Last update 01-04-2026

Health and social care institutions

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Health and social care provision in Spain

Health and social care provision in Spain comes under the management of the autonomous communities. The exceptions are the autonomous cities of Ceuta and Melilla, where they are managed by the Institute for Older People and Social Services (Imserso), under central government.

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Imserso health and social care centres

Centres for the elderly:

  • Care homes
  • Social welfare centres

Centres for people with disabilities:

  • Care centres for people with physical disabilities
  • Rehabilitation centres for people with physical disabilities

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How they are regulated

The following rules apply to admissions to care homes for:

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Conditions of access to centres

The elderly

People who meet the following requirements may be eligible for admission to old people’s homes:

  • Be aged at least 60;
  • Have no infectious disease, chronic illness at a terminal stage or clinical disease necessitating hospital treatment;
  • And have no serious mental disorders which may disrupt normal communal life in the centre.

Another requirement for admission to centres of this type is that the beneficiary must be a pensioner under the social security system or entitled, by law or international convention, to social services provided by it.

Elderly dependants and people with physical and mental disabilities

Places for elderly dependants and for people with physical and mental disabilities for which they have been referred to a specialist residential care service, or specialist day care service, are subject to the following requirements:

  • Having one of the prescribed degrees of dependency;
  • Having resided in Spain for 5 years, two of which must have been immediately prior to the date of submission of the application.

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Users’ contributions to the cost of the service

Amounts

Users of facilities for older people generally contribute an amount towards the cost of the service. This contribution is equivalent to 75% of the basis of means testing, i.e. their total net income, apart from exceptional payments.

Users of residential care facilities for dependent people generally contribute an amount towards the cost of the service. This contribution is equivalent to 75% of the basis of means testing, i.e. their total net income, apart from exceptional payments.

The same contribution procedure as above applies to day centre users, who pay one-third of the calculated amount, as applicable.

Method of payment

Users of residential or day care pay the amount due directly to the centre providing it.

When residential stays at the centre have been paid for, the Imserso refunds the difference between the price of each place occupied and the amount payable by service users, in settlement of the cost of such stays.

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Aid or subsidies

Order SSI/420/2015, of 9 March 2015 (Abre en nueva ventana) (Spanish Official Gazette of 13 March 2015), establishing the award criteria of subsidies to older, disabled and dependent people, within the scope of competence of the Institute for Older People and Social Services, provides for various types and levels of subsidy. These include care homes for older people or the disabled. Subsidies are available for temporary stays in care homes, including board, and for residence in specific cases.

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Rules on rates which privately managed homes may charge

There are no privately run care homes in Melilla.

In Ceuta, only the Fundación Gerón care home and day centre offers 10 private places at two rates, for single and double rooms.

Homes under Imserso management in Ceuta and Melilla

  • What types of home are available: for older people, the disabled, etc?

    Melilla has the Centro Polivalente under Imserso management, offering services specifically for dependent and other elderly people. The Centro Polivalente has a total of 160 places, broken down as follows: 138 in residential care (15 for non-dependent and 123 for dependent people); 7 for temporary residence and 15 at the day centre.

    In addition to its services for older people at the Centro Polivalente in Melilla, the Imserso offers permanent residential and day care places under contract with other organisations in Ceuta and Melilla, within its territorial competence. These places are intended for people who are older and/or have physical and mental disabilities, and for older people who are dependent.

    The territorial directorates of Ceuta and Melilla manage two social welfare centres for older people, which basically promote community living and involvement of older people. They offer social and geriatric care, occupational therapy and other cultural and leisure services. Both centres also have day care units for older people who are dependent.

  • Centres for older people managed under contract

    Centro Asistencial de Melilla care home Places: 100 (95 permanent and 5 temporary).

  • Centres managed under contract for dependent people with physical and mental disabilities and older dependent people

    • Fundación Gerón care home and day centre, Ceuta· Places: 65 (55 residential and 10 at the day centre)
    • ‘Nuestra Señora de Los Ángeles’ care home and day centre, Ceuta (Hermanos Franciscanos de Cruz Blanca) Places: 21 places for people with an intellectual disability, who are in a situation of dependency (on a residential basis).
    • COCEMFE day centre, Ceuta Places: 15.
  • Care centres for people with physical disabilities (CAMF centres)

    These are governed by the Imserso Directorate-General decision of 26 August 1987 (Abre en nueva ventana) (Spanish Official Gazette of 1 October 1987), establishing the criteria for admission, transfers, exchanges and payment for stays.

    Conditions of admission:

    • Have the recognised degree of disability.
    • Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
    • Not have serious mental disorders which might disrupt usual shared living at the centre.
    • Achieve the minimum score required at any given time for admission to the chosen centre, in accordance with the current admission scale.
    • Be a beneficiary of the Social Security System or entitled to social services under the Social Security System by law or international convention for centres owned by the Social Security System.
    • Applicants must be over sixteen years of age for residential places. Children under 16 are eligible for places with half-board.
    • Have a physical disability as a result of which, in the opinion of the relevant assessment and guidance team, another person’s help is required for essential daily activities, such as dressing, walking, eating and the like.
    • There are no reasonable prospects of rehabilitation or returning to work. So that, admission to or continuing treatment at a centre dedicated to this end is not appropriate.
    • Encounter serious difficulties in being cared for in a family setting or at home.

     

    The cost of boarding places is 75% of their pension.

  • Rehabilitation centres for people with physical disabilities (CRMF)

    CRMF centres are governed by the Imserso Directorate-General decision of 18 January 1993 (Abre en nueva ventana) (Spanish Official Gazette of 23 April 1993).

    Conditions of admission:

    • Have the legal status of a person with disabilities.
    • Have no infectious disease or need for continuous medical care in healthcare institutions.
    • Not have serious mental disorders which might disrupt usual shared living at the centre.
    • Achieve the minimum score required at any given time for admission to the chosen institution.
    • Be a beneficiary of the social security system or entitled to social services by law or international convention.
    • Be at least 16 years old. In exceptional cases, individuals aged 14 and over may be admitted if their educational progress and personal needs so require.
    • In the opinion of the relevant Assessment team, show reasonable potential to return to work.
    • Possess the level of knowledge necessary to complete the education that they wish to undertake.

     

    CRMFs are funded by IMSERSO and the European Social Fund. Residential stays and day centre attendance are free to the beneficiary.

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What are the State Reference Centres?

The State Reference Centres (Centros de Referencia Estatal – CRE) within the System for Autonomy and Care for Dependence are financed by IMSERSO. IMSERSO provides the necessary resources for the CREs to fulfil their functions from its budget for costs and provisions.

The purpose of the CREs is to offer quality social services to meet the needs of people in a state of dependency, and their families.

The CREs are centres of expertise for the promotion and exchange of knowledge, professional training and the provision of high-grade services.

As their name suggests, the CREs operate nationwide. Their location is not a barrier to access, but promotes cohesion among Spain’s autonomous communities.

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State Reference Centres in Spain

  • The CRE for People with Neurological Disorders (CREDINE, Langreo)

    The CREDINE is governed by Order SSI/411/2018 (Spanish Official Gazette of 23 April 2018).

    Admission requirements:

    • Be a beneficiary of the social security system or entitled to social services by law or international agreement.
    • Have a recognised situation of dependency at any level, or a degree of disability of 33% or more. In both cases, they must be due to neurological causes and primarily spinal cord injuries, acquired brain damage or amyotrophic lateral sclerosis. Alternatively, a person may be in the process of having such conditions recognised, or be at risk of developing them.
    • Be over 18 and under 60 years of age. In exceptional cases and at the suggestion of the CREDEF interdisciplinary team, younger or older persons may be admitted, provided that the services prove beneficial to the user.

    • Have no transmissible disease at an acute stage, and not need continuous medical care in a hospital setting.

    • Have no behavioural changes that would impede usual shared living in care homes.

    • Succeed in the adaptation and observation period to become a user of the centre. This period may not exceed three months, though it may be extended, in exceptional cases, for a further three months.

  • The CRE for the treatment of people with rare diseases (CREER, Burgos)

    The CREER exists for research, education, study and knowledge management in the field of rare diseases. It creates and disseminates good practices and offers technical advice on improving the quality of life of patients and their families.

    The CREER is governed by Order SAS/2007/2009 of 20 July 2009.

    Conditions of admission:

    • Be a beneficiary of the social security system or entitled to social services by law or international agreement.
    • Be under 65 years old.
    • Have a rare disease as defined by the European Union.
    • Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
    • Have medical stability.
    • Have no behavioural changes that would impede usual shared living in the centre.
  • The CRE for the care of people with serious disability and dependency care (San Andrés de Rabanedo, León)

    The CRE was created and is governed by Order TAS/3460/2007.(Abre en nueva ventana)

    Conditions of admission:

    • Be a beneficiary of the social security system or entitled to social services by law or international convention;
    • Be older than 16 and have a serious disability needing care from another person for BADL and to improve personal independence;
    • Severe or significant limitations to their personal independence;
    • Be medically stable;
    • And have minimum capability for communal living within the centre.
  • The CRE for the care of people with Alzheimer’s Disease and other forms of dementia (Salamanca)

    This CRE is designed as a specialist centre for advanced health and social welfare. It engages in research, analysis, assessment and training to develop the knowledge of Alzheimer’s and other forms of dementia, and the care and treatment of patients and their families.

    It is governed by Order TAS/3775/2007, of 19 December 2007.(Abre en nueva ventana)

    Conditions of admission:

    • Be a beneficiary of the social security system or entitled, by law or international convention, to social services.
    • People with dementia is understood as multiple cognitive impairments that cause significant difficulties in their daily activities, regardless of the underlying cause: Alzheimer's, vascular and other forms, whether early-onset or late-onset. People with cognitive impairment that first appeared before the age of eighteen, regardless of the cause, and those with focal brain lesions caused by trauma, degenerative disease or any other cause are excluded;
    • No infectious disease or need for continuous medical care in healthcare institutions.
  • The CRE for psychosocial care for people with serious mental illness and their families (CREAP. Valencia)

    Founded and governed by Order SSI/2416/2014 of 17 December 2014.

    Admission conditions or requirements:

    • Be a patient with a serious and prolonged mental disorder, confirmed by a report issued by their mental health team of origin;
    • Be a beneficiary of the social security system or entitled to social services by law or international convention;
    • Have a recognised situation of dependency at any level, or a recognised disability of 33% or more, or be in the process of having either case recognised, or be at risk of developing either;
    • Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes;
    • Have no transmissible disease in an acute stage and no need for continuous medical treatment in hospital;
    • Not in a stage of active crisis with serious injuries that could disrupt usual life at the centre or prevent them from benefiting from these services, and they must not exhibit serious aggressive behaviour;
    • Be over 18 and less than 65; older or younger ages may exceptionally be admitted, at the relevant team’s discretion.
  • State reference centre for people dependent on others (CREDEI, León)

    The CREDEI was formed and is governed by Order SSI/1189/2015, of 18 June 2015.(Abre en nueva ventana)

    Its purpose is to drive improvement of the quality of life of people in a state of dependency deriving from mental incapacity.

    Conditions of admission:

    • Be beneficiaries of the social security system or entitled to social services by law or international convention;
    • Have a chronic situation of dependency caused by intellectual disability, or at risk of such a situation developing, in the opinion of the interdisciplinary team at the centre;
    • Be aged 45 or over. In exceptional cases, and upon the recommendation of the centre’s multidisciplinary team, persons aged 40 or over may be admitted, provided that the services are likely to be beneficial to the user;
    • Have family or community support. Have sufficient social, family or community support to enable them to stay in their environment;
    • Have no transmissible disease at an acute stage and not need continuous medical treatment in hospital;
    • Have no behavioural changes which would be detrimental to normal communal living in the CRE.
  • The CRE for the health and social welfare of people in a state of dependency (CREDEF, Soria)

    CREDEF was formed and is governed by Order SSI/1190/2015 of 18 June 2015.

    It was founded as an advanced centre for the promotion, development and dissemination of knowledge, innovative experiments and working methods in social and healthcare and family support. It is also a highly specialised centre providing integral multidisciplinary care to people in a chronic or reversible state of dependency deriving from physical disability. It promotes their independence so that they are able to stay in their usual surroundings.

    Admission requirements:

    • Be a beneficiary of the social security system or entitled to social services by law or international convention;
    • Show a chronic or reversible state of dependency deriving from physical disability, or a risk of such a state, in the opinion of the interdisciplinary team at the CREDEF;
    • Be at least 50 years old (at the suggestion of the CREDEF interdisciplinary team, younger ages may exceptionally be admitted, from age 40, provided that their services may prove beneficial to the user);
    • Have sufficient social, family or community support to ensure the ability to stay in their surroundings;
    • Have no transmissible disease at an acute stage, and not need continuous medical care in hospital;
    • And show no behavioural changes which would be detrimental to normal communal living in care homes.
  • The CRE for personal independence and technical aids (CEAPAT, Madrid)

    The CEAPAT was founded and is governed by ministerial order of 7 April 1989.(Abre en nueva ventana)

    As a reference centre, the CEAPAT offers the following forms of support:

    • Analysis, systematic organisation and distribution of information and knowledge;
    • Promotion of research, development and innovation in working methods and techniques;
    • Professional training and cooperation in the development and application of technical standards;
    • Support, advice and technical help to institutions and other resources in the sector;

    The CEAPAT's aims are as follows:

    • To achieve universal accessibility, both in the house and in its surroundings and spaces, to products, equipment and services;
    • To instil a culture of design for all individuals;
    • To facilitate digital interaction;
    • To ensure the active participation and interaction of users and all staff;
    • To encourage the development, knowledge and application of legal and technical standards;
    • To drive R&D and innovation in the fields of accessibility, design, products and services;
    • To offer information, advice, evaluation and training, and manage the knowledge in worthwhile ways;
    • To participate in national and international platforms and forums and facilitate coordination between agencies.

    The mission of the CEAPAT is effectively to implement the rights of disabled and older people, by full accessibility of supporting products and technologies and design to suit everyone.

  • The CRE for care of brain injuries (CEADAC, Madrid)

    CEADAC is a public social and healthcare facility dedicated to the comprehensive and intensive rehabilitation of people with non-progressive acquired brain injury in the subacute phase, promoting their personal independence, and providing support for their families, as well as research, teaching, information provision, documentation, advisory services and consultancy within this field.

    It was founded and is governed by Order TAS/55/2002 (Spanish Official Gazette of 17 January 2002).(Abre en nueva ventana)

    The CEADAC user profile is as follows:

    • Be a social security beneficiary or entitled to benefits.
    • Be over 16 and under 45 years old.
    • Be affected by consequential and non-progressive damage of any origin.
    • Not require specialist medical care or care that cannot be provided at the centre or that exceeds its capacity, nor have behavioural issues that would impede usual shared living in residential care homes.
    • Have medical stability.
    • Be recently discharged from hospital.
    • Have a reasonable prospect of rehabilitation.
    • Have the ability for a minimum level of shared living within the centre.

     

    Objectives:

    • To offer social and health rehabilitation programmes to people who have suffered brain injury and drive the improvement of quality of life of patients and their families;
    • To provide information and technical advice on rehabilitation of an existing brain injury;
    • To offer information and teach professional people about acquired brain injury;
    • To promote and cooperate in research projects in the field of brain injury.

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Information for each Autonomous Community

Mapa de España con comunidades autónomas Acceso al servicio de Andalucía (Abre en ventana nueva) Acceso al servicio de Aragón (Abre en ventana nueva) Acceso al servicio de Balears, Illes (Abre en ventana nueva) Acceso al servicio de Cantabria (Abre en ventana nueva) Acceso al servicio de Castilla y León (Abre en ventana nueva) Acceso al servicio de Castilla-La Mancha (Abre en ventana nueva) Acceso al servicio de Cataluña (Abre en ventana nueva) Acceso al servicio de Galicia (Abre en ventana nueva) Acceso al servicio de Murcia, Región de (Abre en ventana nueva) Acceso al servicio de Navarra, Comunidad Foral de (Abre en ventana nueva) Acceso al servicio de País Vasco (Abre en ventana nueva) Acceso al servicio de Rioja, La (Abre en ventana nueva) Andalucía Aragón Balears, Illes Cantabria Castilla y León Castilla-La Mancha Cataluña Galicia Murcia, Región de Navarra, Comunidad Foral de País Vasco Rioja, La

Andalucía Aragón Asturias, Principado de Balears, Illes Canarias Cantabria Castilla y León Castilla-La Mancha Cataluña Ciudad de Ceuta Ciudad de Melilla Comunitat Valenciana Extremadura Galicia Madrid, Comunidad de Murcia, Región de Navarra, Comunidad Foral de País Vasco Rioja, La

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Authority responsible for the information

Ministry of Social Rights and Agenda 2030
Institute for Older People and Social Services