In the Fuenfría Valley of Madrid’s Guadarrama Mountains, you will discover a true treasure of healthcare architecture: the La Fuenfría Sanitorium, designed by Antonio Palacios, now called the La Fuenfría Hospital, is a medium- and long-stay centre belonging to the Madrid Health Service (SERMAS).

Inaugurated on 1 December 1921, the La Fuenfría Sanatorium was built to treat one of the main causes of death in 19th century Europe: tuberculosis. The most important and successful school of thought that emerged in treating the disease promoted the construction of sanatoriums in mountainous areas. The clean, dry, cold air and high-altitude conditions had proven to be beneficial for the treatment of the disease.

These mountain sanatoriums, which proliferated throughout Europe, relied on exposure to mountain air, sunshine, rest, gentle exercise, and abundant food as the mainstays of patient treatment.

Interior of the La Fuenfría Sanatorium, taken from one of the original advertising brochures from the 1930s. Antonio Palacios. Photograph property of the La Fuenfría Hospital.


Antonio Palacios, a renowned Spanish architect of the first half of the 20th century, left a significant mark on healthcare architecture through his innovative and functional approach to the design of hospital facilities. In addition to the La Fuenfría Sanatorium, Antonio Palacios designed the Maudes Hospital in Madrid, originally called the Day Labourers Hospital, located in the Chamberí district.

To celebrate Architecture Week, the Official Architects’ Association of Madrid (COAM) is hosting a monographic exhibition about Antonio Palacios. The exhibition shows the importance of the architect whose projects are essential for understanding the city of Madrid.

Palacios prioritised the health and well-being of patients by considering the distribution of spaces with strategic orientation to maximise natural light and ventilation, fundamental elements in the treatment of tuberculosis. The layout of the rooms and common areas encouraged social interaction and therapy through cohabitation.

One of the most important architectural elements for patient recovery was the incorporation of terraces in each of the rooms. These spaces connect patients and their families with nature and the environment and have remained practically unchanged to this day.

Exterior of the La Fuenfría Sanatorium, taken from one of the original advertising brochures from the 1930s. Antonio Palacios. Photograph property of the La Fuenfría Hospital.


Originally, the centre was built on a 2.2-hectare plot of land surrounded by the natural beauty of the Guadarrama Mountains. It consists of a building measuring 6,492 m2, divided into four care floors and a management and central services floor measuring 2,900 m2. A 600-m2 annex building houses the general and management services as well as an assembly hall located in a separate building.


The La Fuenfría Sanatorium is not only an example of the healthcare buildings that arose at the beginning of the last century, but also shows how architecture adapts to change.


Between 1995 and 1998, the remodelling of the hospital area was carried out, which helped adapt and improve care and accommodation needs. The La Fuenfría Hospital has 226 beds distributed in 6 hospital units. Services include a radiology room, pharmacy, rehabilitation room, and support services.


The centre’s architecture facilitates natural light and ventilation because of the orientation of the terraces. From here, patients can be closer to nature and find the calm and relaxation that is key to their recovery. These elements of the centre’s architecture have served as an example for various contemporary projects: Palacios continues to be a benchmark for healthcare projects.


The La Fuenfría Sanatorium stood out not only for the way it treated patients with the latest technologies available, but also for its educational work. The discovery of the first antibiotic capable of treating tuberculosis during the 1950s was a major milestone. Patients were taught healthy habits and, among other things, how to implement preventive measures to avoid infection with their fellow patients.

Patients outside the La Fuenfría Sanatorium. Antonio Palacios. File photo.


With more than 100 years of history, the La Fuenfría Sanatorium has been used to treat everything from respiratory diseases to Covid-19 and is now part of the Madrid Health Service (SERMAS).


The current La Fuenfría Hospital also serves as a referral centre for other patients in the Madrid region who require longer stays for recovery. The rehabilitation of stroke patients, the treatment of chronic diseases, and palliative care have become the centre’s regular activities.


Faithful to its original spirit, the La Fuenfría Hospital continues to prioritise tranquillity, convenience, and comfort in the incomparable surroundings of the Guadarrama mountain range. In contrast to the facilities of other hospitals, each of the rooms at the La Fuenfría Hospital is painted in a different colour. The bright, cheerful, and varied colours, together with the terraces in each of the rooms help patients recover.


The healthcare managers of the centre and the Madrid Health Service, promote patient recovery based on the humanisation of spaces. Among its latest innovations, the La Fuenfría Hospital has decided to focus on food as a differentiating element. Hospital food is also an important area that impacts patient recovery.


Patient on their terrace in what is now the La Fuenfría Hospital. Photograph by Félix Lorrio.