China has issued two mandatory national standards for elderly care institutions, marking a significant step to regulate the sector and enhance safety protocols. The State Administration for Market Regulation and the Ministry of Civil Affairs jointly released the "Basic Specifications for Elderly Care Institutions" (GB 48013-2026) and the "Criteria for Determining Major Accident Hazards in Elderly Care Institutions" (GB 48014-2026) on September 4th. These new standards are scheduled to take effect on August 1, 2027, and represent the first mandatory national standards in this field since the 2019 issuance of the "Basic Safety Specifications for Elderly Care Services."

Wang Yuhuan, Deputy Director of the Department of Technical Standards at the State Administration for Market Regulation, explained that the two standards have distinct yet complementary roles. "One establishes the fundamental rules, while the other is for checking risks. They work together to strengthen the safety net for elderly care institutions," she said. The "Basic Specifications" sets forth a comprehensive baseline for safety and service quality across the entire operational lifecycle of an institution, covering everything from establishment and operation to closure. It systematically outlines 90 specific requirements, clarifying exactly what must be done and to what standard. The "Criteria for Determining Major Accident Hazards" provides a definitive framework for hazard identification, described as creating "hard and fast rules" for risk inspection.

The introduction of these standards responds to an urgent and pressing reality. By the end of 2025, China's population aged 60 and above had reached 323 million, accounting for 23% of the total population, with projections indicating this will surpass 400 million, or over 30% of the population, by 2035. The country currently has 41,700 registered elderly care institutions employing 722,000 people. However, the rapid growth of the sector has been accompanied by serious issues, including substandard operational practices, non-compliant service management, and prominent safety hazards. A major fire at the Guoen Elderly Apartment in Longhua County, Chengde City, Hebei Province on April 8, 2025, resulted in 20 deaths, starkly illustrating the potential consequences of these lapses.

Local inspections have uncovered a range of safety deficiencies. A report from the Zixi County Civil Affairs and Veterans Affairs Bureau found issues at several local facilities, including an unstaffed fire control room, a faulty fire alarm system, insufficient fire extinguishers, uncertified personnel on duty in fire control rooms, and blocked evacuation routes due to clutter.

"Despite the rapid development of elderly care services, the problems of poor operational levels, non-standardized management, and prominent safety hazards in some institutions cannot be ignored," stated Zhang Jun, Deputy Director of the Elderly Care Services Department at the Ministry of Civil Affairs. He emphasized the need for unified mandatory national standards to establish both a baseline and a safety red line for the industry. The lack of a clear, unified standard for hazard determination has long left the sector in a state of "blurred management," where institutions may overlook dangers and regulators struggle with insufficient criteria for assessment. Zhen Bingliang, Secretary-General of the National Technical Committee for Standardization of Social Welfare Services, noted that the drafting team conducted field research in over 100 institutions across more than 10 provinces in eastern, central, and western regions, and collected 13,881 questionnaires to systematically analyze weaknesses in quality and safety.

For the first time, the "Basic Specifications for Elderly Care Institutions" includes mandatory staffing ratios for nursing staff. The national standard now stipulates a minimum of one caregiver for every four residents with complete disability, one for every five with severe disability, one for every twelve with moderate disability, and one for every twenty with mild disability or intact capabilities. This provision directly targets a widespread industry pain point identified in inspections across multiple regions. The standard also mandates that fire control rooms be staffed 24/7 with certified personnel, and requires that open flames and sharp objects used by residents be managed in a centralized manner.

The "Criteria for Determining Major Accident Hazards" specifies 25 direct determination factors, 28 comprehensive determination factors, and two categories of exclusion scenarios. Direct determination factors cover siting, construction, and fire protection. For example, an institution located too close to flammable or explosive materials, housed in a dilapidated C or D-grade building, or with severely inadequate fire protection facilities would be immediately classified as having a major accident hazard.

The development of these standards stems from a need to improve industry oversight and address long-standing gaps. In February, the State Council's General Office forwarded a document from ten departments outlining requirements to strengthen safety management in elderly care institutions, which explicitly called for the creation of mandatory national standards for hazard determination and basic specifications. Zhang Jun outlined three key reasons for issuing these new standards: first, to implement central government decisions and prevent safety risks from the institutional source; second, to promote industrial transformation by providing clear guidance for existing institutions and establishing a benchmark for new ones; and third, to create a more robust comprehensive regulatory system that provides a legal and technical basis for joint law enforcement and hazard investigations.

Zhen Bingliang explained that the drafting team sought broad input to ensure the standards are both scientific and practical. "We have comprehensively summarized lessons from major responsibility accidents and natural disasters in elderly care institutions in recent years," he said. "The standards integrate and optimize key management requirements that were previously scattered across related fields such as fire protection, construction, and food safety, and have also incorporated some recommended standards that have been widely implemented with positive results." The primary goal, as stated in the drafting notes, is "to transform basic service requirements for elderly care institutions from 'optional items' into 'mandatory questions,' ensuring through binding force that elderly people receive more standardized services and that risks are effectively prevented."

The two standards include a one-year transition period before implementation. Zhang Jun described this period as a "learning cycle" for civil affairs officials and facility staff to fully understand the new regulations and restructure their management systems. The Ministry of Civil Affairs plans to conduct extensive publicity and training, use the national standards cloud platform for interpretation, and issue supporting policies to guide institutions in identifying and resolving gaps. Zhen Bingliang put forward three requirements for institutions: learning the standards so every position understands its obligations; conducting self-assessments and establishing problem, rectification, and responsibility checklists; and moving from passive compliance towards more refined management practices.

Following the implementation, institutions that do not meet the mandatory requirements will be ordered to rectify the issues within a specified timeframe. Those that refuse or fail to comply will face measures such as talks, administrative penalties, and joint disciplinary actions. Enforcement will also be linked to institutional ratings, operational subsidies, and government service contracts. The release of these two standards signals a shift in elderly care services from merely having standards to pursuing high standards, and from voluntary guidance to mandatory regulation. As Wang Yuhuan noted, this effort aims to "weave the safety net for elderly care services more densely and secure it more firmly."