Thailand Care Home License Scope: What Services Are Permitted

In October 2026, Thailand’s Department of Health Service Support (สบส. / HSS) launched a nationwide inspection of all 1,203 registered care homes following a high-profile closure in Kanchanaburi province. The operator had been found providing services well beyond what their license permitted. For every care home operator — Thai or foreign — this is the moment to revisit exactly what your license authorises you to do.

The Legal Framework: Two Acts, Two Boundaries

Thailand regulates care homes under the Health Service Establishment Act B.E. 2559 (2016) (พ.ร.บ.สถานประกอบการเพื่อสุขภาพ). Elder-care and dependent-care facilities are classified as a specific type of “health service establishment” under Section 3(3) and Section 12. The subordinate regulations took effect on 28 January 2021, meaning all operators — existing and new — have been legally required to hold a license since that date.

Separately, the Medical Facility Act B.E. 2541 (1998) governs hospitals, clinics, and any facility that diagnoses, treats, or rehabilitates patients. Care homes are not licensed as medical facilities. Crossing into that territory without the correct license carries far harsher penalties.

What a Standard Care Home License Covers

Under an HSS Act license, a care home may provide:

Activities of daily living (ADL) assistance — bathing, dressing, feeding, mobility support
Basic health monitoring — taking vital signs, assisting with medications already prescribed by a physician, basic wound dressing
Wellness and activity programmes — gentle exercise, cognitive stimulation, recreational activities
Coordination with families and healthcare providers — escalating concerns, arranging hospital transport, communicating changes in condition

All of this falls under “dependent care,” not medical treatment.

Services That Exceed the License

The most important compliance boundary is between care and medical treatment. The following activities require a separate medical facility license:

Admitting residents who require ongoing medical treatment — post-surgical patients still needing hospital-level monitoring, or residents in acute clinical distress
Accepting psychiatric patients with severe symptoms — a care home license does not cover inpatient psychiatric treatment
Operating more beds or using more floor space than specified in the license — even if demand exists, exceeding these numbers is a violation
Using physical restraints — cage-style beds, chains, or any unauthorised restraint device is illegal and does not meet the care standard under either Act

If your centre wants to serve residents with more complex needs, the compliant path is to apply for a license amendment or establish a formal referral agreement (MOU) with a licensed medical facility.

Penalties for Scope Violations

The law is specific:

Operating without a license or in breach of license conditions: up to 6 months imprisonment and/or a fine of up to THB 50,000 under the HSS Act 2016
Providing medical treatment without a medical facility license: up to 5 years imprisonment under the Medical Facility Act 1998
License revocation: immediate closure, requiring all residents to be transferred — with no transition period guaranteed

Penalties apply to both the business owner (ผู้รับอนุญาต) and the named operator (ผู้ดำเนินการ) on the license.

A Practical Compliance Checklist

Pull out your establishment license and verify:

Maximum bed count — your actual resident count must not exceed this number
Licensed floor area — any expansion, even informal, requires an amended license
Resident category — some licenses specify only independently mobile elderly; others include dependent-care; confirm yours covers the residents you actually have
Named operator — the person listed must hold a current, valid operator license from HSS

If any of these no longer match reality, contact your regional HSS office to file an amendment before an inspection surfaces the gap. For a full overview of what inspectors look for in documents and staffing records, see the guide on สบส. standards inspection readiness.

How Documentation Ties to License Scope

Care notes are evidence of what your centre does. If records describe procedures that exceed your license — administering injections not covered, performing clinical assessments reserved for nurses in a medical facility — those notes become evidence of a violation.

Caleo’s AI care notes are built around ADL and care observations, not clinical orders, keeping the language of your records naturally aligned with the scope of an HSS Act license. The resident records module gives the team a clear view of each resident’s status — which residents are within scope, and which may need a specialist referral before their condition escalates.

To discuss how Caleo supports standards-compliant record-keeping across your care home, get in touch with our team.