Abstract
<title>Abstract</title> <p>Background Bedroom configuration is a material condition of privacy, dignity and quality in residential long-term care. Although many European long-term care systems have moved towards greater single-room provision and reduced acceptance of multi-bed accommodation, empirical evidence on regulatory compliance with bedroom standards remains limited. This study examined compliance with bedroom configuration requirements in Portuguese residential long-term care facilities. Methods A national cross-sectional online survey was conducted with directors of residential long-term care facilities in Portugal. The analytical sample included 332 facilities with at least 21 residents, to which proportional bedroom configuration rules apply. Conservative estimates of the proportion of single and triple-or-more rooms were derived from categorical survey responses. Four logistic regression models examined non-compliance with the minimum requirement of 20% single rooms, non-compliance with the maximum threshold of 20% triple-or-more rooms, simultaneous non-compliance with both current requirements, and compliance with an earlier, more demanding 50% single-room benchmark with no triple-or-more rooms. Results Non-compliance with current bedroom configuration standards was common. Overall, 24.7% of facilities failed to meet the minimum requirement of 20% single rooms, 25.9% exceeded the maximum threshold of 20% triple-or-more rooms, and 37.7% failed to meet at least one of the two current regulatory standards. Only 14.8% would have complied with the earlier 50% single-room benchmark with no triple-or-more rooms. Lower price levels and larger facility size were associated with insufficient single-room provision. Simultaneous non-compliance was also associated with lower price levels, larger facility size and lower person-centred care scores. Conclusions Bedroom configuration should be treated as a structural dimension of residential long-term care quality rather than a minor architectural requirement. In Portugal, non-compliance remains common despite relatively permissive standards, suggesting that privacy-oriented regulation needs to be aligned with provider capacity, infrastructure renewal and quality assurance.</p>