Madeira creates transitional regime for continuing care units

The Regional Government has created a transitional regime for applying the operating rules to inpatient units in the Integrated Continuing Care Network of the Autonomous Region of Madeira (REDE). The measure is set out in Order No. 569/2026 of 1 October, signed by the Regional Secretariats for Health and Civil Protection, Finance, and Inclusion, Labour and Youth.

The transitional period will last two years from the order’s entry into force and applies exclusively to REDE units that, on that date, have a valid programme contract or can prove that they were already undergoing a contracting process. The regime will remain in force until the definitive rules for licensing the units are approved.

During this period, the units covered must comply with the Technical Recommendations approved by the order. Operating authorisations may be made conditional on compliance with a plan to bring the premises, equipment, organisation and safety arrangements up to standard, validated by REDE’s Technical Coordination body and the authority responsible for authorising operations and licensing healthcare providers. Once the refurbishment requirements have been met, a conditional authorisation may become unconditional.

The order clarifies that these authorisations are provisional, transitional and revocable: they are not equivalent to a definitive licence, do not confer acquired rights and do not, in themselves, provide grounds for compensation if they expire, are revoked or end when the transitional regime concludes. Ongoing conversion, refurbishment and adaptation processes will be supervised by the competent authority, with phased planning intended to prevent interruptions to care.

Technical rules for premises and care

The Technical Recommendations approved as Annex I cover Convalescence Units (UC), Medium-Term and Rehabilitation Units (UMDR), and Long-Term and Maintenance Units (ULDM). They set minimum requirements for premises, equipment, operations, accessibility, safety, technical installations and waste management, applying to new buildings and to renovation, rehabilitation, refurbishment or adaptation works.

The document provides for an exceptional procedure for exemptions or alternative solutions, particularly in existing buildings. Applications must be supported by an Exemption and Equivalence Dossier identifying the requirement, explaining the non-compliance and setting out proposed compensatory measures. Essential requirements for structural safety, fire protection and evacuation, essential accessibility, emergency power, water safety, hygiene and infection prevention, and minimum clinical safety relating to oxygen, medical gases and suction cannot be waived.

Among the operating rules, the recommendations set out requirements for bedrooms, sanitary facilities, corridors, access routes, dining and communal areas, nursing care, rehabilitation, ventilation, emergency power, medical gases, water and drainage. For units located in existing buildings, some adaptations are permitted with technical justification and compensatory measures, provided the safety and quality of care are safeguarded.

The order also stipulates that technical questions about applying the recommendations must be reviewed and harmonised by REDE’s technical coordination body, after consultation with the authority responsible for authorising operations and licensing providers. The legislation states that it creates no new burden on public funds and does not provide grounds for multi-year commitments. It enters into force on the day after publication.