Healthcare Vital Signs

Globally, we observe a substantial increase in cross-border consolidation amongst private pan-European groups such as Orpea or Korian, competing with more national groups such as HC-one in England, Ballesol in Spain or Kursana in Germany. MARKET TRENDS Local markets begin to place more limitations around private care home development: Operators have begun to explore more creative ways of expansion: entering untapped markets (like China and Brasil for Orpea) and diversifying services (nursing, care homes and serviced-flats). RETIREMENT HOMES RECENT M&A (2016 & 2017) Market maturity varies a lot depending on the countries: the most mature ones are France and Germany with sale & lease back strategies and consolidation of large portfolios between active investors in the care homes market. Markets are less mature and more fractured in Southern and Eastern Europe, where Operators are still most often the owner of the real estate with independent Operators owning one or two facilities. We begin to observe a consolidation of those markets, with small Operators being bought by market leaders, which are often bought afterwards by largest foreign Operators (Korian, Orpea). 18 | CUSHMAN & WAKEFIELD