China's three-tier elderly care service network achieves initial results

The Ensign Group expanded its skilled nursing footprint through a coordinated set of acquisitions across Florida, Washington and Colorado. In Florida, it entered the state by adding eight operations with 713 skilled nursing beds and 66 independent living units, while separately buying the real estate and operations of a 118-bed Pensacola facility; it also added four Washington facilities totaling 532 skilled nursing beds and seven Colorado facilities with 760 skilled nursing beds and 47 independent living units. Most acquired operations will run under long-term triple-net leases, while Ensign's Standard Bearer REIT owns the Pensacola property and five additional real estate assets. After these transactions, Ensign said its portfolio reached 418 healthcare operations, including 50 senior living operations, across 18 states, and its subsidiaries including Standard Bearer now hold 189 real estate assets nationwide. As of June 30, 2026, Ensign held $262.3 million in cash and cash equivalents, with long-term debt excluding current maturities at $135.6 million and $591.6 million of available capacity under its line of credit, while net cash provided by operating activities reached $272.1 million in the first half of 2026, up from $228 million a year earlier.

Nichii Holdings Chairman Hiroshi Shimizu, in an interview, revealed a policy of partnering with municipalities and operators to sustain regional elderly care systems. He also indicated plans to invest 30 billion yen over four years starting this fiscal year to improve on-site response capabilities at roughly 1,900 care locations nationwide. Specific partnership measures envisioned include cost efficiency through joint purchasing of supplies and personnel support such as dispatching care assistants. Regional elderly care businesses face a harsh environment due to labor shortages and other factors, and Shimizu noted that "there are limits to what Nichii can do on its own."

Kasikorn Securities assesses that the two-week delay in the election of the Social Security Office board is unlikely to affect the approval of adjustments to medical treatment service rates, which are currently under review by the subcommittee considering medical treatment rate levels. The new SSO board is expected to begin work within November, later than the previously expected October, and the board will be the one to approve the subcommittee's meeting results and set the effective date of the new service rates. Currently, the subcommittee is scheduled to hold its third meeting on October 5, at which a conclusion on the rate adjustment is expected. If no conclusion is reached, a fourth meeting may be needed on October 24, which must be held before that date because it is when the subcommittee's term expires. The research team maintains a neutral view on the hospital sector, with PR9 as its top pick, and holds a positive view that the subcommittee will consider raising the flat-rate payment by 5%, assuming the flat-rate adjustment takes effect from 2027 onward in its profit forecasts for the three social security hospital stocks under coverage. It recommends buying BCH with a target price of 12.50 baht and RJH with a target price of 17.20 baht, and recommends holding CHG with a target price of 1.69 baht. However, if the Social Security Office does not raise service rates at all, the DCF value would fall 5% for BCH to 11.9 baht, fall 4% for RJH to 16.50 baht, and fall 4% for CHG to 1.69 baht.