Slated for completion in 2028, the 190 bed (with 50 long-stay beds for ALS patients) facility is a comprehensive reworking of the old Puerta de Hierro medical clinic (1964) designed by Catalan architect Josep Bosch Aymerich. Per the firm, the roughly $93.5 million project will preserve the architectural identity of the S-shaped mid-century structure—somewhat of a local landmark—while upgrading facilities, accessibility, and energy performance to contemporary standards. Reflecting a “deliberate shift from acute-care logic to long-term inhabitation,” the project was approached not as a conventional hospital but as a “place designed for time: prolonged stays, daily routines, family presence, and emotional resilience.”

Image © Luis Vidal + Architects

Operated by the Community of Madrid Autonomous Government, the city’s future ALS hospital will uniquely integrate advanced medical treatment, rehabilitation, long-term residential support, and family care under one roof, with facilities that include a day center, therapy and rehabilitation areas, and a therapeutic swimming pool. Auxiliary buildings at the site of the old public hospital, which has since relocated to a modern facility in Madrid’s Majadahonda municipality, will be replaced with outdoor gardens spanning about 129,000 square feet. The existing building’s reorganized interior spaces will receive abundant daylight with a central atrium serving as both an “orienting element and a social core.”

“We have shaped this building to provide care, warmth, and comfort to those living with ALS and to the families who walk beside them, creating calm and stress-free designed environments,” said Vidal.

Madrid’s move to incorporate this comprehensive, ALS-focused facility into its public healthcare network is a stark departure from the typically fragmented—and frequently privatized— approach to caring for complex neurological diseases. “This is not just a new building,” a senior healthcare official involved in the project explained in a statement. “It is a new model of public care for patients whose needs extend far beyond acute hospitalization.”