China’s elderly care industry is no longer a bet on the future. It is a market that already moves close to 16 trillion RMB a year, and it is still short of the capacity, the trained staff and the operators it needs. For foreign businesses willing to deal with the licensing and find the right local partner, that gap is the opportunity.
Olivier Verot is the founder and CEO of Gentlemen Marketing Agency, based in Shanghai since 2012. He has advised foreign health, medical device and senior care companies on market entry, licensing and positioning in China for over a decade.
Key Takeaways of the Elderly Care Industry
- China’s overall elderly care sector is estimated at around 16.3 trillion RMB in 2025, with projections near 18.7 trillion RMB in 2026, according to industry data compiled by 中商产业研究院.
- Foreign investors can now own 100% of a for-profit elderly care institution through a WFOE. The sector has been classified as “encouraged” under China’s foreign investment catalogue since 2015.
- Nine out of ten Chinese seniors still receive care at home, not in an institution. This is the “9073” structure that Shanghai set as policy fifteen years ago and that still shapes the whole industry: 90% home care, 7% community care, 3% institutional care.
- A national long-term care insurance system, until now limited to 49 pilot cities, is being rolled out across the whole country over the next three years, under a policy released in March 2026. That changes who pays for care, and how.
- The real opportunity for foreign operators is not just nursing homes. It spans home care services, staff training, medical equipment for the home, rehabilitation, and the software that connects families to caregivers.
How Big Is the Elderly Care Industry, Really
China had close to 310 million people aged 60 or above by the end of 2025, and the number keeps climbing. That demographic story is well known by now. What matters more for a business decision is what is being built to serve them, and who is paying for it.
The market for elderly care institutions alone, meaning nursing homes, assisted living and long-term care facilities, was worth around 222.6 billion RMB in 2024. Private operators already run 76.77% of these institutions. The number of licensed elder care service providers in China grew from 204,000 in 2019 to over 404,000 in 2023, roughly doubling in four years. That is not a market waiting to happen. It is one that is already being built, mostly by domestic players, which is exactly why the door is open for foreign operators who bring something those players don’t have yet: proven models, training standards, or specialized equipment.
Why Home Care Beats the Nursing Home Model
Foreign investors often arrive in China thinking about the nursing home, because that is the model they know from home. But the 9073 structure means nine seniors out of ten stay in their own apartment. Community and institutional care combined make up only 10% of the picture. If your business plan is built entirely around beds and buildings, you are competing for a small slice of a much bigger market.
The companies growing fastest right now are the ones serving home care directly: nursing visits, meal delivery, rehabilitation at home, and remote monitoring. Fushoukang (福寿康), a domestic home care provider, now runs over 200 care stations across the country and is the largest player of its kind. That single example tells you where the demand actually sits, and where a foreign supplier of equipment, software or training has the most room to plug in.
Long-Term Care Insurance: What Changed in 2026
Until early 2026, long-term care insurance in China existed only as a pilot, running in 49 cities and covering about 188 million people. In March 2026, the central government published a policy to build a nationwide long-term care insurance system within roughly three years, moving from scattered local pilots to a country-wide scheme.
This matters more than it looks. Right now, most home care and institutional care in China is paid out of pocket by the family. Once a service or a piece of equipment qualifies for reimbursement under this insurance, it stops being a discretionary purchase and becomes something a case manager can prescribe. For a foreign company selling rehabilitation equipment, monitoring devices or professional caregiving services, getting a product recognized inside this reimbursement system, even a few years from now, is worth planning for today.
What Foreign Businesses Need to Know Before Entering
In 2019, China gave foreign investors national treatment in the aged-care sector, putting them on the same regulatory footing as domestic companies. That principle still holds, and the practical rules have gotten clearer since.
Foreign investors can set up a wholly foreign-owned enterprise to run a for-profit elderly care institution. The sector sits in the “encouraged” category of China’s foreign investment catalogue, which in practice means faster approvals and, in some regions, tax and land incentives. The process runs through three steps: approval from the commerce authorities, a license from the local Ministry of Civil Affairs bureau, and business registration. If the facility also wants to offer medical services, such as an on-site clinic, or catering, each of those needs its own separate license.
None of that removes the need for a local partner. Licensing tells you what you are legally allowed to do. It does not tell you how to hire qualified caregivers in a country that is short on trained nursing staff, how to get referrals from hospitals and community health centers, or how a Chinese family actually decides where to place a parent. A joint operation with a domestic care provider, even without a formal joint venture structure, usually beats going it alone on those questions.
Where the Real Opportunities Are
Beyond the institution itself, several segments are growing faster than the headline market number, largely because China does not yet have enough domestic players who do them well.
- Home care services: nursing visits, housekeeping, meal preparation and transportation for seniors who want to age in their own home rather than move.
- Rehabilitation and physical therapy: post-stroke and post-surgery recovery programs are underdeveloped outside major hospitals.
- Remote monitoring and smart devices: fall detection, vital sign tracking, and emergency alert systems for seniors living alone or with limited family nearby.
- Staff training: China’s nursing shortage is one of the industry’s biggest bottlenecks. Foreign operators with structured caregiver training programs have a real edge here, both as a service to sell and as a way to differentiate a facility.
- Hospice and palliative care: still a small, mostly private-hospital segment, but growing as families become more open to the conversation.
On the product side, this overlaps with categories like adult incontinence products, which we cover in more detail in our companion piece on China’s adult diapers market. If you are selling a physical product into this space rather than operating a service, that article walks through the retail and e-commerce side specifically.
A Case Study: Selling Through the Caregiver, Not the Consumer
Marc runs a small Belgian company that makes wearable fall-detection sensors for seniors living alone. For a year, he sold directly to Chinese consumers through a Tmall flagship store. Sales stayed flat, around 200 units a month, mostly bought by tech-savvy adult children in Shanghai and Shenzhen who found the store through paid search.
The problem was not the product. It was who he was selling to. The real decision-maker was never the senior wearing the sensor. It was the son or daughter managing a parent’s care from another city, and they were not shopping for medical devices on Tmall. They were asking their parent’s home care aide what to buy.
We rebuilt the go-to-market around that insight. Instead of positioning the sensor as consumer electronics, we packaged it as an add-on inside the subscription plans of three regional home care providers, the kind of company that already sends a caregiver to a senior’s apartment two or three times a week. The care coordinator recommends the device during a home visit. The family pays through the same WeChat mini program they already use to book visits. The data feeds straight into the coordinator’s monitoring dashboard, so the caregiver becomes the one using and vouching for the product, not just the person delivering it.
Within eight months, the sensors were installed in about 1,400 households across the three partner networks, at roughly a third of the acquisition cost of the Tmall ads. The mechanism was simple: Marc stopped competing for the senior’s attention and started selling to the person the family already trusts with decisions about a parent’s care.
Challenges Foreign Operators Actually Run Into
The market is large and growing fast, but that does not make it easy to enter. Three problems come up in nearly every conversation we have with foreign operators considering China.
- Staffing. China does not train enough qualified caregivers and nurses for the demand that already exists. Facilities and home care providers compete hard for trained staff, and turnover is high.
- Profitability of institutional care. Nursing homes are capital intensive, occupancy takes years to build, and margins are thin until a facility reaches scale. Home care and equipment models generally reach breakeven faster.
- Cultural expectations around family care. In many Chinese families, placing a parent in an institution still carries a stigma that does not exist in the same way in Europe or North America. A facility or service that frames itself as supporting the family, rather than replacing it, tends to face less resistance.
None of these are reasons to stay out. They are reasons to enter with a local partner who has already solved for staffing and referrals, rather than trying to build that from zero as a foreign entrant.
Marketing to Operators, Families and Regulators
Marketing an elderly care business in China is not the same exercise as marketing a consumer product to seniors themselves. If you are selling directly to older Chinese consumers, our companion article on how to adapt your marketing strategy to the Chinese aging population covers that side in depth.
For a care service, a facility or a piece of medical equipment, the audience is usually different: adult children aged 35 to 55 who research on Baidu and WeChat before ever calling a facility, hospital and community health center staff who make referrals, and increasingly, insurance case managers once reimbursement enters the picture. Baidu SEO and Baidu-indexed content still carry weight here, especially content that establishes credentials: certifications, licenses, staff qualifications. WeChat official accounts remain the main channel for the kind of trust-building content a family reads before visiting a facility in person. On Xiaohongshu, the audience searching “怎么给父母选养老院” (how to choose a nursing home for parents) or “居家养老服务” (home care services) skews toward that same 35 to 55 age group, not seniors. Building content around their questions, in their language, is what turns a search into a phone call.
This is a market where trust is built slowly and lost quickly. A single bad review about a facility’s care quality travels fast on Chinese social platforms, faster than most Western operators expect. Reputation management is not optional here, it is part of the marketing plan from day one.
Frequently Asked Questions
Can a foreign company own 100% of a nursing home in China?
Yes, for for-profit elderly care institutions. Since 2015, the sector has been classified as “encouraged” for foreign investment, which allows a wholly foreign-owned enterprise structure. You still need approval from commerce authorities, a license from the local Ministry of Civil Affairs bureau, and separate licenses for any medical or catering services offered on site.
Is home care or institutional care the bigger opportunity right now?
Home care, by volume. Around 90% of Chinese seniors receive care at home rather than in a facility. Institutional care is growing too, but it needs more capital and takes longer to become profitable. Most foreign entrants find a faster path through home care services, equipment or staff training than through building a nursing home from scratch.
Does the new long-term care insurance policy change the business case?
It should, over time. The system currently covers about 188 million people across 49 pilot cities, and a March 2026 policy commits to expanding it nationwide within roughly three years. Once a service or device qualifies for reimbursement, it moves from an out-of-pocket purchase to something a case manager can recommend, which changes the sales cycle entirely.
Should we market to seniors or to their adult children?
For most care services and equipment, the adult children, usually aged 35 to 55, are the actual decision-makers and researchers. They search on Baidu and Xiaohongshu before contacting a provider. If you sell a consumer product that seniors buy for themselves, the approach is different: see our article on marketing directly to the aging population.
Do we still need a local partner if a WFOE is legally allowed?
In practice, yes. Licensing tells you what is legally possible, not how to recruit qualified caregivers, secure hospital referrals, or work through how Chinese families choose a provider. A joint operation with an established local player, even short of a formal joint venture, generally moves faster than building all of that from scratch.
Partner Up with Gentlemen Marketing Agency
China’s elderly care industry rewards operators who understand both the regulatory process and the people making the decisions. We help foreign care providers, equipment makers and health brands enter this market: positioning for Chinese families and institutional buyers, Baidu and WeChat content that builds the credibility this sector demands, and connections to the local partners who already have the staff and the referral networks in place.
If you want to see whether your care service, facility or medical device has a real path into this market, contact us here. We offer a free consultation to review your positioning and the licensing route that fits your business model.
Sources: 中商产业研究院 elderly care market data via Qianzhan Industry Research; elderly care institution figures via Huaon Industry Research; long-term care insurance policy via the National Healthcare Security Administration; foreign investment rules via The National Law Review. See also our articles on China’s silver economy, healthcare marketing best practices in China, and short-video platforms and the silver generation.
