Senior Care

Healthpeak Properties raised its full-year 2026 guidance for the second time this year, now expecting diluted earnings per share of $0.48 to $0.52, up from $0.46 to $0.50, and diluted FFO as Adjusted of $1.73 to $1.77, two cents higher at the midpoint than its prior outlook. The healthcare real estate owner signed 1.6 million square feet of new and renewal leases in the quarter, lifting outpatient medical occupancy 20 basis points to 90.7% and lab occupancy 80 basis points to 78.5%. Growth was led by Janus Living, the senior housing operator Healthpeak controls with a 73.6% stake, where revenue jumped 45% year over year to $216 million and Adjusted EBITDA rose 34% to $79 million, with same-store margins expanding 250 basis points. Healthpeak funded buybacks and debt paydown largely by selling stakes in existing buildings, including July's recapitalization that sold a 49% stake in an 86-property outpatient medical portfolio to Brookfield for roughly $1.025 billion at a 5.9% cap rate, part of $1.4 billion of proceeds generated in the quarter and through August 3. Lab same-store net operating income fell 3.2%, the only one of Healthpeak's three core businesses to shrink, holding total company-wide same-store NOI growth to 1.8%.

Japan's population aged 100 and over has surpassed 100,000 for the first time. The Ministry of Health, Labour and Welfare said that as of September 15, 2026, the number of centenarians rose to a record 107,677, up from just 153 when records began in 1963 and about 10,000 in 1998. Women make up roughly 88% of all centenarians. United Nations estimates indicate that in 2026 there were about 672,000 centenarians worldwide, with Japan clearly having the largest number of any country. The increase is putting pressure on Japan's fiscal position, since about one in three people, or roughly 40 million, receive state pensions. The ministry has proposed a budget of about 33.7 trillion yen, or 218 billion dollars, for pensions and medical services in the next fiscal year, accounting for nearly a quarter of the roughly 143 trillion yen in total budget requests from all ministries. At the same time, Japan continues to face a declining number of births, with the fertility rate falling for a tenth consecutive year in 2025 and hitting its lowest level since data began in 1947. The number of births was about 671,000, compared with about 1.59 million deaths in the same year. The government estimates that in 2026 the country will need about 2.4 million elderly care workers, up from about 2.1 million in 2024, and is increasingly relying on foreign labour. The number of foreign care workers under the skilled worker visa programme was about 66,000 last year, and the government plans to admit up to 160,700 workers under that framework and a new foreign labour programme.

AWC has partnered with VitalLife Scientific Wellness Center, part of Bumrungrad Hospital, to launch "AYA Wellness Club," the first and largest comprehensive wellness and lifestyle destination in the heart of Bangkok. The first phase will open in 2026, with full operations expected in 2027. Wallapa Traisorat, CEO of AWC, stated that this collaboration will bring preventive health knowledge and the science of longevity to create a wellness ecosystem that caters to Bangkok residents and global tourists. Meanwhile, Assistant Professor Dr. Polakit Teekakeerikul, CEO of VitalLife, noted that this project will make proactive healthcare more accessible and aligned with modern lifestyles.

Bumrungrad Hospital, or BH, announced the expansion of its business into preventive medicine, while continuing to expand into Asian markets to complement the Middle East, and increasing capacity to accommodate patients in Sukhumvit. The company is positioning its Phuket project as a growth engine, with an investment of over 4.3 billion baht to develop Bumrungrad International Hospital Phuket on approximately 16.5 rai of land near Phuket International Airport. The hospital is scheduled to begin services in the third quarter of 2026 with an initial capacity of 120 beds, expandable to 212 beds in the future, to cater to medical and wellness tourism. A senior source from BH stated that the hospital is shifting its model from sick care to health and wellness by creating an ecosystem that reaches consumers in daily life, such as collaborating with hotels and sports communities, as well as offering health and nutrition classes with partners. For the domestic market, BH aims to expand its base to the healthy and wealthy elderly and health-conscious younger generations. In international markets, the company continues to prioritize Asia, especially China, Laos, and Vietnam, to diversify its patient portfolio and achieve long-term balance. Meanwhile, BH has increased its patient capacity by expanding its facility on Sukhumvit Soi 1, which currently has 580 inpatient beds and can accommodate more than 5,500 outpatients per day.

MINT and BDMS are highlighting Wellness & Longevity trends to cater to modern tourists. William Ellwood Heinecke, founder and chairman of MINT, said that MINT currently operates about 600 hotels in 60 countries and has observed growing interest in health across all age groups, not just the elderly. Tourists want Wellness, Longevity, and Biohacking services during their stays. Thailand has a strong ecosystem, including world-class services, food, and affordable medical care. Although Vietnam and Bali are catching up, they still lack such a comprehensive ecosystem. Dr. Pramaporn Prasarttong-Osoth, CEO of BDMS, noted that Wellness has shifted from treating illness to preventive medicine. International tourists stay in Thailand for an average of 10 days, presenting an opportunity for lifestyle transformation. However, the major challenge is connecting various elements to create experiences that encourage repeat visits for continued health care. Sophie Hacher, a neuroscience expert, said that younger generations want health data and are reducing alcohol consumption. Wellness tourism is growing, and Thailand's strength lies in blending modern science with traditional practices such as Thai herbs, Buddhism, and traditional Chinese medicine, which attracts tourists to return repeatedly over decades.

The Ministry of Finance announced on the 4th that the total budget requests for the general account for fiscal 2027 reached a record 143.00656 trillion yen. Finance Minister Satsuki Katayama revealed this at a press conference. The requested amount exceeds the previous year, with increases in social security costs and defense spending seen as the main factors. The government plans to scrutinize the requests from each ministry and compile a draft budget by the end of the year.

Siamese Asset Public Company Limited (SA) has announced its strategy for the remainder of this year, aiming to penetrate international markets with growing demand for condominium purchases. It will expand its existing customer base in China and Taiwan, while opening new markets in India and Dubai through investment programs featuring comprehensive rental management teams. Additionally, the company is preparing to officially launch the "Siamese Wellness and Preventive Care" campaign to enter the Senior Living market, offering residences designed with elderly-friendly features, along with health-promoting activities and 24-hour emergency assistance systems. The event was recently held at the company's headquarters.

According to the latest long-term care insurance business report released by the Ministry of Health, Labour and Welfare on August 27, 2026, the number of people certified as requiring long-term care or support has reached 7.21 million, with approximately one in three people aged 75 or older receiving such certification. Based on calculations using the Ministry of Internal Affairs and Communications' 2025 average results, a household of a married couple aged 65 or older with no employment faces a monthly deficit of about 42,434 yen, resulting in a shortfall of approximately 15.28 million yen over 30 years. For single-person households, the monthly deficit is about 29,980 yen, totaling approximately 10.79 million yen over 30 years. Adding the average long-term care cost of about 5.42 million yen and a reserve fund of 3 million yen, the total exceeds 20 million yen, making the 20 million yen retirement figure a realistic defense line. Additionally, the number of insured persons aged 65 or older (Category 1 insured) was 35.84 million, a decrease of 50,000 from the previous year, but the number of certified persons increased by 120,000, indicating that while the overall elderly population is declining, the demand for long-term care continues to rise.

Bloomberg reports that Taiwan's population may decline to about 12.15 million by 2075, a drop of roughly 48% from 2026 levels, amid a continued decrease in births and young population, while the number of elderly rises significantly, posing long-term challenges to the labor market, economy, and defense capabilities. Estimates from Taiwan's National Development Council (NDC), based on household registration data, indicate that the working-age population will shrink by nearly two-thirds over the next 50 years. By 2075, the population aged 0-14 will be only 585,000, the working-age population (15-64) will be about 5.13 million, and those aged 65 and above will reach 6.43 million, meaning the elderly will outnumber the working-age population and account for more than half of the total population. These figures reflect risks after the population peaked at 23.6 million in 2019, and could also affect Taiwan's security, as the military still relies partly on conscription amid threats from China.

The Ensign Group remains a Buy for investors, supported by favorable demographics and strong demand for post-acute care, with the company raising its 2026 adjusted EPS guidance to $7.75-$7.85. Ensign, which operates 398 healthcare operations across 17 states, has completed 25 acquisitions in the first half of 2026, adding 3,109 beds and spending about $412 million. The Zacks Consensus Estimate for 2026 earnings is $7.65 per share, indicating 16.4% year-over-year growth, and revenues are expected to reach $5.88 billion, up 16.3%. The company's real estate platform, Standard Bearer, owns 177 properties with an estimated fair value of $2.2 billion, and second-quarter rental revenues rose to $44.1 million from $31.5 million. Ensign has $262.3 million in cash and $591.6 million available under its credit facility, with over $850 million in dry powder for future investments. Risks include reimbursement and regulatory pressures, as Medicare and Medicaid account for 69% of service revenues, and rising costs, with expenses up 18% in the first half of 2026.

Villa Kunalai Public Company Limited (KUN) has announced that its 4th series of high-risk secured bonds for 2026, maturing in 2028, which is the final bond lot of 2026, received full subscription from institutional and high-net-worth investors during the offering period from August 20–21 and 24, 2026. The bonds have a term of 2 years and 3 months, with an annual interest rate of 7.40%, paid quarterly. They are secured by collateral valued at up to 1.5 times the offered bond amount, primarily consisting of vacant land within the "Navara Rangsit" project. The company will use the raised funds to develop the Longevity Living project "Navara Rama 2" to create a comprehensive Health Ecosystem. It is currently in negotiations for joint ventures with both domestic and international partners, with expectations to commence concrete operations within 2027. Additionally, the funds will be used to repay debt and roll over bonds maturing in November 2026, amounting to 108 million baht, to enhance liquidity. Furthermore, on August 30, 2026, the company is set to launch "Club Suma" under the "Navara Rangsit" project, a clubhouse valued at over 100 million baht, under the concept "Where Nature Meets Everyday Living," to elevate the quality of life for residents and create a new landmark for residential areas in the Rangsit zone.

Dr. Amnuay Ua-areemitr, Director and Hospital Director of Ekachai Medical Care Public Company Limited (EKH), revealed during an Opportunity Day that the company's Q2 2026 net profit was 60.18 million baht, up 27.88% from the same period last year. For Q3 2026, revenue is expected to continue growing due to full-quarter recognition of new projects. The company aims to become a specialized hospital under the JUMP+ Business Plan, targeting 2028 revenue of 1.94 billion baht through the development of Khun Hospital, BLUM Hospital, and the expansion of W Center in the Wellness & Longevity segment, which is expected to open fully in September 2026. Meanwhile, Khun Hospital's Rama 2 branch has a bed occupancy rate of 95-99%, with plans to add 10-15 more beds in early to mid-2027. The Ao Nang branch, which recently opened about two months ago, has a bed occupancy rate of 10-20% and is expected to turn profitable when occupancy reaches 30%.

Nanjing Xinjiekou Department Store disclosed its 2026 semi-annual report on the evening of August 26, reporting first-half operating revenue of 2.89 billion yuan and total profit of 163 million yuan. The company adhered to its dual-engine strategy of "big health plus new consumption," with progress across its modern commerce, health and elderly care, and biomedical segments. In modern commerce, the company advanced store renovations, introduced first stores and benchmark brands, and created younger-oriented consumption scenarios. In health and elderly care, Ankangtong won 82 projects, while overseas subsidiary Natali completed the acquisition and integration of several UK elderly care companies. In biomedicine, Qilu Stem Cell completed filings for two new technologies, and Dendreon China's Provenge is in Phase III clinical follow-up. The company said it will continue to seize opportunities in the silver economy and the cell and gene therapy industry to promote high-quality development.

BDMS disclosed that the third quarter of 2026 trend is clearly recovering, with hospital revenue in July 2026 growing 8% from the same period last year, accelerating from just 1% growth in the first half. This was supported by Thai and international patients, including the insured group. The bed occupancy rate rose to 65% from 55% in the second quarter of 2026 and was above the 60% level of the previous year. Revenue from insured patients grew 11%, Thai patients grew 9%, and international patients grew 6%. Excluding Cambodia and the Middle East, growth reached 14%. The Middle East market is starting to recover, with August appointment bookings rising to more than 3,500 from about 2,000 in April. BDMS is also continuing to expand beds and specialty centers, and investing in the WellEra project with a budget of 29 billion baht, which is expected to begin affecting EBITDA and free cash flow from 2030.

Techno Medical Public Company Limited, or TM, reported first-half net profit of 14.10 million baht, up 33.3% from the same period last year, with total revenue of 354.45 million baht, up 3.4%, as sales of medical equipment and consumables rose to 336.62 million baht after shifting strategy to focus on low-cost imports from China and raising prices in the second quarter of 2026, lifting gross profit margin from sales to 40.5%. Service revenue under The Parents project reached 14.21 million baht, up 34.6% year-on-year, with an average of 45 to 50 nursing home users per month and an occupancy rate of about 80%, or an average of 50 beds. The company is confident The Parents will reach break-even by the end of this year, targeting service revenue of about 4 million baht per month, while also expanding into wellness with hormone therapy services that use AI to calculate individual hormone levels, plus home care services sending nurses and medical assistants to care for the elderly. The TPTC training center has just produced its latest class of 25 assistants, ready to work immediately.

Brookdale Senior Living reported second-quarter results that management framed as proof its turnaround is taking hold, even as occupancy growth keeps arriving slower than the company originally expected. The senior living operator reaffirmed its full-year guidance of 8% to 9% RevPAR growth and adjusted EBITDA between $502 million and $516 million, pointed to a shrinking pool of underperforming communities, and unveiled two acquisitions meant to turn leased real estate into owned assets. Second quarter RevPAR climbed 8.2% year over year, while consolidated occupancy reached 82.4%, up 230 basis points from a year earlier and the 57th straight month of year-over-year occupancy gains. Brookdale closed on the 244-unit Brookdale Galleria in Houston for $23.4 million at the end of June, and announced plans to buy 17 communities it currently leases for approximately $157 million, a deal expected to close in the fourth quarter and lift 2027 EBITDA and cash flow. Management called the pace of improvement in its weakest communities not sufficient, and full-year consolidated occupancy is now projected to land around 83%, while leverage stood at 8.4 times adjusted EBITDA, above the company's own target of under 6 times.

The United States is facing rapidly rising demand for senior housing as the Baby Boomer generation ages, but efforts to increase supply are running into resistance from long-time older residents who do not want large projects to change their neighborhoods. Bloomberg Businessweek highlights the case of Rockridge, a residential district in Oakland, California, where homes sell for millions of dollars and many residents hold liberal political views. Yet when large senior housing projects were proposed for the area, strong opposition emerged. Around 300 Rockridge residents banded together to oppose two proposed senior housing developments that, if fully built, would add 618 units to a supply-constrained market. The first project is a seven-story building on the former site of a Red Cross blood donation center. The other proposal calls for towers of 31 and 25 stories on land currently occupied by Trader Joe's, and opponents have dubbed that project the Trader Joe's terrible towers. The problem is likely to intensify with demographic shifts. This year, the first Baby Boomers turn 80. A 2023 study published in JAMA found that the average age at which older adults move into senior housing is about 84. The number of Americans aged 80 and older is projected to double to 29.4 million by 2045. Demand for senior housing has remained at record highs since 2025, with average occupancy at 92.5 percent. NIC MAP estimates the United States needs about 582,000 additional senior housing units by 2030 to meet demand, but construction has been steadily declining, and most existing senior housing in the country was built before this century. Another obstacle is that many people in their 60s and 70s do not yet think they will need to move into senior housing. Rodney Harrell of the AARP Public Policy Institute calls this phenomenon Peter Pan Syndrome, the feeling that while other people may age and need help, we ourselves are likely to be the exception. The problem is that the need for this type of housing often arises suddenly, such as after a fall, after a hospital stay, after the death of a spouse, or after losing the ability to drive. At that point, some older adults find they can no longer stay in their own homes, but their communities offer no alternative other than large single-family houses. This situation is playing out across the United States, with senior housing developers facing opposition from the very demographic that is their target market, from Milwaukee and the Chicago suburbs to Stamford, Connecticut. Reasons range from loss of green space and fire safety concerns to density and changes to community character. In Rockridge, the key issues are affordability and neighborhood identity. Myrna Walton, 84, a member of Upper Broadway Advocates, insists her group is not opposed to building housing, but is opposed to high-rises. One of the contested projects proposes towers of 31 and 25 stories near the Rockridge BART station, with 371 independent living units, 18 assisted living units, and 26 memory care rooms, along with dining facilities, a swimming pool, and a fitness center, but no affordable housing. Walton argues the area's urgent need is not market-rate housing but affordable housing. However, building affordable housing in the Bay Area is extremely expensive, with construction costs for a single apartment potentially reaching 800,000 to 1 million dollars, making many projects unworkable without public subsidies. As a result, even some affordable housing activists support adding market-rate homes because they see every new unit as new housing supply. The Rockridge developer has not disclosed proposed rents, but points to a nearby senior living facility, Merrill Gardens, which charges about 6,000 dollars per month for a studio and up to 13,350 dollars for a two-bedroom unit, including meals, transportation, housekeeping, and 24-hour staffing. Walton acknowledges that she herself is in the project's target demographic and may eventually want to move into senior housing near her family, but she still believes the 31- and 25-story towers are too large and may not benefit the surrounding community much. On the other side, Lori Droste, director of housing and planning policy at SPUR, argues that building affordable housing is essential, but it should not be used as a reason to stop building other types of housing. If communities choose to build nothing and wait for a perfect project, the affordability crisis will worsen, especially as wealth from the AI industry may push up the purchasing power of high-income earners and crowd out other buyers. One idea supporters advance is moving chains, based on supply and demand. When more market-rate housing is built, people with purchasing power move in, freeing up their previous homes and creating a chain of supply that cascades to other groups. If both Rockridge projects, totaling 618 units, are built, and just one-third of residents move from nearby areas, hundreds of existing homes could be released back onto the market. Another paradox lies in the wealth of long-time homeowners in California. Many Rockridge homes are now worth more than 2 million dollars, but long-time owners may pay property taxes on assessed values below 500,000 dollars because California's Proposition 13 limits increases in assessed value for tax purposes. As a result, many older homeowners hold assets worth millions of dollars but face very low carrying costs, giving them little incentive to sell or downsize. At the same time, they may feel that senior housing at 10,000 dollars a month is too expensive. The problem also affects younger generations, because when older adults remain in large homes, those homes do not return to the market for younger families. Micki, 78, who still lives in a three-story house she bought 42 years ago, puts it bluntly: if a suitable condo or senior housing were built near her home, she and her husband would be interested in moving. Because we old people are still in our own homes, those homes are not being passed on to younger families, and I think that is bad for the whole community. Community resistance is beginning to lead to compromise. On August 19, the developer of the Trader Joe's site announced revised plans, reducing building heights from 31 and 25 stories to 26 and 23 stories, moving loading docks away from residential streets, adding retail space open to the general public, and setting aside space for a grocery store with the goal of keeping Trader Joe's in its current location. The Rockridge case reflects a conflict unfolding in many parts of the United States, as the country needs to build more housing to address both the housing crisis and an aging society, while existing residents must choose between preserving the familiar character of their neighborhoods and accepting greater density to create housing for the next generation, and for themselves in the future.

Ekchai Medical Care Public Company Limited, or EKH, has approved the establishment of Koon Bangna Company Limited to operate a specialist hospital for palliative care. The hospital is expected to officially open for services within 2028. Koon Bangna Hospital will have 45 to 50 beds, with a total investment value of 270 million baht and registered capital of 300 million baht, starting with initial registered capital of 30 million baht. The shareholding structure consists of Ekchai Nursing Home Company Limited, a wholly owned subsidiary of EKH, holding 75 to 80 percent, Narai Property Company Limited holding 15 percent, and a group of medical personnel holding 5 to 10 percent. Funding will come from the company's working capital. Dr. Amnat Ua-areemit, director and hospital director, said that this collaboration with business partners who have expertise is an important step in building strength, in line with the policy to expand specialist hospital businesses for the elderly and dependent care centers, which is a market with high growth potential.

Phyathai Hospital Network and Paolo Hospital Network have launched the Addwise Comorbid platform, Thailand's first intelligent physician assistant system, to proactively assess risk in patients with comorbidities and the elderly. Dr. Anantasuk Apairat, Chief Medical Officer, said that the traditional treatment model, which focuses only on resolving specific symptoms, is insufficient for creating long-term health outcomes. This platform helps doctors assess risk across nine major body systems, following the Value-Based Healthcare concept that measures success primarily through patient health outcomes. On the technology side, Dr. Jet John Thepratongwaja explained that the software was developed on a Review of Systems foundation, integrating algorithms based on international Evidence-Based Medicine principles and Clinical Practice Guidelines. It serves as a clinical decision support system, while diagnosis and treatment decisions remain under the clinical judgment of the attending physician. At the same time, the hospital networks have created a new role for medical personnel as Longevity Assistants to connect patient data, doctors, and digital systems, and have established the Addwise Comorbid Academy to provide training and issue standard work certifications. This model adjustment builds on more than 40 years of medical experience of the Phyathai-Paolo network, aiming to create a New Standard of Care for Thailand's public health system.

Sonida Senior Living reported strong second quarter 2026 results, with same-store weighted average occupancy up 240 basis points year over year to 87.8% and same-store community net operating income growing 16.9% with margin expanding 250 basis points to 32.6%. Total portfolio normalized FFO per share was $0.48, and the company completed a $380 million five-year term loan with Ally Bank on August 7 to refinance debt and extend maturities. As previously disclosed, the company completed its acquisition of CNL Health Properties Inc, or CHP, on 03/11/2026, and 14 communities, more than a quarter of the CHP SHOP portfolio, transitioned to Sonida management as of July 1. The company is under contract to acquire approximately $88 million of assets expected to generate mid-teens unlevered IRR and accretion to normalized FFO and NAV per share.

Principal Capital Public Company Limited, or PRINC Group, reported medical service revenue for the second quarter of 2026 of 1.56 billion baht, up 11.03 percent from the same period last year. This brought first-half revenue to 3.10 billion baht, growth of 8.22 percent. Earnings before interest, tax, depreciation and amortisation, or EBITDA, from core operations in the quarter reached 106.7 million baht, up 93.39 percent, while first-half EBITDA stood at 232.0 million baht, up 26.82 percent. The growth came from the expansion of its hospital network, including the acquisitions of Thanakan Hospital and Por Paet 1 and 2 Hospitals, as well as the opening of Phitsanuvej Kamphaeng Phet Hospital in June. The company now operates 19 hospitals across 15 provinces. It plans to open a new building at Phitsanuvej Phichit Hospital in October and a full-scale cancer centre with radiation therapy services at Phitsanuvej Hospital in January 2027.