Why Senior Living Companies Are Increasingly Interested In International Growth

Senior living operators have long talked about demographics in the U.S. supporting new investments and growth initiatives. Those opportunities also extend to markets overseas, at least for savvy companies.

Like in the U.S., international markets like Canada, China and the United Kingdom have favorable demographics of aging older adults in the years ahead. Recent international deals include real estate investment trust (REIT) Welltower in Canada and CareTrust REIT (NYSE: CTRE) in the UK. Senior living operators including Thrive Senior Living also are interested in markets beyond U.S. shores, such as South Korea, where the company formed a joint venture partnership with a multifamily operator to launch independent living communities in the future.

This pace of international investment stems partly from a lack of senior living options for aging older adults in those places. This has positioned operators and ownership groups taking bold steps to be pioneers in new markets and exporting U.S.-style operating models to older adults living in other countries.

“There’s a real opportunity here to bring what is U.S. senior housing to these markets because a lot of these markets don’t have things like independent living and rental is still a burgeoning and growing area,” said JLL Capital Markets Senior Managing Director Jay Wagner.

Operators including Thrive Senior Living, Priya Living have all taken steps in recent years to export senior living in the U.S., while financial entities like Keppel Capital and JLL Capital Markets look to aid both in-bound and outbound international investment.

Demographic wave ‘a global phenomenon’

Last month, Toledo, Ohio-based Welltower announced plans to acquire a portfolio of communities from Amica Senior Lifestyles in Canada in a deal worth approximately $3.2 billion USD. With the deal, the REIT gained 38 “ultra-luxury” communities and nine development parcels and a minority ownership stake in Amica.

Meanwhile, its REIT peer, Ventas (NYSE: VTR) has reported strong operating results from its 37-community partnership with Canadian operator Le Groupe Maurice, reporting having nearly reached 100% occupancy last year.

At the same time, international capital has its eye on the domestic U.S. senior housing market, with a lot of interest coming from companies based in Asia and the Middle East, according to Wagner.

“Some of it is foreign capital that’s looking to align directly with existing investment managers and then there’s a handful that are looking to form direct joint ventures with operators to get into the sector,” Wagner said.

While REITs continue to expand beyond U.S. borders, a select handful of senior living operators also have their eyes set on international markets, from the Dominican Republic and United Kingdom to China, India and South Korea.

Favorable demographics, affordable construction costs and lower staffing costs are all potential drivers of investing in international markets.

Singapore-based asset manager Keppel Capital, which owns Watermark Senior Living, and the expansive entity has shown interest in expanding investment abroad, including opening an assisted living community in Nanjing, China in 2024.

“The demographic wave is not a U.S. phenomenon, it’s a global phenomenon and it’s occurring all over the place so Keppel understands the demand and, hence, the interest in the Asia markets,” said Keppel CEO of Global Healthcare Kai Hsiao in a recent interview with Senior Housing News. 

Specifically in China, due to the country’s former one-child policy, demographic trends skew older, which has driven demand for senior living options in the country, Hsiao said. Keppel is working with Ping An Insurance Group, a large Chinese financial conglomerate, to establish third-party management opportunities of communities the insurer builds in the future, Hsiao said.

Due to the early success seen at Sindora Living Nanjing Qixia, Hsiao said Keppel is fielding new interest for other investment opportunities within senior living across Asia.

But it’s important to seek value alignment in future partners looking to grow international senior living, Hsiao said, noting that challenges within the industry in-part have been caused by “investor tourists” who might not understand the prolonged lifecycle of a senior living deal compared to traditional multifamily real estate.

“We take a close look at the criteria and who our partners are, ensuring we’re working with those who not only understand the mission but also the complexity of the business. That’s a huge factor,” Hsiao added.

Operators expand beyond the U.S. driven by demand

It’s no secret that there are barriers to entry in senior living, both from an operations perspective and for those looking to invest in the space.

San Francisco-based Priya Living’s endeavor to expand internationally was prompted close to home, with many residents with family members still living in India showing strong interest in being able to visit a Priya community while traveling, according to Priya Living CEO Arun Paul, coupled with demographic-driven demand in India.

“There’s growing demand for communities in India, and of course, a strong domestic market as well,” Paul told SHN. “We initially approached it from the perspective of the U.S. customer, asking how we could better serve them. But as we explored further, it became clear that the need in India is enormous and extends far beyond our original scope.”

Priya Living Flower Valley / via Priya Living Priya Living Flower Valley / via Priya Living

Priya Living opened its first community in India in 2023, Priya Flower Valley in Gurgaon followed by Priya Living Hyderabad, which opened earlier this year.

Priya’s development push in India is also driven by demand from families in India seeking quality senior living options. From the company’s perspective, building in India and staffing up communities there is favorable from a cost and staffing availability perspective, Paul added.

Later this year, Priya will open its latest community in Ahmedabad, India, the company’s third project in India, with five additional communities planned across five Indian cities to begin construction throughout 2026 and beyond, Paul said.

Atlanta, Georgia-based Thrive Senior Living has established relationships in the UK and Asia, establishing a 12-community portfolio in England and has recently launched a new management platform in South Korea with the country’s largest multifamily operator, GH Partners. The company’s efforts in Asia are concentrated through a holding company in Singapore due to favorable tax standards in the country.

Thrive Senior Living also has participated in consulting work for companies in Thailand, and opportunities have opened up in Asia, according to CEO Jeramy Ragsdale.

“The idea of rental real estate is new, and it’s exploded. It’s becoming extremely popular in sort of a barbell fashion in South Korea, with younger people and with seniors. The challenge in South Korea is there are no operators for senior living,” Ragsdale said.

Entering markets in Asia, Ragsdale said, poses significant challenges as there aren’t many existing senior living options, making any companies in the region a “pioneer,” with no pre-established “commercial real estate food group” for senior housing.

In order to overcome unfamiliarity with rental senior living options, Ragsdale said it was essential to develop relationships with organizations in-country to build out an investment or development pipeline.

Moving forward, Thrive is “actively engaged” with potential projects in Malaysia, Thailand, Philippines and Vietnam outside of South Korea. In Asia, Ragsdale sees opportunity in providing independent living and residential options in lower acuity senior living across Asia.

“The only solution is spending time with [partners] on the ground, in-person and burning up the air miles going back and forth,” Ragsdale said. “That’s made a huge difference.”

In the short term, Wagner said that while there won’t be a flood of international investment inbound from foreign-based investors or outbound investment by U.S.-based senior living providers, he expects interest to grow in the years to come as demographic needs demand more senior living on a global scale.

“I think that ultimately there will be some additional transaction activity over the next year or two, but not on the same scale as what just transpired [with Welltower],” Wagner said.

The post Why Senior Living Companies Are Increasingly Interested in International Growth appeared first on Senior Housing News.