With €1B War Chest, Belgian Care Homes Giant Lines Up Expansion Across Ireland

Belgian healthcare REIT Aedifica is stepping up expansion in Ireland, fuelled in part by €1B earmarked for growth after its planned merger with domestic rival Cofinimmo was given shareholder go-ahead.

The company, one of Europe’s largest in the healthcare sector, believes the consolidation will create a significantly larger platform for investment, including in care homes, and strengthen its ability to pursue growth opportunities in key markets such as Ireland.

With three projects currently under construction and Ireland’s buoyant economy and undersupply of care home facilities, Aedifica has left no doubt that Ireland is in the sights of a specialist investor determined to grow its footplate across the country.

“There is not enough capacity in Ireland, and new schemes fill very quickly," said Aedifica Country Manager and Head of UK and Ireland Bruce Walker, who has established a three-person Irish team to drive growth.

The Brussels-listed group specialises in acquiring and funding development of healthcare real estate including nursing homes, assisted living facilities and other care infrastructure.

Over recent years, it has become one of the largest healthcare real estate investors in Europe, and Ireland has emerged as one of the most attractive markets within its network, with an ageing population, a shortage of modern care facilities and a fragmented operator landscape creating favourable conditions for long-term investment.

And Aedifica’s expansion ambitions have been reinforced by its move to combine with Belgian peer Cofinimmo, which will see a full merger and absorption of Cofinimmo within the group.

The merger with Cofinimmo takes its total portfolio from around €6B to €12B, and a combination of sales required for competition compliance in Finland — plus the recycling of noncore assets from the acquisition — is going to mean the group should have around €1B to reinvest in the next 12 months, Walker said.

Chief Executive Stefaan Gielens highlighted Ireland as one of the key expansion markets during a recent call with investors, as it was “doing much better than the rest of Europe,” describing the current holdings as a young portfolio with mature assets.

“But what we do see in the portfolio in Ireland is that ramping up is going at quite remarkable speed, meaning that for most of these Irish care homes, 12 months after delivery of the asset, we already see occupancy rates going above 80%, in some cases, even reaching 90%,” Gielens said, stressing that the occupancy reported in Ireland’s facilities would take twice as long to achieve in other European countries.

Across the portfolio, operator occupancy levels at Aedifica’s facilities had also hit 96% in Ireland, compared with an average of 91% across the group’s portfolio. The company first entered the Irish market in 2021, two years after the UK, where it has grown to circa 120 properties valued at more than €1.2B.

In Ireland, it has been highly active ever since, now owning 22 properties with 2,300 users, having expanded rapidly through a mix of acquisitions and development partnerships with care operators. 

"Our model is to create or refurbish to very high environmental specifications and then hand over the operations to specialists, who will then benefit from low energy costs, which is obviously a major cost in a care home,” Walker said.

Indeed, the company’s investment model focuses on acquiring or developing purpose-built care homes and leasing them to operators under long-term contracts, typically running for 25 to 30 years and structured as triple-net agreements indexed to inflation.

Ireland is particularly attractive because the care home sector remains highly fragmented and undersupplied and many facilities in the country are relatively old and require replacement or refurbishment to meet modern care standards, Walker said. 

Aedifica has already committed significant capital to the Irish market, totalling around €450M, and new developments are part of the strategy. The group has various projects underway, including a Limerick cancer care centre — to be operated by UPMC and Bon Secours Health System, Ireland’s largest private hospital group — and care homes in Kilcoole and Crumlin, Dublin under development, with completions due next year and in early 2028.

The company also owns Beaumont Lodge in Dublin, which at 221 beds is Ireland’s largest transitional care unit, providing a short-term care facility where patients stay for step-down care after being discharged from hospital before transitioning to home or another care setting. Walker said it has been very successful and represents a cost-effective way of providing care and unblocking beds in the nearby hospital and is an area the company would also like to expand.

“Ireland has already hit critical mass, and the capital recycling going on across the group should provide significant new funds to invest over the next 12 months or so and the UK and Ireland are key markets for growth. The merger has weighted the estate back to continental Europe, and, given the right opportunities, there will be an onus to rebalance that,” he said.

Its ambitions are supported by the group’s latest financial results, which showed continued growth in rental income and earnings as the portfolio expands. For the year to December 2025, Aedifica reported earnings of €244M, up around 4% year-on-year, while rental income rose by about 7%. The company’s total real estate portfolio reached approximately €6.3B across more than 600 sites in Europe.

The results also showed the group had a total investment programme worth around €276M at the end of last year, with Ireland’s budget valued at €102M, the highest market listed. 

However, Walker does see one obstacle to expansion in Ireland compared with the UK, where it is also looking to grow, pointing to new build costs.

“While we view Ireland very positively, the one obstacle that there is still a 13% VAT cost on building, compared with zero in the UK, which obviously has an impact on viability and capital deployment," he said. “The changes in residential tax regulations are encouraging, and we would like to see that extended to care homes."