IMMOTISS QUARTERLY – Q2 2026
The Market Index for Nursing Homes in Germany
The foundation holds: market, prices, and creditworthiness are above the normal value of 50, and operator creditworthiness reaches its high of 83. At 54 index points, the ICX remains in balanced territory despite the transaction low.
ICX – OVERALL INDEX – ASSET CLASS NURSING HOME
Quarterly Trend
Data-driven and objective: benchmark for the nursing home market environment. Overall index and four sub-indices by quarter.
The IMMOTISS Care Index (ICX) stands at 54 index points in the second quarter of 2026 (Q1 2026: 75). As in all six quarters since Q1 2025, it remains above the reference value of 50 but reaches the lowest level in the series. The transaction low largely explains the decline; market, prices, and creditworthiness are above 50. The individual quarter shows activity, while the annual cycle shows the market environment: at an average of 61, it remains balanced. Overall, the ICX makes individual events visible, puts them in context, and shows whether they support the overall picture.
– Commentary on this issue
“A weak quarter is not yet a weak market. The ICX stands at 54 because transactions have collapsed. Market, prices, and creditworthiness are all above the normal value. The foundation holds and is more resilient than market perception would suggest.“
Jochen Zeeh
Managing Director, IMMOTISS
Operator Creditworthiness
INCANS® Global Portfolio Score
Creditworthiness and probability of default, now also for the German nursing home operator market: the portfolio of the 100 most relevant operators is curated exclusively with Income Analytics.
In the second quarter of 2026, the creditworthiness of the 100 relevant operators reaches 83 points, its highest level since measurement began, placing it in the Medium to Low risk band. The score describes the portfolio and does not replace an assessment of individual operators.
CHANGE OF PERSPECTIVE: HEALTHCARE
Overall Market View
The ICX measures the development of nursing homes. From here, the view widens to the entire healthcare investment market: nursing homes, assisted living, and healthcare provision real estate compared.
HEALTHCARE INVESTMENT MARKET
Transaction Volume
The healthcare investment market quarter over quarter: the IMMOTISS transaction volume shows where investors are active and how much capital they are moving.
Transaction volume rises to €580 million in the second quarter of 2026 (+104% versus Q2 2025: €285 million). This was driven almost entirely by traded healthcare provision real estate (€500 million), owing to a large deal involving a nationwide hospital portfolio; nursing homes (€50 million) and Senior Living (€30 million) trail behind. The healthcare market is growing, but inpatient care as an ICX component is below the prior-year quarter.
HEALTHCARE INVESTMENT MARKET
Year-on-Year Comparison
Healthcare transaction volume reaches €1.82 billion in the first half of 2026, already 50% above the entire prior year (€1.2 billion). Just under two-thirds arose in the first quarter, driven by two large deals: Aedifica’s takeover of Cofinimmo and the sale of an outpatient portfolio to TPG.
HEALTHCARE INVESTMENT MARKET
Prime Yield Trends
Prime yields have moved only marginally in recent quarters and remain at a stable level for nursing homes and Senior Living. In 2026, the prime yield for inpatient nursing homes is 5.2%, 20 basis points above healthcare provision real estate (5.0%) and 70 basis points above Senior Living (4.5%). The premium on nursing homes reflects operator risk: with nursing homes, investors buy the property as well as the credit quality of the tenant/operator, whereas in Senior Living it is mainly the residential value that carries the investment.
IN FOCUS: OPERATOR CREDITWORTHINESS
Two Years on an upward Trend
The INCANS score of the 100 most relevant nursing home operators has risen steadily from 75 to 83 points since Q2 2024. The score predicts the probability that a company will default within the next twelve months and takes into account not only balance sheets but also payment behavior, court judgments, and shareholder structure. A score of 83 corresponds to an annual probability of default of 0.1 to 0.5%, equivalent to a bond rating of BBB. The concern about operator defaults is therefore not reflected in the figures: defaults are isolated cases, and with carefully vetted operators, the risk can also be well contained through active management. This supports the attractiveness of nursing homes as an asset class.
83
INCANS® GLOBAL
PORTFOLIO
SCORE
“The creditworthiness of operators shows substance and stability. Those who look closely and, above all, manage actively will find in nursing home operators not a default risk but solid partners.””
Daniel Wolf
Managing Director Asset Management
FAQ
Frequently Asked Questions about the ICX
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The ICX is the benchmark for the nursing home market environment in Germany: data-driven, objective, and unsmoothed. It combines four market signals into a single number between 0 and 100 rather than relying on individual events, and is updated every quarter.
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The database that understands the healthcare market – in depth, up to date and structured. It links operators, properties and markets into clear patterns.