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1 Market summary

1.1 Market definition and presentation

A nursing home, is a structure that welcomes people over 60 years of age who are physically and/or mentally dependent demanding permanent supervision by a medical team. This medical facility offers individual or collective rooms and also offers assistance with daily life as well as personalized medical care, catering, laundry services, entertainment, etc.

In Portugal, we find the terms of "Lar para idosos" (home for the elderly), which are residential facilities, guaranteeing and providing food, health care, hygiene and comfort. These are also called places of stimulation and cohabitation, where lderly people can spend their free time through social activities. There are also the "Residências para idosos" (retirement homes), which are similar to homes, but with the privacy of a single room or a studio.

The nursing home sector has been growing rapidly over the past 10 years. This is explained by the ageing population as well as the increase in illnesses. This phenomenon is pronounced as binding regulations create a barrier for new entrants. The potential clientele of nursing homes is constantly increasing and new trends are arising, such as premium services, more independency and precautions regarding COVID-19 and flue infections. Institutions must adapt to these structural changes in order to attract people who are still afraid of leaving home. Besides all the difficulties present to enter this market, there is still an enormous margin for it to grow.

1.2 A growing worldwide market

The industry of Nursing Homes and Care Facilities includes continuing care retirement communities and assisted living facilities for the elderly. The former offer personal care (***) in a variety of residential settings and include on-site nursing care facilities. The later, provide similar room, board, supervision, and daily assistance services, but do not ...

1.3 The Portuguese market

Following the world trend, the Portuguese market for retirement homes is becoming increasing, particularly on the Algarve region (***). [***]

The services offered consist mainly of one-bedroom flats or a combination of flats and villas, which can be purchased freehold or leasehold. It is hard to estimate precisely the market for medicalized retirement ...

2 Demand analysis

2.1 New demographics

The medicalized retirement home industry is believed to be strongly influenced by changing demographics. The largest age group in Portugal, indeed, is the one represented by the so called “over **”, which define approximately **% of the entire population. The database from the Portuguese National Institute of Statistics show that this age group ...

2.2 Profile of seniors in Portugal

Senior citizens, who are people over ** years old, are increasingly numerous in Portugal. This is, above all, linked to an increase in life expectancy, which is gradually rising from **.* years old at birth in **** to **.* years old in ****. At the same time, healthy life expectancy at birth has not enlarged in ...

2.3 Where do senior citizens live?

The old-age dependency ratio is the ratio of people older than ** to the working-age population--those ages **-**. Data are shown as the proportion of dependents per *** working-age population. Analysing the old-age dependency ratio by municipality, we notice some concentration at the Northeast of the county, around the regions of Trás ...

2.4 How and how long?

If we look at the distribution regarding how much time the elderly stay at those types of residence, we will notice that the vast majority do not stay more than * years. In other words, the retirement homes indeed happen to be the place to spend the last years of their ...

3 Market structure

3.1 Organization and dynamics of the market

Given the estimated decrease in the population (***), more than **% of the population will then be dependent on third-party care. This worrying scenario is outlined in a report by the European Commission on health care, long-term care and sustainability of public accounts.

In the coming decades, due to accelerated ageing and technological ...

3.2 New trends

Residents wish for more autonomy

If, on the one hand, we find that the main reasons for entering a home are the state of poor health, psychomotor difficulties and lack of autonomy for the activities of daily living, it is also true that, in the current model of home (***), there is ...

3.3 A new refuge for the British

Since ****, European retirees who settle in Portugal are exempt from paying taxes for ten years of the pension they receive in their home countries. This tax relief has seduced thousands of retirees from all over Europe, and a big part of them are the British. It is estimated that there are ...

COVID-19 impact expectations

The unexpected Covid-** outbreak took all the retirement homes managers and employees by surprise, resulting in a high percentage of positive cases and associated mortality rates in several residences around the world. This situation served as an in-depth reflection on this type of institutions, essentially in terms of rethinking its function ...

4 Analysis of the offer

4.1 Historical short of supply

The use of this kind of solution to treat and care for fragile elderly people is somewhat new. In the beginning of the ‘**s only *% of the elderly population had a place in nursing homes. A significant increase in the number of nursing homes units created by the solidarity network took ...

4.2 Great price variance

As one would expect, prices vary according to the amount of nursing care required by the person, to the region’s cost of living and how premium the location is in terms of natural beauty and distance from city centres, for instance. The cost per person may also be reduce in ...

4.3 Segmentation in terms of recovery programs

Some residences may cover some specific treatments or either adapt to all the needs of any potential client. Nevertheless, we tried to segment some areas of recovery that players usually offer to their seniors.

Neurofunctional Recovery

Conducted by a team of physiatrists, neurologists, neuropsychologists, physiotherapists, occupational therapists and speech therapists. A ...

4.4 Included services versus a la carte services

Senior citizens' residences differ from each other in that they offer regarding a certain number of services and activities, in addition to the rental or purchase of housing adapted to senior citizens. An example of an offer is as follows:

Rental accommodation (***) Home purchase (***) Additional services and activities

It is these ...

5 Rules and regulations

5.1 Regulation

The economic activity of a Nursing Home is included in the CAE *** group - Social Action Activities, more specifically in subclass ***** - Social action for elderly people with accommodation.

The main regulations that future and current players should beat in mind are listed below:

Decreenº **/****: about functioning and installation of residential ...

5.2 Medical benefits

Complemento por Dependência

Complemento por dependência, or “supplement by dependency”, is a cash payment given to necessary people and the elderly who are in a situation of dependency, that is, who provides daily help from another person (***).

For this Complement, two degrees of dependence are considered:

*st grade ...

6 Positioning of the actors

6.1 Segmentation

  • Santa Casa da Misericórdia de Alhos Vedros
  • Residências Montepio
  • Monte da palhagueira
  • José de Mello Residências e Serviços (Groupe)
  • Luz Saùde
  • Orpéa Emeis

List of charts presented in this market study

  • Espérance de vie vs espérance de vie en bonne santé à la naissance
  • Difficultés à prendre soin de soi en fonction de l'âge
  • Répartition des types de logements recherchés par les utilisateurs
  • Répartition des séjours en maison de retraite par durée de séjour
  • Evolution du nombre de structures résidentielles pour les personnes âgées dépendantes

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Latest news

Orpea hopes to reinvent itself under the aegis of Caisse des Dépôts - 08/01/2024
  • On December 19, 2023, Caisse des Dépôts et Consignations took control of Orpea with 50.18% of the capital.
  • Orpea's share price fell by 99.7% in 2023.
  • Orpea employs 76,000 people, including 45,000 caregivers, and more than 260,000 residents. Orpea plans to divest 500 million euros a year for three years.
Orpea launches a capital increase of around 3.9 billion euros - 13/11/2023
  • Private nursing home group Orpea plans capital increase of around 3.9 billion euros
  • Orpea's total debt exceeds 9 billion euros.
  • Orpea's financial restructuring includes three successive capital increases, totalling 5.4 billion euros.
  • On completion of the restructuring, a consortium led by Caisse des Dépôts, with Maif, CNP and MACSF, will own 50.2% of Orpea's capital, creditors will own 49.4%, while current shareholders will have 0.4% (if they decide not to participate in the capital increases).
Orpea: Ehpad occupancy rates recover - 07/11/2023
  • Average occupancy rate for retirement homes in France in the third quarter of 2023: 84.4
  • Year-on-year sales growth: +11.1
  • Nine-month total sales: 3.9 billion euros
  • Nine-month sales growth: +10.8
  • Sales target for 2026: 6.4 billion euros
  • Occupancy rate target (clinics and Ehpad) in 2026: 90.8
  • Expected sales in 2023: 5.2 billion euros Expected occupancy rate in 2023: 84% (vs. 81.6% in 2022)
  • Planned capital increases: 3.9 billion euros
  • Share of capital held by the consortium led by Caisse des Dépôts in December 2023: 50.2%.
  • Net debt at the end of 2023: 4.65 billion euros.
Trade unions accuse Orpea of being involved in speculative real estate activities. - 24/02/2022
  • All of the company's real estate assets, located in several European countries and valued by Cictar at 7.4 billion euros, "were acquired and then sold off through complex arrangements involving companies in Luxembourg and the British Virgin Islands, most of which were never disclosed to shareholders or the public", the report states.

Companies quoted in this study

This study contains a complete overview of the companies in the market, with the latest figures and news for each company. :

Santa Casa da Misericórdia de Alhos Vedros
Residências Montepio
Monte da palhagueira
José de Mello Residências e Serviços (Groupe)
Luz Saùde
Orpéa Emeis

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the market for medicalised retirement homes | Portugal

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