How do operators view the care real estate market?

Cushman&Wakefiled has published “CARE REAL ESTATE OPERATOR SURVEY 2023”

Care properties have become increasingly popular with investors in recent years. The linchpin of this particular market are the operators, who create a differentiated range of care provision for a wide range of needs and continuously adapt this to changes in social, structural and regulatory requirements. These have intensified again in the past year: for example, digitalisation, stricter ESG requirements and personnel shortages were joined by further reporting obligations, massively increased energy costs and the new Tariff Compliance Act.

“The demand for high-quality care operations is steadily increasing due to demographic change. Nevertheless, some operators have adapted their expansion plans to the difficult market conditions,” – comments Jan-Bastian Knod, Head of Residential Investment Germany, Head of Healthcare Advisory at Cushman&Wakefield.

The company asked 30 operators of nursing homes, outpatient facilities and assisted living about the trends, challenges and opportunities in the current market. Operators Lively and Aiutanda provide particularly deep insights in interview.

  • What is the attitude of operators towards the reporting obligations increasingly demanded by owners?
  • To what extent is there openness towards sustainability goals?
  • How do operators deal with higher energy prices and inflation-related rent increases?
  • What role does digitalisation play in care facility operations?

Read the full report: CARE REAL ESTATE OPERATOR SURVEY 2023

Threestones Capital acquires German retirement homes

Threestones Capital acquires German retirement homes

Luxembourg-headquartered Threestones Capital has acquired two retirement homes in Cologne and Künzell from companies belonging to the Huk-Coburg insurance group.

Berlin-based investment and asset management company TSC Real Estate, which specialises in property for healthcare, senior citizens and life science, advised Threestones on the acquisition of the so-called Ginkgo portfolio.

The facility in Cologne (pictured above) is located in the Kalk district close to the city centre and consists of 40 assisted-living apartments and 80 in-patient care beds. The facility was built in 2002 and is operated by a not-for-profit organisation.

The second property (pictured below) is located in Künzell in the state of Hesse. It is an in-patient nursing care facility and comprises 118 beds, primarily in single rooms.

“We are pleased that in these challenging times we have once again been able to successfully initiate and conclude a structured transaction process,” said TSC Real Estate team lead investment management, senior investment manager Maximilian Woiczikowsky.

The buyer was advised by KL Gates, JLL, Savills and Immotiss. CBRE functioned as the broker. GSC Stockmann was the seller’s legal adviser.

Author: Paul Strohm

Source: Real Asset Insight

Savills: UK Care Home Development

Spotlight: UK Care Home Development

Care Homes have proven to be a countercyclical real estate asset class, performing strongly in economic downturns, according to Savills’ latest report.

KEY POINTS

144,000 additional care home beds needed to meet population growth in the next 10 years

The number of people aged over 80 in the UK is forecast to increase by 1.1m between 2022 and 2032, to 4.5m. With life expectancy no longer increasing, the ratio of over 80s to care home beds is a good proxy for demand and indicates the need for an additional 144,000 care home beds over the next 10 years, or 14,400 new beds per annum, just to keep pace with population growth.

c.30,000 care home beds in development pipeline by 2032

There are currently 132 care homes, comprising c.5,900 beds, under construction, of which 65 are expected to complete in 2023. Looking further ahead, there are an additional c.23,300 beds at different stages in the planning system.

It is estimated that 95% of these beds will be delivered by 2032, which will equate to c.3,000 per annum and help meet the mounting need. However, there remains a significant lack of new supply coming forward to meet future demand, highlighting the very strong case for increased development.

175 days to secure planning permission in 2022 – although the planning process is getting faster, it still presents a hurdle

In 2022 there were 221 applications for new care homes across the UK: 46% of these have secured planning permission to date and on average took 175 days to progress from application to permission.

This is down from an average of 252 days in 2017, indicating some progress in reducing planning timelines.

Only 14,500 care home beds delivered since 2020, and the sector remains significantly undersupplied

Across the country around 300 new care homes have been completed since 2020, adding an additional 14,500 beds. Close to half of these new beds are in London, South and East England.

The new delivery equates to an average of c.3,900 beds per annum, which is less than one-third of the 14,400 beds needed to maintain current ratios, given population growth.

c.66% of new development planned in London, South and East England

The majority of pipeline is coming forward in South and East England, driven by higher levels of housing wealth, which underpins the ability of residents to pay for private care.

However, this also highlights a challenge facing the sector in terms of how to deliver much-needed care homes in less affluent markets.

61% of care homes have an EPC C or above

The majority of existing care home stock has an EPC Grade C or above, putting the sector in an advantageous position compared to the broader residential market, where only 40% of homes meet or exceed EPC Grade C. In the short term, this positions care homes favourably to comply with forthcoming energy efficiency regulations, which are slated to mandate a minimum EPC Grade C by 2027.

However, regulations are then expected to tighten further to require an EPC Grade B from 2030, which will create a need for further investment in, or potentially the replacement of, approximately 70% of existing care home stock, intensifying the focus on ESG and Sustainability standards for new developments.

Read the full report: Spotlight: UK Care Home Development

The Future of Serviced Living: The 3rd Annual Senior Living Conference

Serviced Living is growing in importance and is being recognised by policy makers as an important component in the planning of urban neighbourhoods. If you want to find out more about future developments and business opportunities in the sector, don’t miss the 3rd Annual Senior Living Conference.


Taking place on 18-19 October at the SZ Tower in Munich, Germany, the conference promises inspiring presentations, interactive workshops and networking opportunities. Experts such as Dr Philip Huperz from GSK Stockmann will show you how to incorporate ESG requirements into your projects in compliance with regulatory requirements. The AEGIDE Group, presented by Julien Claude, will showcase successful international implementations of serviced housing.


The event will also focus on sustainable supply concepts for demographic change in urban environments. Prof. Dr. Harald Rau will present the Future Project Cologne, showing new ways in healthcare real estate.
The conference programme covers a wide range of exciting topics, including the integration of serviced housing into urban and regional planning, cost-effective solutions in cooperation with construction companies and the implementation of co-living models with senior citizens. Flexible and digital service delivery will also be on the agenda.


Get a head start on your knowledge with world-class presentations, high-profile speakers and exciting discussions. You can also take advantage of the Early Bird Offer until 14.08.2023, which will give you a €200 discount on your ticket to the event.


We look forward to opening up new perspectives and bringing you together with some of the leading minds in the industry.


To find out more and register, please visit [link] https://www.sv-veranstaltungen.de/de/senior-living/

Senior Housing & Healthcare Summit 2023

Betting on a “social premium”

The care home sector can be the perfect testing ground for impact investing

Investing with purpose is a conviction play at the moment, as social impact is difficult to quantify and measure and there are no specific regulations yet. But experts believe that it’s not just the right thing to do but it will also deliver dividends, a “social premium” just like the green premium that sustainable buildings enjoy.

“At the moment it’s very intangible value, but over the long term it will make a big difference and impact investors will get the premium and the others will get the discount”, Amand-Benoit d’Hondt, Chief alternative investments &sustainability officer, AG Real Estate, told the recent Senior Housing and Healthcare Association (SHHA) Summit.

The EU Social Taxonomy will help push companies in the right direction, but it’s still work in progress. In the meantime, “we need to make the right bets and hope that the market will recognise the difference”, said d’Hondt. “It may well happen faster than many anticipate”.

In senior housing and care homes, many elements need to be combined to achieve that goal of having content, cared-for residents; a happy workforce that feels valued; capable and skilled operators; quality buildings and interiors and a pleasant and healthy environment.

Well-designed spaces

Architecture can play a major role, said Graham Place, CEO, Box Architects: “In the design phase we have a really good opportunity to make a difference to the social aspect and there is more social value being delivered already than many realise. It’s already happening on the ground”.

Positive social impact can be achieved in the design phase, through the process of delivery and then throughout the lifespan of the asset.

“It’s all about human-centric design”, explained Place. “Our behaviour is heavily influenced by the environment we’re in, so good design, the colours used, the light can change our mood and impact our ability to flourish”.

Little things can make a big difference, like letting in daylight, making sure the orientation is correct, having a window that actually opens, having an electrical socket that isn’t so far down the wall that you have to bend down to reach it.

Care homes could and should follow the example of the office sector, Place said: “In that market the operators are building more and more facilities for the people who work there, putting in canteens, gyms, crèches, cafes, bars, wellness centres, prayer rooms and so on. In care homes our brief restricts us a small staff room somewhere, a tea point, when we should be putting in gyms and wellness spaces that both staff and residents can use”.

Attracting and retaining staff

Improvements must be made, he said: “If we want to attract more people into this sector we need to make their working conditions better”.

As finding and retaining staff is a big challenge across European markets, addressing this issue can determine the viability of a business as well as ticking the social impact box.

“It’s a good investment that makes financial sense”, said Sébastien Berden, CIO, Cofinimmo. “Good design has such an impact on the wellbeing of staff and of residents, on the way the facility works and also on the community. I think we’ll see an acceleration of obsolescence of badly designed buildings”.

It is useful to ask employees about their experiences at work to make them feel valued and to spot any potential issues before they become big problems. “Satisfaction surveys are very important and must lead to action plans”, said d’Hondt. “It’s important to realise it’s not the paycheck at the end of the month that matters, but the atmosphere and culture of the place and the training they get”.

Surveys can also be useful in assessing residents’ satisfaction.  

“We try to measure the wellbeing of our tenants”, said Judith Tillie, Property management manager, Woonzorg Nederland. “We do regular surveys and we learn a lot from their feedback. For example recently we found that a nice view was important to them and would contribute a lot to their wellbeing. But the most important thing is creating a sense of community, which is why we have developed several co-living concepts so that people can keep each other company and look after each other”.

Whether it’s doing gardening or cooking, residents enjoy doing things together. Several studies have shown that social interaction can improve physical as well as mental wellbeing, so the trend now is to “de-cluster” senior living and move away from isolated and isolating facilities.

“There are many successful pilots where nursing homes are integrated with a mix of other care services like assisted living or ambulatory care”, said Berden. “So you create a constant flux of people coming into your facility and bringing in a bit of life. Isolation and loneliness are a big problem, so making the place more lively increases residents’ satisfaction and sense of wellbeing”.

Senior Housing & Healthcare Summit 2023

Demand for care homes rises rapidly

Care-home provision in Europe is falling despite the fact that demand is increasing greatly, delegates heard at the recent Senior Housing and Healthcare Summit, organised by SHHA and EPRA.

“At the moment, there’s an inability to meet the needs of people, as the availability of care-home beds is falling in many countries,” said Richard Valentine-Selsey, head of European living research and consultancy at Savills.

“However, more investors are willing to deploy capital in the sector. Being realistic, we’ll have to wait, but next year we should see a real turnaround.”

The number of beds in residential long-term care has increased in the Netherlands, Sweden and Germany, but it has declined in France, Austria, Ireland and the UK. Denmark, Italy and Poland have experienced the sharpest, two-digit falls.

Europe’s population is ageing fast. The percentage of the population over 65 years of age varies from a low of 12% in the Netherlands and 15% in Ireland to 22% in Portugal and Germany and a high of 23% in Italy. Demand for care homes will grow rapidly as the number of over-65s is set to rise in all countries over the next two decades.

Market fragmentation

The fragmentation of the market is an obstacle to provision, Valentine-Selsey said, with very little concentration of ownership in most countries. The UK is in a unique position, with over 80% of the market in private hands. Germany hovers around the 40% mark, while the Netherlands, Spain, Italy and France are around 20% or below.

The good news is that investment across senior housing and healthcare continues to increase as a percentage of all investment in the living sector and has now reached 13%. While, in the past few years, care homes attracted more capital than senior living, in Q1 2023 the investment was split evenly between the two for the first time.

The UK and Germany have been the most active markets in the past 12 months, accounting respectively for 30% and 28%, far ahead of France at 11%, Sweden, Italy and Spain at 4% and Portugal at 1%.

care homes
Source: OECD *latest year of data available: Germany is 2019, Denmark, Ireland and Italy are 2021 and the rest are 2020

Across Europe, investment activity in the sector has been driven by cross-border capital, a mix of institutions, private and REITs, which has accounted for 42% of the total. The capital has come primarily from France and Belgium, but also from the US, UK, United Arab Emirates, Switzerland and Luxembourg.

“Investors are attracted by the consistent annual returns that healthcare provides,” said Valentine-Selsey. “In France, one-year returns are close to 10%, in Germany and Sweden five-year returns are over 8% and, in the UK, 10-year returns are over 7%.”

Increasing allocations

In the next three years, investors aim to increase their allocations to the broader living sector, according to a Savills survey. Most are targeting multi-family, purpose-built student accommodation and co-living, but 43% are opting for senior living. Care homes, which are seen as a more niche subsector, spark the interest of only 24% of investors.

“Those who are targeting the sector are looking to deploy a significant amount of capital,” said Valentine-Selsey. “Around 33% of investors are aiming to deploy €100-€500 million in care homes, while 11% are willing to invest between €500 million and €1 billion, with another 11% ready to deploy over €1 billion.”

Most investors are keen to pursue pan-European strategies, according to the Savills survey, but there are barriers that need to be overcome to unlock that investment.

“The biggest barriers are the pricing and return profile, access to stock and scalability, regulatory risks and operational risks, while lack of familiarity with the sector is not seen as a barrier at all,” said Valentine-Selsey.

“In the short term, there are some headwinds facing the sector, but the long-term fundamentals remain strong,” he concluded.

Source: Real Asset Insight

Northern Horizon buys Danish aged care home portfolio

Northern Horizon buys Danish aged care home portfolio

Northern Horizon is acquiring a portfolio of six care homes and linked assets from NREP in what will be Denmark’s largest care home transaction to date.

In addition to the care homes, the portfolio includes two kindergartens, 23 senior living units and the assets are a mix of new space and buildings under construction.

“The acquisition is a prime example of our investment strategy,” said Northern Horizon co-fund manager and investment director Denmark Kasper Wehner. “The assets are modern and well-located in Danish growth cities, long lease agreements ensure stable cash flows and, being new, the assets respond well to the high sustainability targets that we have set for the fund’s portfolio,” he added.

The acquisition was made on behalf of the Northern Horizon-managed Aged Care IV fund, which has a total investment capacity of €648 million and already has 17 care homes in the Nordics.

Its previous largest acquisition was a portfolio of aged care properties in Sweden, acquired from SBB in 2022. With this transaction, the fund is 75% deployed.

The latest assets are located in Holte (pictured above), Odense, Sorø, Greve, Helsinge, and Kolding and have a total lettable area of 39,502 sq m. Most of the assets will be taken over in 2023 but possession of the last asset is expected in May 2025.

Since 2007, Northern Horizon has acquired more than 130 care homes across the Nordics.

Author: Paul Strohm

Source: Real Asset Insight

One of the healthcare properties just acquired in Flanders

First healthcare acquisitions in Benelux for BNP Paribas REIM

BNP Paribas Real Estate Investment Management Belgium announced yesterday it has acquired from Baltisse Real Estate five healthcare properties in Flanders with a total area of 33,000 sq m and a combined capacity of 510 beds.

One of the healthcare properties just acquired in Flanders

Four of the properties are located close to three major cities – Brussels, Antwerp and Ghent – while the fifth is in Maasmechelen, not far from Maastricht and close to the Dutch border. The acquisition was made on behalf of Healthcare Property Fund Europe (HPF Europe), managed by BNP Paribas REIM, which aims to provide diversification in the healthcare sector in Eurozone countries.

“HPF Europe continues to expand its healthcare portfolio via this off-market transaction, which is the fund’s first acquisition in the Benelux region,” said Casper van der Woude, director, BNP Paribas REIM Belgium. “This acquisition fits perfectly with the fund’s strategy to diversify geographically in the Eurozone. We are extremely pleased to have purchased this nursing home portfolio that meets the needs of the continuing ageing population in Belgium.”

The nursing homes are being operated by renowned and reliable specialists. Triple net agreements were concluded for all assets, of which the average remaining term is approximately 20 years. They are all fully indexed on a yearly basis.

BNP Paribas REIM’s strategy is based on three main pillars: investing in different types of healthcare real estate, having a wide geographical exposure in Europe and establishing a long-term partnership approach with operator tenants.

After investing in the healthcare real estate sector since 2011, the group has a portfolio of around 80 properties in Europe. Ten health establishments are currently being built or extended in Spain, Germany, Italy and France, with a view to developing the healthcare offer.

HPF Europe, which was launched in March 2020, has reached two milestones: €1 billion in inflows and €2 billion in investments and disposals.

2022 was a strong year for the fund, with around 30 new acquisitions of healthcare facilities in Spain and Italy in the long-stay nursing home segment; in France, in short and medium-stay clinics and hospitals and in the long-stay nursing home segment; and in Germany, in the medium-stay clinics and long-stay nursing home segment.

 “We are keen to develop our healthcare portfolio in 2023 and to continue building resilient and sustainable investment strategies in Europe, notably through HPF Europe,” said Paul Darribère, head of fund management, BNP Paribas REIM France. “Our expertise and conviction in this market also makes it possible for some of our funds to diversify into the healthcare sector, which looks to be one of the most resilient, given its fundamental and a-cyclical features.”

Author: Nicol Dynes

Source: Real Asset Insight

Belgian firm Care Property Invest acquired a facility at Skibbereen, Ireland, in January.

Irish care sector jumps hurdles to post record 2022 volumes

The Irish Nursing Home market saw record investment in 2022 despite the challenges faced by the operators in the sector, according to CBRE research.

According to the report, Irish Nursing Home Market Owners, Operators, Investment, these challenges included steeply rising energy costs, rent increases linked to CPI, alongside growing labour shortages and staff costs. 

According to Maureen Bayley, director of the healthcare team at CBRE Ireland there was significant pressure on smaller nursing home operators in particular and 16 closures were noted in 2022, nationwide.

She pointed out that investment deals in Ireland’s nursing home sector continue to originate from European operators, backed by real estate investors seeking to increase their foothold in the market. 

CBRE said that due to the limited availability of good quality standing stock, “investment into the development of purpose-built, future-proofed homes will prove an increasingly popular pathway to bed acquisition”.

However, Ireland lacks healthcare developers, the firm said, and any that test the market with initial schemes require substantial capital in order to overcome barriers to economic development such as exceptionally high build costs and high land prices.

Projects located outside Dublin have “weak viability” owing to the mechanics of the Fair Deal rate system, Bayley added.

However, investor appetite for forward funding and forward purchase opportunities, coupled with yield compression in 2021 and early 2022, did see some new schemes completed, she pointed out.

“Looking into 2023, we expect continued investor interest in the sector, given its defensive nature, however elevated construction costs and the increased cost of capital, alongside yield expansion, could prove a challenge to executing forward-structured transactions.”

Author: Paul Strohm

Source: Real Asset Insight

assisted living development in Saarbrücken

Saarbrücken assisted living buy broadens spread for AIF fund

Alternative investment fund specialist AIF Capital Group has acquired an assisted living development in Saarbrücken, Germany from the developer, IFA Gesellschaft für Immobilien.

The planned residential quarter, known as Am Anger, has been bought for the open healthcare fund AIF Fürsorge I which now has nine assets. AIF stated that the acquisition will diversify the fund’s spread of locations and operators. IFA Gesellschaft für Immobilien specialises in commercial and healthcare real estate.

The property occupies a 4,400 sq m site and consists of three buildings with a total rental area of around 6,300 sq m. It will provide 84 apartments ranging in size from 45 sq m to 170 sq m.

Construction will be according to the KFW Efficiency House 40 standard. Completion is scheduled for 2023.

Daniel Wolf, managing director of AIF Management said the acquisition will further diversify the healthcare portfolio. “Demand for the assisted living segment is increasing. The living conditions of the older generation and the individual need for support are very heterogeneous. The various housing and care offers for seniors will therefore be further differentiated in the future.”

AIF Capital was legally advised on the transaction by Mayer Brown and on technical due diligence by CBRE. The price was not disclosed.

Author: Paul Strohm

Source: Real Asset Insight