The German care real estate market presents a two-tier picture in the third quarter of 2026. The IMMOTISS Care Index (ICX) climbed from 54 points in the previous quarter to 60 points, signalling an overall balanced market environment above the baseline of 50 points. The barometer, unveiled for the first time at Expo Real 2026, weights four equal market indicators: operator creditworthiness, price index, market index, and transaction activity. The current increase is primarily driven by the returning activity of institutional investors.
Transaction market gains momentum
The sub-index for transaction activity, which tracks capital flows and investor interest in the care sector, recorded a marked increase from 17 to 54 points. Sabine Hirtreiter, Senior Consultant at IMMOTISS, offers an objective assessment of the development, noting that a single quarterly pick-up in the transaction market is initially just a snapshot, whereas the true sustainability of the trend will only become evident later in the year.
The remaining components of the ICX appear largely stable, though they show slight adjustments. Operator creditworthiness held firm at 82 points, close to its historic peak of 83 points in the previous quarter, based on the credit and default analysis of the 100 leading operating companies in Germany. The price index, which measures the relationship between costs and revenues, fell slightly to 58 points (Q2: 61 points), but remains comfortably above the average. By contrast, the market index slipped to 46 points, reflecting the balance between openings, closures, insolvencies, and the development pipeline.
- —Transactions: Increase from 17 to 54 points signals returning investor interest
- —Operator creditworthiness: High stability at 82 points following 83 points in the previous quarter
- —Price index: Solid refinancing foundation at 58 points, above the reference value
- —Market index: Slight decline to 46 points due to muted pipeline activity
Sharp drop in new project planning
While investments in standing assets are gaining ground, new-build activity has noticeably stalled. In the third quarter of 2026, plans were drawn up for only 1,280 new fully inpatient care places. This represents a 52 percent decline compared to the second quarter and a 57 percent drop compared to the third quarter of 2025. This brings an end to a four-quarter recovery phase in which an average of around 2,740 places had been initiated per quarter.
The analysis cites rising inflation rates driven by geopolitical crises, alongside tighter financing terms and stricter banking regulations, as the underlying causes. Calculations prepared nine months ago frequently prove no longer viable under the altered framework conditions. Hirtreiter warns of delayed consequences: experience indicates that around two years elapse between the initial project concept and the start of construction, followed by a construction period of approximately 18 months. Projects halted today will be missing from the market in three to four years, both as essential care capacity and as investment assets.
Founded in 2009 by Jochen Zeeh, the IMMOTISS Group regularly analyses the care sector using its proprietary database Trasenix®. With head offices in Frankfurt am Main and Bremen, the consultancy advises operators, developers, and investors on healthcare and residential concepts with a team of more than 30 specialists.
