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Global Adult and Retirement Communities Industry

  • January 2012
  • -
  • Global Industry Analysts

The global outlook series on Adult and Retirement Communities provides a collection of statistical anecdotes, market briefs, and concise summaries of research findings. Illustrated with 56 fact-rich market data tables, the report offers an aerial view of adult and retirement industry, highlights latest market trends, and key market drivers. Regional markets briefly abstracted and covered include North America, United States, Canada, Japan, Europe (including Finland, Monaco, and UK), Asia-Pacific (including Australia, China, India, Indonesia, Korea, Singapore, and Taiwan), Latin America (including Mexico), and Africa (including Morocco). The report offers a compilation of recent mergers, acquisitions, and strategic corporate developments. Also included is an indexed, easy-to-refer, fact-finder directory listing the addresses, and contact details of 206 companies worldwide.

Table Of Contents

Global Adult and Retirement Communities Industry



1. OVERVIEW 1
Retirement Communities - An Introduction 1
Location and Design - Key Factors for Retirement Units 1
Lifestyle Demands - Vital for Retirement Community Setting 1
Geriatric Living Solutions - An Overview 2
Skilled Nursing Facilities (SNFs) 2
Service Description, Typical Patient Profile and Period of
Stay for Skilled Nursing Facilities 2
Senior Living 2
Independent Living 3
Assisted Living 3
Continuous Care Retirement Communities 4
Service Description, Typical Patient Profile, and Period of
Stay in Senior Living Market by Category - Independent
Living, Assisted Living, and Continuous Care Retirement
Communities (CCRCs) 4
Table 1: Senior Housing in the US (2010): Leading Senior
Housing Owners by Number of Units (in '000) 5
Primary Operating Models in Senior Living 5
Comparison of Major Operating Models in Senior Living Market 6
Global Demographics - A Review 7
Ageing World Population 7
Table 2: Global Aging Population - Percentage Breakdown of
Senior Population (Above 65 Years, and Above 85 Years) by
Select Region for the Years 2000, 2015, and 2030 7

Table 3: Most Populous Countries in the World: Population in
Million for the Year 2008 and Projections for 2050 8

Table 4: Top 10 Countries with Oldest Population in the
World (2011): 65+ Population by Gender for Japan, Germany,
Italy, Sweden, Greece, Austria, Bulgaria, Belgium, Portugal,
and Finland 9
Most of the Aged Population Live in Developed Nations: A Myth 9
Table 5: Global Distribution of Population for Age Group
(60+, and 80+) by Region for Years 2010 and 2050 (In Million) 10

Table 6: Global Average Annual Rate of Change of Total
Population for Different Age Groups by Major Region for
Years 2009-2050 (in %) 11

Table 7: Global Distribution of Population for Age Group
(60+, and 80+) by Major Areas for Years 2010 and 2050 (In
Million) 12

Table 8: Global Average Annual Rates of Change of Total
Population for Different Age Groups by Major Area for Years
2009-2050 (in %) 13
Addressing the Needs of Aged Population 14
Table 9: Percentage of Assisted Living (AL) Residents Who
Require Help for Daily Living Activities - Bathing,
Dressing, Eating, Medication Management, Toileting, and
Transferring 15
Dementia: Imminent Global Healthcare Crisis 15

2. MARKET TRENDS and ISSUES 16
Latest Trends in Senior Living: An Insight 16
Assisted Living Continues to be a Popular Choice over Nursing
Facilities 16
Housing Industry Adopts Universal Design for Adult Communities 17
Credit Crunch Impacts the US Seniors' Housing Loan Volumes 17
Net Worth of Seniors Declines 17
Highly Fragmented US Senior Market Offers Opportunities for
Consolidation 17
Recession Generates New Opportunities 18
Stable Occupancies and Limited Supply of Units 18

3. MERGERS and ACQUISITIONS 19

4. STRATEGIC CORPORATE DEVELOPMENTS 39


A REGIONAL MARKET PERSPECTIVE 48

1. NORTH AMERICA 48
Seniors Population Continues to Grow 48
Improvements in Lifestyles and Life Expectancy 48
Senior Care Shifts from Family Care to Professional Care 48
Investment Trends in Senior Housing 48
Senior Women - The Prime Target Customers 49
Consolidation of Divided Ownership 49

1a. UNITED STATES 50
US Senior Housing Market - An Overview 50
Independent Living and Continuing Care Communities Bore the
Brunt of Plunge in the Housing Sector 50
Impact of Recession on Assisted Living Sector: An Overview 50
Favorable Demographics Continue to Drive Market Growth 51
Table 10: US Population in Million by Age Group: 2010-2020 52

Table 11: US Population (Above 65 and Above 85) in Million:
2010-2050 52
REITs Fuel Senior Housing Sales 52
Retirement Communities Adapt to Evolving Needs of Today's Aged
Population 52
Active Adult Communities: A Favorite Choice of Baby Boomers 53
Baby Boomers Shift to AACs Likely to Attain Record Levels in
Future 53
Table 12: Active Adult Retirement Communities in the United
States by State (2011) 53
Present-day AACs Specially Customized as per Baby Boomer
Specifications 54
Assisted Living: An Overview 54
Table 13: Long Term Care Market in the United States (2011):
Percentage Share Breakdown by Type of Care for Nursing Home
Care, Home Care, Assisted Living, and Hospice Care 54
Table 14: Estimated Number of Senior Housing Units in the
United States by Type (2010) 55
Table 15: Senior Housing in the United States (2010):
Percentage Share Breakdown by Value for Independent Living,
Skilled Nursing, and Assisted Living 55

Table 16: Senior Housing Communities in the United States by
Type of Community (2010): Percentage Share Breakdown for
Majority Skilled Nursing, Majority Assisted Living, Majority
Independent Living, and Continuing Care Retirement
Communities 55

Table 17: Number of Units/Beds in Senior Housing Communities
in the US by Type of Community (2010): Percentage Share
Breakdown for Majority Skilled Nursing, Continuing Care
Retirement Communities, Majority Independent Living, and
Majority Assisted Living 56

Table 18: Average Cost (in US$) of Assisted Living and
Nursing Homes (Private and semi-Private) in the US: 2010 56
Continuing Care Retirement Communities 57
Continuing Care Retirement Communities in the US: An Overview 57
Background 57
CCRCs Poised to Gain Greater Market Share in Future 58
Independent Living Communities 58
Independent Living Communities: An Overview 58
Table 19: Independent Living Communities in the US as of
2006 by Select Province: A Historic Perspective 59
Assisted Living Communities 59
Assisted Living Communities: An Overview 59
Table 20: Assisted Living Communities in the US as of 2006
by Select Province: A Historic Perspective 60
Assisted Living Properties - Types 60
Table 21: US Assisted Living Market (2010): Percentage
Breakdown of Various Settings for AL Residences (by
Property Type) - Freestanding Assisted Living, Assisted
Living/Dementia Care, Continuing Care Retirement
Communities, Assisted Living/ Independent Living, Assisted
Living/Nursing, and Freestanding Dementia Care 61

Table 22: US Assisted Living Market (2010): Percentage
Breakdown of Various Settings for AL Residences (by Number
of Units) - Assisted Living/Dementia Care, Freestanding
Assisted Living, Continuing Care Retirement Communities,
Assisted Living/Independent Living, Assisted
Living/Nursing, and Freestanding Dementia Care 61
Public and Private for-Profit Companies: Dominance of
Private Pay Model 62
Table 23: US Assisted Living Market (2008): Percentage
Breakdown by Ownership Type - Private-For-Profit,
Public-For-Profit, Not-For-Profit, and Others 62

Table 24: US Senior Living Market (2010): Percentage
Breakdown of Annual Average Cost for Senior Living by
Category - Pent- Up Home Equity (Opportunity Cost),
Housing, Food, Transportation, Utilities, and Entertainment 63
Assisted Living - Dementia Care Facilities 63
Service Description, Typical Patient Profile and Period of
Stay for Memory Care Facilities 63
Table 25: Dementia Care Facilities in the US as of 2006 by
Select Province 64

Table 26: Average Cost of Assisted Living and Nursing Homes
(Private and Semi- Private) (2010) 64
Nursing Homes 65
Nursing Homes in the US: An Overview 65
Growth of Nursing Homes 65
Nursing Home Residents 65
Table 27: US Nursing Homes Market (2010): Percentage
Breakdown of Residents Seeking Assistance in Activities of
Daily Living (ADLs) 66
Nursing Home Costs: A Historic Review 66
Table 28: US Nursing Homes Market (2007): Average Nursing
Home Costs per Day in US Dollar for Semi-Private Room and
Private Room in Select Areas 66
Senior Housing - Glance into History 67
Table 29: US Assisted Living Market - Growth of AL
Properties: Percentage Breakdown by Time Period - Before
1989, Between 1990-1999, 2000 or later 68
Factors Affecting Senior Housing Industry 68
Lending Scenario 68
Increasing Buyers' Expectations 69
Key Mode of Operations in the US Senior Housing Market 69
Table 30: US Senior Housing Market (2009): Average Occupancy
Rate in Assisted Living and Independent Living Facilities for
Sunrise Senior Living, Brookdale, Emeritus, Capital Senior
Living, and Five Star Senior Living 69

Table 31: US Senior Housing Market (2009): Average Occupancy
Rate in Skilled Nursing Homes for Kindred Healthcare, Sun
Healthcare, Skilled Healthcare Group, Ensign Group, and Sun
Healthcare 70

Table 32: Brookdale Senior Living - Number of Facilities,
Occupancy Ratio, and Total Units/Bed Capacity by Select
Community - Assisted Living, Independent Living, and CCRCs 70

Table 33: Top Senior Housing Owners in the United States in
Terms of Percentage Increase in Number of Units Owned: 2010 71

Table 34: Top Senior Housing Managers in the United States in
Terms of Percentage Increase in Number of Units Managed: 2010 71
Real Estate Investment Trusts 71
REITs in the US 71
General Factors Influencing the US Senior Housing Industry 72
Delayed Retirement of Active Adults: Decline of Independent
Living Segment 72
Seniors Delay Entry into Adult Communities: Constriction of
Market Size 73
Seniors Seek Short-Term Assistance: Need Driven Growth of
Assisted Living Segment 73
Limited Options to Meet Assisted Living Expenses: Decline in
Occupancy Rate 74
US Assisted Living Market - Primary Reasons for Residents
Leaving AL Facility by Ranking 75
Table 35: US Assisted Living Market - Primary Reasons for
Residents Leaving AL Facility (2010) - Percentage Breakdown
by Reason - Shift to Nursing Home, Death, Shift to Private
Home, Another Residence, Hospital, and Others 75
Financially Constrained Seniors Seek Alternatives 75
Adult Communities in Urban Areas: Moderate Occupancy 76
Current Status of the Industry: Recapitulating the Impact of
Influential Factors 76
Adult Community Operators Simplify Procedures and Extend
Services 77
Active Adult Communities Mull over “Age Desegregation” 77
Upscale Assisted Living Segment Remains Strong: Hospitality-
based Model 78
HUD Revamps FHA to Offset Credit Crisis 78
Superimposition with Health Care Industry 78
Market Outlook 79
Attractive Demographics 79
Baby Boomers - A Snapshot 79
Table 36: Percentage Share Breakdown of Grandparents in the
US by Age Group (2011) 79

Table 37: 65 + Population in the United States by Gender 80
Generation-Xers - Snapshot 80
High Expansion of Capacity Unlikely in Senior Living Industry 80
Senior Housing Market Remains Attractive for Investment 81
Table 38: US Current and Future Analysis for Assisted Living
Communities - Number of New Units for the Years 2010 through
2015 81
Independent Living Communities 82
Table 39: US Current and Future Analysis for Independent
Living Communities - Number of New Units for the Years 2010
through 2015 82
Continuous Care Retirement Communities 83
Table 40: US Current and Future Analysis for Continuing Care
Retirement Communities - Number of New Units for the Years
2010 through 2015 83

Table 41: US Current and Future Analysis for Continuing Care
Retirement Community (CCRC) Services- Revenues in US$
Billion for the Years 2010 through 2015 84
Skilled Nursing Facilities (SNF) Versus Senior Living: Outlook 84
Comparison of Skilled Nursing Facilities and Senior Living
Communities in the US 85
Table 42: US Current and Future Analysis for Skilled Nursing -
Revenues in US$ Billion for the Years 2010 through 2015 85

1b. CANADA 86
Investments in Canadian Senior Housing Industry 86
Canadian Adult Communities 86
Table 43: 65 + Population in Canada by Gender 87

2. JAPAN 88
Japanese Dankai Generation 88
Table 44: Living Arrangement of Japanese Older Population:
Percentage Breakdown by Mode of Living for Years 1980, 1995,
and 2010 88

Table 45: 65 + Population in Japan by Gender 89

3. EUROPE 90
Aging Population in Europe - An Overview 90
Table 46: European Population Statistics for Age Group (Below
65, and 65+) for Select Countries - France, Germany, Italy,
United Kingdom, Russia, and Spain 90

Table 47: Rest of Western European Population Statistics for
Age Group (Below 65, and 65+) for Select Countries - Austria,
Belgium, Denmark, Finland, Greece, Ireland, The Netherlands,
Norway, Portugal, Sweden, Switzerland, and Turkey 91

Table 48: Eastern European Population Statistics for Age
Group (Below 65, and 65+) for Select Countries - Bulgaria,
Czech Republic, Hungary, Poland, Romania, and Slovakia 92

3a. FINLAND 92
Overview 92

3b. FRANCE 93
French Retirement Homes Market 93
Demographic Trends 93
Over 65 Years Age Group 93
Over 85 Years Age Group 93
Table 49: 65 + Population in Canada by Gender 93

3c. UNITED KINGDOM 94
Overview 94
Need for Private Investment 94
Nursing Care and Residential Care Real Estate Market to Surge 94
High Growth Potential as Supply Likely to Surpass Demand by 2030 94

4. ASIA-PACIFIC 95
Overview 95
Attractive Demographics 95
Table 50: Asia-Pacific Population Statistics for Age Group
(Below 65, and 65+) for Select Countries - Australia, China,
Hong Kong, India, Indonesia, Korea, South Malaysia, New
Zealand, Philippines, Singapore, Taiwan, and Thailand 95
Consumer Behavior 95

4a. AUSTRALIA 96
Overview 96
Demography and Other Growth Factors 96
Current and Future Status of the Industry 96
Table 51: Australian Current and Future Analysis of Continuing
Care Retirement Community Services Market - Revenues in US$
Billion for the Years 2010 through 2015 97

4b. CHINA 98
Overview 98
Senior Living Market in China: A Prelude 98
Rapid Increase in the Costs of elderly Care 98
Background 98
Real Estate for Elderly Care, a Promising Market in China 99
China: An Emerging Hotspot for Elderly Care Real Estate
Investment 99
Demographics 99

4c. INDIA 100
Overview 100
Senior Care and Living 100

4d. INDONESIA 100
Overview 100

4e. KOREA 100
Overview 100

4f. SINGAPORE 101
Overview 101

4g. TAIWAN 101
Overview 101

5. LATIN AMERICA 102
Boom of American Retirement Communities in Latin America 102
Table 52: Latin American Population Statistics for Age Group
(Below 65, and 65+) by Gender for Select Country - Argentina,
Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Venezuela in
2011 102

Table 53: Latin America Population Statistics (2011): 65+
Population by Gender for Select Regions - Argentina, Brazil,
Chile, Colombia, Ecuador, Mexico, Peru, and Venezuela 103

5a. MEXICO 104
Overview 104

6. AFRICA 105
Overview 105

6a. MOROCCO 105
Overview 105

7. REST OF WORLD 106
ISRAEL 106
Table 54: Distribution of Assisted Living Facilities in
Israel (2011) 106

Table 55: Distribution of Beds among Elders in Assisted
Living Facilities in Israel (2011) 106

Table 56: Distribution of Beds (in ‘000) among Elders in
Assisted Living Facilities in Israel (2011) 107


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