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Market Overview

Germany has one of the most stable funding systems for long-term care in Europe with currently c. EUR 7bn of a funding surplus.

The state provides a Social Long-Term Care Insurance (Soziale Pflegeversicherung) for those that are eligible for social payments (frail people according to the Medical review Board of health insurers “Medizinischer Dienst der Krankenkassen”).

Healthcare expenditure increasing in Germany

With >11% of GDP spent on Healthcare, Germany is among the top healthcare spenders in Europe

Source: Federal Statistical Office, PKV Pflegedatenbank

Market structure and competitors

  • The nursing home market in Germany is segmented between private operators, the non- profit operators and the public operators,
    of which 42% are private.
  • In terms of the occupancy levels, the average rate is around 85% and vary depending on the regions and the operators.
  • Currently the main issue for operators and in general for the market,
    at least in the medium term, is the recruitment and retention of qualified employees, since there are not enough nursing professionals
    in the market to cover the high demand of elderly care in Germany.
  • Furthermore, the option of international recruiting is not always considered due to the high bureaucracy, difficulties and legal u ncertainties in the process of hiring and assessing the qualifications acquired abroad by the foreign applicants.
  • From the competitors panorama the market behaves stable except for the risk of compliance and quality of services, due to the lack of professional qualified staff to fulfill the corresponding tasks.

Nursing home operators split

by type (# of beds)

Source: Federal Statistical Office of Germany, 2017

Top private operators (by # of beds)

Source: Federal Statistical Office of Germany, 2017

Market future


  • As per the demographic trends, the nursing home market in Germany will continue to increase during the next years.
  • The German government and different national institutions are working on appropriate framework conditions for the nursing profession.
  • The greatest risk in the Healthcare and Social Services sector is the shortage of qualified staff. Therefore, a proactive option to mitigate this risk is to recruit skilled workers from abroad is important and part Helske’s focus
  • The market reflects a stable and positive growth in the medium term and is currently favorable for business opportunities.
  • Some of this is repetitive with previous slides, also perhaps there is too much information on making the case for germany, that wont be the hard sell it will be more why Helke are the right company to back

Additional Demand for Care Beds by 2030

(nursing home ratio 2013 +5%)

Source: Federal Statistical Office 2015, Georg Consulting (2016)

Growth forecast for inpatient and outpatient care

Today 3.5% of German population are care dependent. Inpatient care is expected to grow by 400k, outpatient care by 300k until 2030.

Outpatient Care

Source: Federal Statistical Office 2015

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