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The Cuban government has defined a set of detailed regulations governing how the private sector can open and operate nursing homes and care centers for vulnerable individuals. These regulations establish strict requirements, constant state oversight, and clear limits on their operations.
The provisions were included in the Resolution 247/2025 of the Ministry of Public Health, published in the Official Gazette No. 35 on April 21, 2026.
The regulation, signed by Minister José Ángel Portal Miranda on November 18, 2025, outlines what was previously approved by the Council of Ministers to allow the participation of so-called "non-state economic actors" in this type of service.
According to the document itself, the goal is to "establish the premises for the operation and control of care services authorized to be offered by non-state economic actors", in a context characterized by the rapid aging of the Cuban population and the insufficiency of the state system.
A private sector under strong state supervision
The resolution clearly outlines the scope of the regulation from the outset: “its purpose is to regulate the operation and control of care services to be offered by non-state economic actors,” both natural and legal persons.
One of the first filters will be administrative.
Those interested must request authorization, and local authorities will have a short period to respond: “the municipal health directors […] issue, within five days, the endorsement certifying compliance with the preliminary requirements”.
This endorsement will be essential, along with the health license and the training certification of the staff.
Strict requirements for opening residences
The document sets conditions that range from infrastructure to staff training.
Among them, the requirement for adequate facilities: “to have a premises with a sound construction structure, free of architectural barriers, with an enabled service for electricity, drinking water, adequate lighting, and ventilation”.
Amid the country's energy crisis, a key obligation is included: "to have an alternative system for obtaining electric energy independent of the national energy system."
It is also required that the staff assigned to the care of the elderly be certified "by caregiver schools", a training that will have an official cost of 500 Cuban pesos according to another resolution published in the same Gazette.
Additionally, the regulation includes a mandatory social component: "to allocate at least ten percent of capacity to address needs driven by social interest".
How private nursing homes will operate
The resolution acknowledges three modes of operation.
From 8:00 am to 6:00 pm, and the beneficiaries do not stay overnight at the facility.
2- The permanents "work twenty-four hours."
3- There is a mixed option that combines both.
In all cases, a limit is set: "to establish a maximum capacity of sixty people to be cared for per location".
The text emphasizes the rights of the beneficiaries, establishing as a principle “to guarantee respect for the dignity and self-determination of the beneficiaries”, prohibiting “engaging in acts of discrimination, violence, or mistreatment”.
Mandatory integration with the healthcare system
Although the services will be managed by private entities, they will be integrated into the state system. The residences will be considered “a closed community within the health area where they are located”.
To enter, residents must present a medical report, a summary of their medical history that includes a general assessment of their health status.
They will not be admitted if they have uncontrolled infectious diseases or conditions that require hospitalization.
Medical supervision will be periodic, once a month, in addition to annual check-ups in other specialties.
The State also maintains a clear limit: “Medical care is part of the free health services guaranteed by the System; these are not included in the fees”.
Inspections, control, and sanctions
The monitoring system will be rigorous.
During the first year, the centers will be under constant surveillance to monitor the service's operation, with a monthly frequency during the first year; after this period, supervision will be quarterly.
Authorities must act in the face of irregularities if "anomalies, irregularities, or manifestations of violence, mistreatment, or discrimination are detected."
Sanctions may include the closure of the business.
The regulation warns that “the proven acts that violate dignity, self-determination, security, health, and quality of life" are sufficient grounds to revoke the authorization”.
A necessary step in the face of the collapse of the state system
This regulation occurs in a critical context.
The government itself has acknowledged that it lacks sufficient resources to support the vulnerable population, while the state care system shows signs of serious deterioration.
The opening up to the private sector responds to growing demographic pressure: Cuba is the most aging country in Latin America, with a public system unable to meet the demand.
The existing social programs barely reach a portion of those in need, which has forced the State to seek support from non-state actors.
However, the opening comes under strict administrative, health, and economic control.
In practice, the new legal framework creates an opportunity for the private sector, but under strict conditions that could limit its expansion in an already complex economic environment.
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