Healthcare real estate is gaining weight within investment strategies in Spain. This category includes very different assets — nursing homes, hospitals, social and healthcare centres, or new formats such as senior living — but they all share one feature: their demand is closely linked to long-term demographic and care-related trends.
Investor interest reflects this change in scale. Spain closed 2025 as the fourth-largest European market by healthcare investment volume and began 2026 with 471 million euros invested during the first quarter, the best figure for that period in JLL’s historical series.
The phenomenon is not exclusively Spanish. Healthcare investment increased by 28.3% in the EMEA region during 2025. However, population ageing, the supply deficit and market fragmentation place Spain in a particularly relevant position.
A record first quarter, with large transactions playing a major role
The 471 million euros recorded between January and March multiplied the volume of the same period in 2025 by more than ten. However, this figure requires some nuance: it was influenced by two pan-European transactions with a significant presence in Spain — the integration of Cofinimmo and Aedifica and the acquisition of ISEMIA by TwentyTwo Real Estate and Farallon Capital.
The record therefore reflects both activity involving Spanish assets and the growing weight these assets have within large international portfolios.
This interest was preceded by an exceptional 2025. According to Colliers, real estate investment in healthcare reached 1.358 billion euros, the highest volume in its historical series. Nursing homes and hospitals accounted for most of that activity.
Nursing homes: a deficit that already exists and will continue to grow
Nursing homes currently constitute the main segment of healthcare real estate.
Spain has around 10.3 million people over the age of 65 and approximately 413,000 residential care places. This puts coverage at around 4%, below the 5% usually used as a reference level.
The deficit can be viewed from two perspectives. Colliers estimates that around 103,000 places are currently lacking to achieve adequate coverage. JLL also incorporates future demographic evolution and calculates that around 240,000 new places will need to be added over the next decade to maintain coverage and approach 5%. That expansion would require an estimated investment of between 16 and 19 billion euros.
These are therefore not contradictory estimates. The first describes the existing deficit based on the current population; the second incorporates the expected increase in the elderly population over the coming years.
Investment volume already reflects this imbalance. According to Colliers, nursing homes accounted for 867 million euros in 2025, around two-thirds of all healthcare investment.
A market that remains highly fragmented
The shortage of places is compounded by another relevant characteristic: the fragmentation of supply.
The ten leading nursing home operators account for barely 20% of existing places in Spain. This atomisation leaves room for consolidation processes and for the growth of specialised platforms capable of gaining scale.
In fact, the increase in investment does not come only from institutional funds. Colliers also highlights the participation of family offices, both in operational assets and in new developments.
This helps explain why healthcare is gaining depth as a real estate market: it is not only necessary to build new supply, but also to professionalise and consolidate part of the existing stock.
Hospitals: a large pipeline, but still insufficient
The second major block is the hospital segment. Ageing, rising healthcare needs and the growth of private health insurance are driving new projects.
In Spain, waiting lists stand at an average of 101 days and private healthcare spending represents close to 30% of the total. Around 26% of the population also has private health insurance, according to estimates gathered by JLL and Colliers.
There are currently more than 70 hospital projects in different stages of development, which will add more than 10,000 new beds in the coming years. The most active operators include Quirónsalud, HM Hospitales and Vithas.
However, the pipeline could still prove insufficient. Colliers estimates that, even including the planned supply, the ratio of private beds could decline over the coming years due to rising demand. Its report calculates that around 5,500 additional beds would need to be developed in the short term to maintain current coverage levels.
Investment in hospitals reached 411 million euros in 2025, around 30% of the total volume recorded by Colliers.
Senior living: still small, but with room to grow
Healthcare does not end with hospitals and nursing homes.
Senior living is mainly aimed at independent older people looking for adapted homes, services and community spaces, without the care component typical of a nursing home.
It is still a small segment: Colliers places 2025 investment at around 80 million euros and estimates that Spain has just over 4,000 operational units. However, stock could approach 8,000 units by 2031.
The consultancy also identifies other underdeveloped niches, such as certain assets linked to mental health, which could progressively expand the healthcare investment universe.
Demand alone is not enough: the operator is key
Healthcare has one characteristic that differentiates it from other real estate assets: the property and the activity carried out inside it are closely linked.
A nursing home or hospital may be located in an area with high demand and still perform poorly if the operator does not manage the asset properly.
That is why, in addition to the property itself, it is worth analysing:
- the operator’s experience and solvency;
- occupancy;
- sustainability of rents;
- staff costs;
- duration and structure of contracts;
- investment and maintenance needs;
- applicable regulation;
- and the ability to replace the operator if necessary.
Population ageing creates a structural need, but it does not automatically turn any healthcare project into a good investment.
More capital also increases competition
Growing interest also has another consequence: more investors competing for the best assets.
The Colliers Healthcare in Spain Report points to a compression of required returns — yields — especially in higher-quality assets and new developments.
This introduces a common real estate paradox: solid fundamentals can attract more capital, raise asset prices and reduce the return available to those entering later.
Market growth should therefore not be interpreted solely as a positive signal. The acquisition price, the quality of the operator and the economic sustainability of the operation remain decisive.
A structural sector, but an increasingly selective one
Data from JLL and Colliers portray a market supported by trends that are difficult to ignore: an ageing population, a shortage of residential care places, greater healthcare demand and the need to expand infrastructure.
But social need and investment opportunity are not exactly the same thing.
As more capital enters the market, selection becomes even more important. Location, price, operator, contract and care model determine whether those strong fundamentals can truly translate into economic results.
Healthcare therefore presents a structural opportunity for Spanish real estate, but also an increasingly professionalised market in which understanding the specific transaction is just as important as identifying the underlying trend.
