private Health Services Regulatory Council (PHSRC) in 2007. This Act is the successor legislation for private healthcare regulation and may partially or fully supersede the 1949 Act's regulatory functions.
Section 21 of the 2006 Act fully repeals the Nursing Homes (Regulations) Act (Chapter 220). A 3-month transition period was provided for existing registered institutions. The PHSRC (28 members) replaces the Nursing Homes Advisory Board (7 members) as the regulatory body for private healthcare institutions.
Medical Ordinance, No. 26 of 1927
The definitions of "registered midwife" and "registered nurse" in Section 11 reference the Medical Ordinance. The staffing requirements (S.3(4)) depend on these registration categories.
Amendment Timeline
Amendment No. 62 of 1988 — Fee Increase
Endorsed 17 December 1988. Significantly increased registration and renewal fees to reflect inflation since 1949:
| Fee | Original (1949) | Amended (1988) |
|---|---|---|
| Initial registration | Rs. 100 | Rs. 10,000 |
| Annual renewal | Rs. 50 | Increased (exact amount in amendment text) |
Amendment No. 63 of 1988 — Director Redefined
Endorsed 17 December 1988. Redefined the term "Director" in the interpretation section (S.11) from Director of Health Services to Director-General of Teaching Hospitals. This change shifts regulatory authority for nursing homes and affects:
- Registration (S.3): Applications now go to the Director-General of Teaching Hospitals
- Refusal/cancellation (S.4): Decision-maker changed
- Inspection (S.6): Authorising officer changed
- Advisory Board chairmanship (S.9): Chairman is now the Director-General of Teaching Hospitals
The consolidated text header lists "Acts Nos. 16 of 1949, 12 of 1952, 29 of 1953" as the source acts. However, Act No. 12 of 1952 is the Health Services Act and Act No. 29 of 1953 is the Assignment of Ministers' Functions (Consequential Provisions). Neither is a direct amendment to the Nursing Homes Act. The actual amendments are Nos. 62 and 63 of 1988, identified from parliament.lk records.
Entity Relationships & Governance
Governance Hierarchy (1952 Design)
Current Replacement Structure (Post-1989)
Data Confidence
Definitions (Section 11)
| Term | Definition |
|---|---|
| Director | Director-General of Teaching Hospitals (amended by No. 63 of 1988; originally Director of Health Services) |
| Maternity home | Premises used for the reception of women during pregnancy or confinement |
| Nursing home | Premises used for the reception and treatment of persons suffering from illness or injury (excludes government/local authority premises and prescribed bodies) |
| Registered midwife | As defined in the Medical Ordinance |
| Registered nurse | As defined in the Medical Ordinance |
Research Gaps
The following areas require further investigation:
- Consolidated header discrepancy: The consolidated text header references Acts 12/1952 and 29/1953 but neither is a direct amendment (the actual amendments are Nos. 62 and 63 of 1988) — the nature of the header references needs clarification
- Repeal status: Whether Section 21 of the Private Medical Institutions (Registration) Act, No. 21 of 2006 partially or fully repeals this Act
- Current enforcement: Whether the Director of Health Services still registers nursing homes under this Act or whether PHSRC has assumed this function
- Advisory Board activity: Whether the Nursing Homes Advisory Board still convenes; current membership unknown
- Regulations made: Which regulations have been made under Section 7, and whether they are still in force
- Registered nursing homes: Number of currently registered nursing homes under this Act
- Penalty adequacy: The Rs.50 fine is negligible in modern terms; whether there have been any prosecutions under the Act