IFC’s appraisal considered the environmental and social management planning process and documentation for the Project and gaps, if any, between these and IFC’s requirements. Where necessary, corrective measures, intended to close these gaps within a reasonable period of time, are summarized in the paragraphs that follow and (if applicable) in an agreed Environmental and Social Action Plan (ESAP). Through implementation of these measures, the Project is expected to be designed and operated in accordance with Performance Standards objectives.
PS1: Assessment and Management of Environmental and Social Risks and Impacts
Environment and Social Management Systems: KIMS’s approach to E&S risk management is largely integrated into its established Quality, Projects, Engineering/Facilities, Life & Fire Safety, and Human Resources Management Systems. The Company applies standardized quality and healthcare operational systems, across its hospital network, that are accredited to India's National Accreditation Board for Hospitals (NABH) and American Accreditation Commission International (AACI) standards. KIMS Hospitals has an overarching set of policies that define E&S objectives and principles and commit to compliance with applicable legal requirements. The Company follows a regulatory compliance approach in managing E&S risks. For brownfield acquisitions and greenfield developments, appropriate E&S risk screening including life and fire safety risk screening is undertaken to inform the management decisions.
E&S Organisation: Organizationally, E&S-related responsibilities are distributed across corporate functions under the Group Chief Operating Officer including Quality, Projects, Fire Safety, and Human Resources (HR). At each of the Hospital facilities, multiple teams under the Hospital Unit Head/Medical Director including Quality, Nursing, Engineering/Utilities, Housekeeping, Fire Safety, Administration/HR, Security, and Patient Services manage E&S risks and impacts.
Management Program: KIMS maintains documented management programs and procedures, including training programs covering key E&S risk aspects. Monitoring and review are conducted through permit compliance tracking, pollution monitoring and reporting, NABH-aligned key performance indicator (KPI) tracking including selected safety and HR indicators, internal audits by a designated internal auditor pool, and regular management review meetings at facility and corporate levels.
Based on IFC’s limited ESDD, KIMS demonstrates foundational elements of an ESMS consistent with IFC PS1 requirements. The E&S Management system is currently characterized as compliance and accreditation-driven and the responsibility is dispersed across multiple functions. As part of the IFC investment and agreed Environmental and Social Action Plan (ESAP#1), KIMS will strengthen the Corporate E&S organisational capacity by appointing a Corporate EHS Manager to coordinate and manage E&S risk screening for new projects, legal compliance management, incident investigation and reporting, and consolidated E&S performance monitoring and reporting across the expanding KIMS Hospitals network.
PS2: Labor and Working Conditions
In FY25, KIMS Hospitals maintained a workforce of 25,800+ including ~5,000 contractor staff and reported 53% women participation in its workforce.
Human Resource (HR) Policy and Management: KIMS has a Corporate HR Department that codifies all HR related policies and tracks HR performance across all KIMS Hospitals. The Corporate HR Department has formulated a HR Management Manual that applies to all its hospitals/centers. Specific customization is allowed at the hospital/center level with prior approval of the management. KIMS’ HR manual covers key HR management aspects and related standard operating procedures (SOP) which are largely in line with national labor laws and those specifically for hospitals. Facility level HR Department is supported by Corporate HR, trained and fully empowered to implement HR Management Systems (HRMS) and formulate HR procedures to align with local labor regulations.
KIMS HR policies commit to fostering a fair and inclusive workplace free from discrimination on the basis of race, gender, religion, age, disability or other characteristics. The Company promotes diversity and inclusion through inclusive hiring. To support women employees and strengthen workplace safety and well-being, KIMS provides day-care facilities, maintains an active prevention of sexual harassment (POSH) Internal Committee and operates a grievance redressal mechanism. The company does not restrict any form of freedom of association.
Learning and development is delivered through 600+ programs with an expectation of ~40 training hours per employee annually, covering clinical, operational, behavioral, compliance and occupational safety topics (including POSH, NABH/ISO and emergency preparedness). KIMS management reports no legacy events of mass worker strikes, retrenchments to date and no material labor litigation against the Company till date.
KIMS Hospitals has implemented new labor code-aligned payroll restructuring from 1 April 2026. Based on the limited assessment, IFC has identified that there are opportunities to strengthen Company's contractor labor law compliance aspects specifically payroll compliances, working hours, weekly off, overtime hours and payments, employee accommodation standards and GBVH and CP risks.
Under the IFC investment and as per agreed ESAP#2 requirements, Company agrees to review and strengthen the ongoing internal human resource (HR) audit programs and external HR compliance process audit program by expanding their respective scope to include IFC PS 2 requirements and contractor labor law compliances (specifically the payroll compliances and attendance management systems). Based on the internal and external audit assessment of Company operations, enforce and ensure labor law compliances by implementing the audit corrective action plan within agreed timelines at each of the operational facilities.
Company provides residential accommodation along with food and transportation facilities to nursing staff across most of its hospital facilities. The accommodation standards can be improved to meet IFC Worker Accommodation Guidelines, August 2009 specifically with regards to density standards, bed arrangements and storage facilities, sanitary and toilet facilities, leisure and social facilities, health and safety including life and fire safety and security facilities. As per agreed ESAP#3 requirements, KIMS Hospitals will review and update its internal nursing hostel accommodation standards and in a phased manner upgrade the existing nursing accommodation across the business operations to meet IFC Guidelines on Worker Accommodation.
Grievance Mechanism: KIMS has established a multi-channel grievance redressal mechanism including anonymous provisions for direct employees, allowing concerns to be raised orally, anonymously or in writing and reviewed by a Grievance Redressal Committee to ensure fair hearing and appropriate action; employees may appeal to Management if dissatisfied. KIMS reports that no material grievances were received relating to occupational health and safety (OHS), working conditions or human rights violations.
Gender Based Violence (GBV)/Sexual Exploitation, Abuse and Harassment (SEAH) and Child Protection (CP) Risks: The Company has implemented internal mechanisms to address human rights impacts through a comprehensive Grievance Policy, a formal Code of Conduct applicable across all levels, and internal committees overseeing human-rights-related standards, including a zero-tolerance approach to workplace sexual harassment supported by POSH-aligned Internal Complaints Committees (ICCs) at each facility with external legal members. The grievance process is structured, confidential and designed to protect anonymity and privacy, and KIMS prohibits retaliation against complainants or participants in investigations through aligned policies (Whistle Blower Policy, Code of Conduct and Grievance Policy).
As part of GBV/SEAH risk management, Company management: conducts periodic policy reviews; reinforces awareness through onboarding and refresher trainings and line-manager communication; escalates POSH reporting to the Board; reviews POSH compliances every quarter by a Women Executive Director on Company Board; and maintains patient data confidentiality under CTO oversight. As per agreed ESAP#4 requirements, KIMS Hospitals will implement a comprehensive, corporate-level GBV/SEAH and CP management system aligned with IFC Performance Standards and the Good International Industry Practice, addressing prevention, management response and reporting covering the entire business operations. The Company will focus on establishing policies and codes of conduct, strengthening workforce and patient-facing safeguards, implementing survivor-centered grievance and incident management mechanisms, and extending requirements to third-party workers. It will also include targeted measures to address under-reporting, CP, and technology-related risks, supported by training, monitoring systems, and external expert engagement. Collectively, these actions are designed to institutionalize robust safeguards across the Company in the context of rapid expansion and heightened exposure to vulnerable populations.
Occupational Health and Safety (OHS): The OHS management systems and protocol followed across all KIMS Hospitals are aligned to NABH requirements. The protocol covers, among other items, biological hazard safety (e.g., nonsocomial infections, needle stick injuries), practices for handling hazardous drugs (e.g., chemotherapeutic drugs), radiation protection, PPE use, preventive medicine, waste anesthetic gas scavenging, work place monitoring and medical examination of employees. KIMS Hospitals follows AERB (Atomic Energy Regulatory Board of India) guidelines with respect to radiation equipment installation, operation, maintenance, and workplace safety across all its hospitals.
KIMS in-house Clinical Manual covers workplace safety among other things and is applicable to all hospitals. The Quality Committee formulated under Director (Operations) monitors and reports OHS related mandatory parameters as per NABH standards. Additionally, periodical NABH surveillance audits and quarterly NABH internal auditing are undertaken covering engineering, clinical and non-clinical aspects of Hospital administration.
PS3: Resource Efficiency and Pollution Prevention
Resource Efficiency: KIMS Hospitals has initiated its sustainability journey and plans to set short, medium and long-term sustainability key performance indicators (KPI) across climate change mitigation, energy efficiency, water conservation, waste management, reduction of air emissions and GHGs, and biodiversity protection, while also increasing the share of renewable energy across select facilities through ongoing investments in clean energy infrastructure. Resource efficiency (real-time building management systems are deployed to monitor and manage electrical and mechanical equipment, solar water heaters, wastewater recycling) aspects are being integrated into new project design. Progressively, the respective facility management strives to implement resource efficiency improvement programs with respect to water and electricity as part of their annual targets and improvement programs.
GHG Emissions: In FY25, KIMS Hospitals reported total GHG emissions of 10,800 tCO2e, comprising both Scope 1 emissions of about 1,000 tCO2e and Scope 2 emissions of 9,800 tCO2e. To reduce GHG emissions, KIMS Hospitals is prioritizing energy efficiency, including a 2018 partnership at KIMS Secunderabad with leading energy conservation services provider under the performance-based model, which enables implementation of energy conservation measures without upfront capex and provides a guaranteed minimum 10% annual energy savings versus the baseline. The Company has also adopted cleaner technologies and energy-efficient practices across units, including a complete transition to LED lighting, supporting reduced energy consumption and associated carbon emissions.
Energy and Air Emissions: Energy supply at KIMS hospitals is primarily sourced from the public electricity grid, supported by diesel generator (DG) sets and UPS battery systems as standard back-up during grid outages; critical care areas such as ICUs and OTs also have dedicated battery back-up in addition to central systems. DG sets are fitted with acoustic enclosures and compliant stack heights in line with permit conditions to manage noise and air emissions. For cooling, major KIMS Hospitals operate air or water-cooled central HVAC systems using Freon 134A, a CFC-free refrigerant, while district hospitals typically use individual AC units that also operate on CFC-free refrigerants.
Water and Wastewater: Water is sourced primarily from local municipal supply and or on-campus groundwater wells, with tanker water used at select facilities during summer months. Water Treatment Plants (WTPs), including Reverse Osmosis (RO) systems for drinking and dialysis, are installed across hospitals, and treated water quality is regularly monitored to ensure compliance with applicable standards. As part of its sustainability initiatives, KIMS Hospitals has implemented a Zero Liquid Discharge (ZLD) based sewage treatment plants (STP) at key locations. For example, treated sewage from Secunderabad, Nellore and Rajahmundry hospitals is treated and reused for toilet flushing and cooling systems, while treated wastewater at the Ongole unit is used for on-site landscaping. Most of the district hospitals either operate in-house STPs or discharge domestic sewage through municipal sewer lines, while highly infectious wastewater from medical areas (e.g., operation theatres) is segregated and pre-treated with 1% sodium hypochlorite and held for an hour (or stored in separate underground tanks for pre-treatment where sewer disposal is used) before discharge to STPs or municipal systems. Wastewater quality is monitored regularly as per permit conditions and relevant regulatory agencies.
Wastes: KIMS Hospitals operates an established waste management system across its network to ensure appropriate segregation, labelling, handling, storage, transport and disposal of solid and liquid waste in line with State Pollution Control Board requirements, the Bio-Medical Waste Management Rules (including BMW Rules, 2016) and other applicable regulations, supported by regular staff training and tracking systems. Bio-medical waste is disposed of through authorised vendors and CPCB-authorised treatment facilities, while plastic waste (including packaging) is minimal and is sold only to authorised plastic recyclers, and e-waste is sent to CPCB-authorised recyclers. Hazardous waste streams—including mercury, residuals from the sewage/wastewater treatment plant, and other healthcare operational wastes—are disposed of through authorised municipal and biomedical channels. Radioactive waste from radiation oncology and X-ray departments is managed as per AERB guidelines; for oncology-related radioactive dyes that may be present in patients excreted bodily fluids (primarily urine) that remain radioactive, KIMS provides “hot toilet” facilities to allow radioactive decay before discharge to sewage treatment plant through a separate plumbing line.
PS4: Community Health, Safety and Security
Traffic and Transport: KIMS Hospitals seek to maintain adequate traffic management and parking arrangements, with the security team responsible for guiding vehicle movement and parking at all hospitals/centres. Some locations face space constraints affecting internal traffic flow and parking availability and Company has been adding car parking capacity through additional basement parking with a double-deck car park arrangements to meet rising demand or lease open neighborhood spaces. As part of the life and fire safety audit program proposed to be strengthened under IFC investment, at every facility, car parking scheme would be streamlined to ensure free access to fire engines and other emergency vehicles in line with local fire safety codes.
Life and Fire Safety: KIMS Hospitals maintain Life and Fire Safety (L&FS) management systems and infrastructure aligned with local fire safety codes, permitting requirements and NABH Standards. Emergency evacuation procedures are codified and staff are trained using NABH-standard emergency announcement codes (including “Code Red” for fire/smoke/explosion threats), with quarterly fire/mock/evacuation drills, monthly fire drill demonstrations for new staff, and recurring awareness programmes (monthly Fire Safety Awareness and annual Fire Safety Week). L&FS systems are audited through internal teams and regulatory inspections, with annual internal audit reports shared with fire authorities as required by permit conditions.
KIMS Hospitals has instituted a two tier LFS organization - both at Corporate and Facility Level. At Corporate, a trained and experienced Fire Safety Officer is employed to guide, monitor and manage LFS risks in the entire business operations ranging from brownfield acquisition, greenfield development and operational hospitals. At facility level, Unit Fire Safety Officer along with shift-wise firemen who are trained and experienced in LFS management has been deployed.
IFC’s appraisal assessment indicates that a continual improvement program based on periodical internal and external LFS audit assessments specifically focusing on adequacy of facility level fire marshals and emergency response team across all shifts; maintaining unhindered access to fire engines around the facility perimeter at all times; and maintaining all exit pathways (corridors and staircases) clear of any temporary storages could be established to improve upon the LFS risk management. Under the IFC investment commitments and ESAP#5 requirements, KIMS Hospital will strengthen its internal and external L&FS audits by incorporating WBG General EHS Guidelines (2007) requirements on LFS risk aspects and implement time-bound, facility-specific corrective action plans. For future greenfield or brownfield Hospital projects in the pipeline, KIMS will engage an IFC-acceptable L&FS consultant at design stage to benchmark against internationally recognized codes (e.g., Indian NBC or US NFPA), conduct post-construction inspections, and provide IFC with professional certifications confirming installation, testing and compliance, with any remedial actions completed within an agreed timeframe.
Community Exposure to Disease: KIMS Hospitals follow a patient safety protocol aligned with the requirements of NABH, which includes control of nosocomial infections. The company has put in place engineering and administrative controls such as proper ventilation systems with independent air handling units (AHU) for critical care rooms, restricted access, architectural segregation, decontamination practices, and controls on water, food and waste, among other preventive and corrective measures. Only filtered and cool air is circulated in open cycle Air Handling Unit (AHU) or HVAC systems for improving infection control in individual patient care rooms.
Security Personnel: All hospitals are guarded round the clock with security personnel (guards) outsourced from private agencies. Security Manager is generally a company staff and reports to Head of Operations or Medical Director independently. Security guards do not possess arms and there have been no past incidents of conflict with community. Security personnel are trained to manage the entry/exit gates, vehicular movement, pedestrian movement, lifts, parking areas, hospital floors and overall movement of visitors inside the hospital premises.
