At the Happy Community housing development in Beijing, China's largest property developer is setting aside 24,000 square meters (258,000 sq ft) for active seniors to test whether this rapidly ageing nation will pay for Western-style retirement living.
China Vanke Co Ltd <000002.SZ> thinks there is "ample room for development" in the senior care sector, a spokesman said, and is testing a second pilot project for seniors in the coastal city of Qingdao. The company plans to open a showroom in the Chinese capital over the Lunar New Year in February.
Overseas players including New York-based hedge fund Fortress Investment Group LLC and China Senior Care, backed by one of the principals of U.S. private developer Lerner Enterprises, are also investing in elderly care and retirement facilities, betting that the demographic fallout from China's one-child policy will soften traditional attitudes towards out-of-home care.
"If you understand the Chinese culture, they're not about to abandon their old and aged parents in the nursing homes," Lim Cheok Peng, managing director of the world's second biggest listed healthcare provider IHH Healthcare Bhd , said in an interview in Singapore.
"Ten to 20 years down the road things may change."
As in most East Asian societies, China's elderly have traditionally been looked after by their children at home.
But for people born in the one-child era after 1980, that could mean caring for two parents and four grandparents alone. For married couples, that's eight grandparents to handle. About 22 percent of China's population will be over age 65 by 2040, up from 9 percent now.
Beijing wants to encourage investment in healthcare services. In January, China reclassified the sector as "permitted" rather than "restricted", meaning overseas companies can own 100 percent of an operation in China.
But elder care does not come cheap. China Senior Care, which is building a 64-bed acute-care facility in Hangzhou, plans to charge at least 40,000 yuan ($6,300) per month, putting it far out of reach for all but the wealthiest in China.
The company paid 28 million yuan ($4.4 million) for a 1.6 acre (0.65 hectare) site, but the process was complicated.
"As far as I know we're the first Western company to take down a site to do a greenfield project," said Mark Spitalnik, chief executive of China Senior Care, who moved to China in 1998. "You really have to develop relationships with guys up and down the food chain."
The company has raised $20 million with backing from Robert Tanenbaum, a property developer with Washington, D.C.-based Lerner Enterprises who is also one of the owners of the Washington Nationals baseball team.
It plans to use this first project as a flagship to help it break into management of acute-care facilities. It also aims to raise a $100 million fund for senior-care facilities.
'LIKE LIVING IN A JAIL'
While the potential market is vast, investors in the sector face cultural as well as financial and administrative barriers.
Filial piety is a pillar of the Confucian philosophical tradition, so the thought of shuttling elderly relatives off to a nursing home remains anathema to many in China.
Yang Fengqin, an 87-year-old grandmother from the coastal city of Fuqing, in Fujian Province, has lived with one of her sons for 50 years and still heads to the market each day to buy ingredients for meals she cooks for him and a grandson.
"If I live in an old age home I will lose my freedom - I want to be able to go out whenever I want," Yang said. Living in an old-age home "is like living in a jail. You cannot go out."
Yang, who gets 1,600 yuan ($250) from the government each month, believes the elderly should be cared for either by their family or the government. She spends only around 300 yuan on food each month and gives the rest of the money to her son.
Most people in Asia expect to support themselves in retirement, according to a survey of six countries in east and southeast Asia. Attitudes are very different in China, where 63 percent people believe the government should do that job, and 71 percent get at least some government support, according to a survey by the Center for Strategic and International Studies sponsored by insurer Prudential .
The Shanghai municipal government envisions a "90-7-3" system, where 90 percent of the city's elderly population lives with family, 7 percent visit community centers and 3 percent pay for private senior homes. The latter figure may sound modest, but Richard Brubaker, the founder of the non-profit Collective Responsibility, says the city actually has only half that capacity for private elder care.
Even if just 3 percent of China's population opts for private care, that still adds up in a country of 1.3 billion.
"People are just beginning to understand what gerontology means in the Chinese context," said Bromme Cole, a consultant who runs Hampton Hoerter, which advises companies on healthcare and senior care facilities.
ASIAN HOSPITALS EYE EXPANSION
At Cherish-Yearn, an upscale retirement community on the outskirts of Shanghai, Chairman Xi Zhiyong has invested 600 million yuan to build 800 apartments, with just over 60 percent full. Residents buy flats with a membership fee of 980,000 yuan ($155,400) per couple, and then pay an annual fee of 30,000 to 70,000 yuan, depending on the size of their apartment, for cleaning services, activities and the help of a secretary.
Fortress, which has said it wants to invest $1 billion in senior care in China, has formed a venture with the conglomerate Fosun Group <0656.HK>, which has extensive property operations, to develop senior housing in China. It launched its first project, Shanghai Starcastle Senior Living, in August, providing independent-living apartments as well as assisted living.
Chinese insurance companies have also started to pump money into the sector, with Ping An <601318.SS> staking 17 billion yuan in a retirement community in Zhejiang Province in September. That is the fourth insurance investment in retirement homes in as many month, after smaller projects from China Life <2628.HK> <601628.SS> in Hebei, Taikang Life in Beijing and Taiping Life in Shanghai.
Singapore-based firms are also looking to expand.
Econ Healthcare Group, which runs nursing homes and a hospital in Singapore and Malaysia, is consulting with the government of Suzhou on a retirement village with more than 300 apartments, which could be up and running by mid-2013, Executive Chairman Ong Chu Poh said.
Econ also has a project in Tianjin, and is looking for a local partner to build facilities in cities such as Shanghai and Guangzhou.
"There are many local developers who want to come into this huge seniors' market, and they don't know how to go about it," Ong said.
Some early investors learned the hard way that China does not always live up to the hype.
Private equity investor Adam Lazar said he sank almost $1.5 million into his first senior-care project, but after five years only some of the planned 62 high-end villas were actually built and none were sold. He's now locked in a legal fight over his stake.
"To invest $100 million in senior housing is going to be challenging," said Lazar, the founder of Lazar Capital Management. "To invest $1 billion - it's a pipe dream." ($1 = 6.3093 Chinese yuan)
(Additional reporting by Clare Baldwin and Joy Leung in Hong Kong, and by the Beijing bureau; Editing by Emily Kaiser and Alex Richardson)