NABH 6th Edition Standards: All 10 Chapters, 639 Objective Elements and What Changed

Last reviewed 8 November 2026 · Checked against official NABH standards, programme pages and notifications.

The 10 Chapters of NABH 6th Edition

Chapters 1–5 are patient-centred; chapters 6–10 are organisation-centred.

*NABH’s summary table lists COP as 135 objective elements. Its level breakdown totals 136, and the COP chapter itself states 136. The published overall total is 639; the summary column totals 638 because of this one-element discrepancy.

Core, Commitment, Achievement and Excellence

Every objective element is graded at one of four levels. Hospitals are assessed on more of them as they move through the accreditation cycle.

Key Dates: 5th to 6th Edition Transition

What Changed from the 5th Edition

The 6th Edition keeps the 10-chapter structure, reduces objective elements from 651 to 639, renames the infection-control chapter, and adds requirements in the areas below.

The hospital standards do not mandate a fixed share of digital records. Digital maturity is assessed separately under NABH’s Digital Health Standards.

Why NABH Accreditation Matters

NABH was established in 2006 as a constituent board of the Quality Council of India (QCI). Since then, it has evolved into the gold standard for healthcare quality in India, with its standards recognised and accredited by the International Society for Quality in Health Care (ISQua) — placing it at par with top global accreditation bodies.

Accreditation gives hospitals a structured framework for patient safety, reliable care and continuous improvement. Insurer and government-scheme eligibility and payment incentives depend on the applicable current rules; confirm those with the payer rather than budgeting against a general percentage.

Which NABH Programme Fits Your Hospital?

Full accreditation is relevant for medical-tourism empanelment and major corporate hospital networks. Programme eligibility and applicable requirements should be checked with NABH before applying.

Official fees — Hospital Accreditation (HCO)

Fees below are listed on NABH’s current programme pages, checked 8 November 2026, excluding 18% GST. The HCO page labels its schedule as revised from 1 April 2024. NABH may revise fees.

SHCO (up to 50 beds): application ₹25,000; annual ₹1,50,000.

Entry-Level Certification, 2nd Edition — two-year fee

Other fees include a virtual assessment fee (₹3,000–₹15,000 for hospitals), a focus assessment fee (₹15,000) and a certificate re-issue fee (₹6,000). See the linked official programme pages for the current schedule.

The 12-Month NABH Roadmap

Whether you are a 200-bed district hospital or a 10-bed clinic, a structured timeline prevents last-minute scrambles. Here is a proven 12-month plan:

Month 1–2 — Gap Assessment: Conduct an internal audit against all 10 chapters. Identify critical non-conformities. Appoint a NABH Coordinator and department-level Champions. Download the official 6th Edition standards (free on nabh.co) and assess each of the 639 objective elements, chapter by chapter.

Month 3–4 — Policy & Documentation Sprint: Draft and approve all mandatory policies. Build your Document Control System. Ensure 200+ documents are organised and accessible digitally.

Month 5–6 — Staff Training: Conduct all-staff orientation on NABH standards — particularly infection control, patient rights, medication safety, and emergency protocols.

Month 7–8 — Mock Assessment: Simulate the actual NABH audit. Walk the floors as an assessor would. Identify and close remaining gaps. Log corrections with evidence.

Month 9–10: Apply Online. Once the standards have been running in all departments for at least 3 months, apply on NABH’s accreditation portal (hcoaccreditation.nabh.co) with the required documents, and pay the application fee. Entry-Level applicants apply on nabh.qcin.org.

Month 11–12: Desktop and On-site Assessment. NABH reviews your documents (desktop assessment) and then schedules the on-site assessment. Close any non-conformities within the stipulated timeline. Under Entry-Level 2nd Edition, you receive one consolidated set of desktop observations and get a single cycle to close non-conformities.

The Role of Staff Training in NABH Success

HRM Chapter 9 of NABH mandates not just that staff are trained, but that training is documented, tracked, and linked to competency outcomes. This is where most hospitals quietly struggle.

Manual training — printed handouts, classroom sessions, sign-in sheets — creates documentation nightmares. A healthcare LMS solves this by automating the entire training lifecycle: course assignment, progress tracking, assessment, certification, and audit-ready reporting.

• Auto-generate quizzes embedded in training videos
• Proctored assessments for high-stakes compliance modules
• Department-wise completion dashboards for the NABH assessor
• Integration with HR systems so training records stay linked to employee profiles

Our deeper guide on why every NABH-aspiring hospital needs an LMS in 2026 covers the feature checklist in detail.

Training and competency evidence is assessed under the HRM chapter (76 objective elements).

Common Reasons NABH Assessments Are Deferred

• Incomplete documentation — especially medication policies and consent forms
• Hand hygiene compliance below NABH-specified thresholds
• Absence of a functioning quality committee with documented meeting minutes
• Staff unable to articulate patient rights during the walkthrough
• Missing calibration records for biomedical equipment
• No evidence of root cause analysis for sentinel events

Each of these is preventable with systematic preparation. Keep a record of each non-conformity, its owner and the evidence of closure.

NABH and India’s Digital Health Ecosystem

NABH’s 6th Edition sits alongside three digital frameworks that hospitals will be held to in 2027.

1. NABH Digital Health Standards, 2nd Edition (September 2025)

The separate digital-health framework covers 8 chapters, 38 standards and 182 objective elements, with Silver, Gold and Platinum levels. Its chapters cover AAC, COP, MOM, Digital Infrastructure, Digital Operations Management, Finance and Procurement Management, HRM and IMS.

• Create ABHA IDs at registration.
• Link laboratory and radiology reports to ABHA.
• Connect external appointment platforms to the hospital’s HIS/EMR through UHI.

2. Ayushman Bharat Digital Mission (ABDM)

By September 2026, ABDM had linked nearly 120 crore health records to 97.6 crore ABHA IDs and onboarded about 4.1 lakh healthcare facilities. See the PIB update and our AI in healthcare statistics for 2027.

3. DPDP Act and Rules

Hospitals are data fiduciaries. From 13 May 2027, they must meet the Rules’ obligations on notice and consent, patient rights, security safeguards and breach reporting. These map directly to PRE and IMS, so build the evidence once for both. Our DPDP Act for hospitals guide covers the department-wise checklist.

What Changes in 2027

• 13 May 2027: DPDP obligations apply. Consent records, patient-rights requests and breach procedures need to be in place and auditable.
• Large hospitals (more than 300 beds) can no longer use Entry Level as a stepping stone. Plan directly for full accreditation.
• HOPE-era Entry-Level certificates are moving to the 2nd Edition. Hospitals certified under HOPE (validity on or after 1 August 2025) can renew on nabh.qcin.org within six months of expiry. After that, the application is treated as fresh.
• Digital maturity is now assessed. Expect insurers and partners to ask for Digital Health Standards levels alongside accreditation.

How Digital Systems Produce NABH Evidence

Assessors look for evidence that a process runs every day, not just a policy file. Digital systems help because they create that evidence as a by-product of routine work.

References

1. NABH Hospital Accreditation Standards, 6th Edition (January 2025)
2. NABH 6th Edition implementation plan — 10 September 2024
3. NABH Hospital Accreditation Programme — eligibility, portal and current fees
4. NABH SHCO Accreditation Programme — current fees
5. NABH Entry-Level Certification Programme, 2nd Edition — current fees and bed limit
6. NABH Entry-Level implementation and migration notification — 13 February 2026
7. NABH Digital Health Standards for Hospitals, 2nd Edition (September 2025)
8. MeitY — Digital Personal Data Protection Rules, 2025
9. Press Information Bureau — ABDM update, September 2026

Update log: 8 Nov 2026: corrected chapter names and OE counts to the official 6th Edition; added the Entry-Level 2nd Edition, the 300-bed rule, Digital Health Standards 2nd Edition and DPDP 2027 timelines.