rubicon senior care report - pages 1-12

Senior Care MarketE D I T I O N N U M B E R 3 / A S I A M A R K E T S E R I E S

CHINA

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2 - CHINA’S SENIOR CARE MARKET

China’s Senior Care Market

Authored by:

Joseph Christian, China Senior Housing Advisors

Damjan Denoble, Rubicon Strategy Group

Michael Qin Qu, Law View Partners

Benjamin Shobert, Rubicon Strategy Group

Yu Yan, Rubicon Strategy Group

S T R A T E G Y G R O U P


CHINA’S SENIOR CARE MARKET

Table of Contents

Contributor Biographies.......................................................................... B-1

Abbreviations .................................................................................................... 1

Executive Summary ....................................................................................... 2

Investor and Operator Key Takeaways ................................................ 4

Operator Profiles ........................................................................................... 19

Beijing Ensen Care Holdings ......................................................................... 22

Cascade (Columbia Pacific, Emeritus) .......................................................... 28

Changcheng Property Group (Goshar, Jiaying) ............................................ 33

Cherish Yearn ................................................................................................. 43

China Senior Care .......................................................................................... 50

China Taiping International Senior Living Community ................................... 54

General’s Garden ........................................................................................... 59

Landgent Senior Living (Golden Heights) ...................................................... 62

Li’ai Beijing Enterprise Management Consulting Co., Ltd., by REIE ............. 71

Merrill Gardens ............................................................................................... 74

Poly-Anping Hexihui Senior Living ................................................................. 79

Silvercare ........................................................................................................ 88

Shanghai Starcastle Senior Living Services Ltd. (Xing Bao) ......................... 91

Union Life ....................................................................................................... 94



Operator Profiles (continued)

Vanke Hangzhou (Sui Yuan Jia Shu) ........................................................... 100

Vcanland Holdings ....................................................................................... 104

Yanda International Health City .................................................................... 108

YaDa International Holdings / Wuzhen Graceland / Greentown ................. 115

Regulatory Analysis .................................................................................... 120

List of National Legislations during the 12th Five-Year Period ... 149

Best Practices ................................................................................................ 154

General China Business and Go-To-Market Best Practices ....................... 154

China Partner Due Diligence Best Practices ............................................... 156

Counter-Party Motives ..................................................................... 157

Counter-Party History ....................................................................... 158

Counter-Party Capabilities ............................................................... 160

Counter-Party Concerns .................................................................. 161

Counter-Party Self-Awareness ........................................................ 162

Senior Care Regulatory Best Practices ....................................................... 162

Operational Best Practices ........................................................................... 165

Sales and Marketing Best Practices ............................................................ 167



Home Healthcare ......................................................................................... 168

Approved Home Healthcare Regulatory Categories ................................... 170

Types of Services Allowed in the Home ....................................................... 175

The Article 88 “Medical Equipment” Clause .................................. 177

Non-Binding Guidelines from Other Official Documents ................. 179

Nursing Stations ............................................................................... 181

Who Can Legally Work within the Home Healthcare WFOE andin What Capacity? ........................................................................................ 183

Competitive Assessment .............................................................................. 185

Care Visions Healthcare Services Ltd. ............................................ 186

Home Instead Senior Care .............................................................. 187

Pinetree Senior Care Services ......................................................... 189

Right at Home .................................................................................. 191

Starcastle .......................................................................................... 192

United Family.................................................................................... 195


B-1 - CHINA’S SENIOR CARE MARKET

Contributor Biographies

Joe Christian, J.D., Founder, China Senior [email protected]

Since 2012, Joe has been a fellow at the Harvard Kennedy School, where he has been researching and writing about the senior housing industry in China. In 2013, he founded China Senior Housing Advisors, LLC, which advises western companies on entering the China senior housing market, and Chinese companies on how to develop their own domestic senior housing businesses. He is also a Senior Foreign Lawyer in Law View Partners, a boutique law firm in Shanghai that specializes in helping foreign investors doing business in China, with an emphasis on the senior housing and care industries. He currently represents U.S-based clients in their expansion into the China senior housing industry, and a Chinese company that is developing a senior housing project in Beijing.

Joe is the industry co-chair of a working group organized by the U.S. Embassy in Beijing to bring best practices in the U.S. senior housing industry into China and help facilitate the entry of U.S. operators and investors into the industry. Over the past few years, he has chaired and spoken at many conferences on the industry in China. He is a member of the advisory board of the International Association of Housing and Services for the Ageing (China).

Joe has over a dozen years of experience with transactions in South Korea and China, and lived and worked in Hong Kong for over three years, where he co-headed the Asia real estate group of a global law firm.



Damjan Denoble, M.A., J.D., Associate and China Hospital Lead, Rubicon Strategy Group [email protected]

Damjan Denoble (杜德平), heads Rubicon’s China hospital practice, where he has led market research work in China and as of July 2014, a project in Vietnam. In September 2014, he led a consumer research project highlighting what the modern Chinese consumer expects from their healthcare. Prior to joining Rubicon, he was the lead editor of Health Intel Asia (formerly the Asia Healthcare Blog). Before joining Rubicon he worked as a law clerk at the offices of Harris & Moure, the leading boutique international law firm for China legal services, and was a contributor to its widely praised production of the China Law Blog. Before law school, he worked as a China health industry consultant for China-side government clients.

While living in China, Damjan saw first hand the challenges foreign companies and entrepreneurs face. His experiences at the famous expatriate restaurant group, The Kro’s Nest, were profiled by Bloomberg BusinessWeek. Damjan’s writing and analysis has been featured in many of the leading China media outlets including the China Business Review, The Atlantic Magazine, Reuters, Thompson Reuters’ Bioworld, The Burrill Report and many others.

Damjan is fluent in spoken and written Mandarin. In addition to the language skills he gained while living in Beijing, he has completed more than four years of formal Chinese language training at Duke University, Peking University, the Middlebury College Chinese Language School, and the University of Michigan. In addition to Mandarin, he speaks English, French and Serbo-Croatian. He holds three degrees: a B.A. From Duke University in Public Policy, with a certificate in Health Policy, an M.A. From the University of Michigan Rogel-Lieberthal Center for Chinese Studies, and a J.D. From the University of Michigan Law School.



Michael (Qin) Qu, Managing Partner, Law View Partners [email protected]

Michael is the Managing Partner of Law View Partners, a boutique law firm in China that specializes in providing services to foreign investors and companies in high-growth sectors including healthcare and senior care. The firm’s resources and services span foreign investment and trade, M&A and finance, construction and real estate, corporate compliance, as well as market-leading experience advising clients in corporate transactional advice, intellectual property and commercial litigation.

For years, Michael’s team has been focused on advising foreign investors, emerging companies and investment funds, capital investment, mergers and acquisitions, and business strategy and operation. The firm’s strengths are in the fields of senior housing and healthcare; advertising, technology and media (“ATM”); corporate compliance; and personal legal issues.

Benjamin Shobert, Founder and Managing Director, Rubicon Strategy Group [email protected]

Ben is the Founder and Managing Director of Rubicon Strategy Group, a boutique consulting firm specialized in market access and project management work in China and Southeast Asia’s healthcare, life science and senior care industries. During his work at Rubicon, Ben led the team that obtained the first foreign home healthcare license issued in Beijing, the second such foreign home healthcare license granted for all of China. He also built their strategy around the company’s launch including administrative infrastructure, HR, referral source development, and marketing. Ben regularly advises institutional investors, private equity and operators focused on China and Southeast Asia healthcare and senior care sectors. Under Ben’s leadership, Rubicon completed a research project for one of the first foreign entrants into China’s senior care and private hospital sectors. This research was a key part of their successful $200m capital raise for investments in China.



Ben is a member of the National Committee on U.S.-China Relations and holds advisory board seats at Indiana University’s Research Center on Chinese Politics and Business as well as IAHSA-China (The Global Aging Network). He is a member of the Pacific Council on International Policy. For six years, he wrote a column for the Asia Times on U.S.-China trade and economic policy matters, with a particular focus on how relations between the two countries are being impacted post the 2008 financial crisis. For the last several years, he has written on China’s healthcare, senior care and life science sectors at AsiaHealthcareBlog (now HealthIntelAsia). In addition, his work has been featured at CNBC, China Business Review, Forbes China, Harvard Asia Quarterly and many others.

Yu Yan, Research Analyst, Rubicon Strategy [email protected])

Yu Yan is based in Beijing, where she completed a number of the in-person interviews of key executives for this report. She is a graduate of the University of Michigan’s Asian Studies program, where she successfully completed their M.A. program. She has also worked at the US-China Business Council, where she has been researching the market and policy climate that affects US companies doing business in China, with topics including policy & economic reform, market access, intellectual property regulation, and anti-monopoly investigations.



Abbreviations

AL: Assisted Living Facility

CCRC: Continuing Care Retirement Community

CIRC: China Insurance Regulatory Commission

FDI: Foreign Direct Investment

GOSC: General Office of the State Council of the People’s Republic of China

IL: Independent Living Facility

MCA: Ministry of Civil Affairs of the People’s Republic of China

MC: Memory Care

MLR: Ministry of Land and Resources of the People’s Republic of China

MOF: Ministry of Finance of the People’s Republic of China

MOHURD: Ministry of Housing and Urban-Rural Development of the People’s Republic of China

MOH: Ministry of Health of the People’s Republic of China

NDRC: National Development and Reform Commission

NHFPC: National Health and Family Planning Commission

SAIC: State Administration for Industry and Commerce

SN: Skilled Nursing Facility

WFOE: Wholly Foreign Owned Enterprise



Executive Summary

By 2050, China’s senior care market is projected to reach several trillion dollars in value, as measured by investments in senior housing developments, home healthcare operators, and other ancillary goods and services specifically positioned to serve China’s aging population. Much has been written in various outlets about China’s senior care sector; however, to date no one has attempted a comprehensive review of the regulatory system, commercial models, and strategic insights relative to what is, and is not, working. The purpose of this market research report is to develop precisely these insights, in three ways.

First, to provide a qualitative review and analysis of the experiences from the premier early-stage domestic and foreign senior care operators and investors, capturing key lessons around the market’s acceptance of senior care products and services.

Second, to evaluate the most important regulatory systems currently in place, as well as those under development, that effect the ability of senior housing operators and investors to open, in addition to those government funding mechanisms being piloted across the country that hold the potential to add further stimulus to the senior care sector.

While large in number, China¹s current elderly cohort are also careful consumers. Having lived through periods of instability and economic uncertainty, they are going to require significant education on the value of senior care services - to themselves and their families.



Third, to develop a list of best practices for both domestic and senior care providers that reflects what is currently understood about the Chinese family, its economic concerns, and how to sustainably access and scale a senior care business in China.

The report has a final detailed analysis of the key players, regulations and strategic issues home healthcare operators are facing in China. This section comes last in the report, simply to ensure that confusion around operating models, regulations and commercial insights specific to home healthcare is not muddied. Those senior housing operators that have home healthcare as part of their CCRC are profiled in the earlier section on key senior housing developments.

Overall, this market analysis is focused on practical insights that shape the ability of senior care investors and operators to actually execute in China. The market research was led by in-person interviews through Rubicon’s Beijing office, over the course of six months (spanning late 2014 through early 2015), with an emphasis on interviews with the senior executives and investment managers who have been responsible for the projects in question.

The next section of the report, Investor and Operator Key Takeaways, is a top-level capture of the whole research report. The subsequent section and its bullet-point format are designed for executives who want to gather only the most critical strategic insights into China’s senior housing sector, but who may not have the time to read the report in its entirety.

Among the most important triggers for a viable senior care industry to emerge in China will be the expansion of private long term care financial vehicles. Many of these are already under development, and will be offered to existing middle aged Chinese employees as benefits their elderly parents can have access to as part ofthe younger family member’s employment.

rubicon senior care report - pages 1-12

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