Why More Investors, Operators Are Seeking to Export Senior Living

Why More Investors, Operators Are Seeking to Export Senior Living


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For years, I have assumed that relatively few senior living operators had ambitions to grow their holdings beyond the U.S. and Canada. In 2024, I no longer hold that assumption.

On Tuesday, I caught wind of Thrive Senior Living’s plans to grow a new joint venture independent and active adult management company in South Korea with GH Partners, a Seoul-based company that is the largest multifamily operator in the country.

Thrive is no stranger to international senior living, and the company has quietly worked in places like Thailand and the U.K. in recent years. But when I spoke with Thrive Founder Jeramy Ragsdale, he said he sees markets in countries like South Korea as increasingly good opportunities for growth in 2024 and beyond.

What has changed is that institutional investors are now looking to deploy dollars designated for senior living in markets outside of the U.S., he said. As they do so, they are often looking to export the U.S. private-pay model by bringing in companies with track records and experience in the sector.

“In Asia now, you’ve got a couple of big fund managers that have raised dedicated seniors housing funds or dedicated alternative residential funds with a senior housing allocation in them,” Ragsdale told me. “What they’re looking for are experts that are experienced in the space, even if that’s in another market.”

In this week’s members-only, exclusive SHN+ Update, I analyze the state of companies with holdings in the U.S. expanding overseas, and offer the following takeaways, including:

  • The philosophy behind Thrive’s plans in South Korea and its quiet growth in the U.K. 
  • Other companies growing overseas in 2024
  • The ripe conditions for exporting the U.S. senior living model internationally

Thrive’s quiet international strategy

Earlier this week, Thrive Senior Living announced the launch of its new joint-venture company, Thrive-GHP. The company is aiming to serve the rapidly growing South Korean senior living sector, particularly in the independent living and active adult categories.

Frankly, I was somewhat surprised to see Atlanta-based Thrive announce its latest international plans. Over the years, I’ve known the company for its forward-thinking projects in the U.S. To date the company has about 17 communities stateside, and it’s been involved in dozens others over the years that have changed hands.

But it turns out that the company has had international ambitions for some time. About eight years ago, Thrive entered the U.K. market with a partner, and now the companies have about a dozen communities in the region, with more growth potentially on the way, Ragsdale told me. The operator also has consulted overseas in parts of Asia over the last five years.

Under the arrangement in South Korea, Thrive holds 50% joint ownership, and the new company also carries the Thrive brand name. Looking ahead, Ragsdale said he foresees more growth in South Korea, and the company expects to announce something to that end in the next 120 days.

“There are a lot of really unique dynamics about Korea, not just in general, but right now, that we think make this really compelling,” he said. “Just like we did in the U.K., we’re stepping into this with an existing best-in-class joint venture partner from day one.”

Thrive is not the only company making moves overseas. In the last 12 months, some other companies with operations in the U.S. have made public moves to grow and change overseas.

They include Priya Living, which in 2023 launched a new management platform in a handful of cities in India; Singapore-based Keppel Corporation, which owns a majority stake of Watermark Retirement Communities and recently opened a community in Nanjing, China; and Columbia Pacific, which in May merged its Columbia Pacific Communities arm in India with Kites Senior Care, another Indian firm.

REITs including Ventas and Welltower have also opened and acquired communities in both the U.K. and Canada in recent years.

International deals have thus far not led to big, fruitful expansions for U.S.-based senior living companies. I think back to the companies that invested in operations in China in the mid-2010s, before some of those same companies began to pull back on those investments in 2019 after difficulties getting off the ground there.

Still, as Ragsdale told me, institutional investors are looking to put their money into other emerging markets. I think that this could change the game with regard to international expansion – but that does not mean that such efforts will be easy.

Exporting U.S. senior living

In many ways, the new joint venture company in South Korea is the culmination of a long learning process for Ragsdale and Thrive.

“We’ve made our own share of mistakes, and we’re trying to be students of everyone else’s mistakes, as well,” he said.

Ragsdale said there have been plenty of mistakes to study. He said he’s observed many international deals fall apart over the years, and come away with the notion that any international deal must be undertaken with a strong partner who knows the local market.

To be fair, that’s a philosophy I’ve heard over the years from other senior living operators, including some whose platforms didn’t get off the ground. But I also think things have changed since the Covid-19 pandemic started in 2020.

Aging populations in countries like Japan, India and China mean there are potentially hundreds of millions more older adults in other countries to serve in the years ahead. That doesn’t mean operators should jump headlong into these markets without good plans, but I do think it means they should be thinking about it.

Indeed, Ragsdale believes now is the time to expand in international markets like those in South Korea. He pointed to the fact that the South Korean commercial and residential real estate markets are now more mature than they’ve ever been, and that senior housing largely does not yet exist as an asset class there.

“In terms of penetration into the market, there’s almost zero, and we see just a ton of investor interest beginning to grow in that space,” Ragsdale told Senior Housing News.

International expansion brings risks but also opportunities, and I’m most excited to see how overseas projects could lead to greater innovation in senior living globally, including in the United States. We’ve reported on terrific examples of international innovation over the years and honored some of these efforts in our Architecture & Design Awards. One example is Rawhiti Estate in New Zealand, where care-intensive residents have balconies overlooking a lush atrium that serves as a space for socialization and activities.

“Even if somebody is in a bed, they can still listen to the piano, they can still be part of the energy,” project architect Anthony Flannery, director of re-Imagine Ltd., told SHN in 2021.

Priya Living CEO Arun Paul is another big proponent of senior living innovation as well as overseas growth. The company is forging ahead with a concept wherein older adults returning to India for a short trip can book stays of just 30 days. For that concept, Paul said he’s seen “demand from all over the globe.”

“The reality is the U.S. senior living industry is very advanced globally. We’ve actually got a great product when you think when you think globally,” he told me in 2023. “So why aren’t we exporting our product?”

Keppel, the majority owner of Watermark, is another company that is thinking globally. The company, which has $79 billion of funds under management, is looking to places like China, which has a “population age pyramid,” according to Kai Hsiao, CEO for Healthcare at Keppel and former CEO of U.S.-based Eclipse Senior Living.

“That need for senior living is going to be pretty great. In China, because of the previous one-child policy, now you can have one couple in charge of four parents. That makes the need even greater,” he said in an Argentum interview earlier this month.

The company’s new 400-bed community in Nanjing, China, is its first in Asia. But Hsiao said the opening is “a launchpad for our expansion into other senior living markets in China and beyond.”

“What we’ve done in China is take the lessons that we’ve learned in the U.S., along with some of the lessons that we’re learning in the U.K. through our satellite office, and we’ve tried to address them upfront versus down the road, while adapting our offerings to the local context and culture,” he said.

I think it’s likely we see more U.S.-based companies launch new products and platforms in other countries, especially as they seek growth for the future. Like Keppel, I believe that other companies are building their own respective launchpads from which to propel future plans.



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