by Redazione FriuliSera
The increase in life expectancy in Italy and the ongoing demographic crisis has also brought with it an increase in the number of non-self-sufficient persons with physical or cognitive disabilities who require home or residential care. The RSA sector has seen a strong expansion of large private groups. The main players in the Italian market are Kos Care (belonging to the CIR-De Benedetti group and the F2i fund), Massimo Blasoni's Sereni Orizzonti - the first group by growth in 2024 - and the French multinationals Korian and EMEIS (formerly Orpea).
In the panorama of care for the elderly, Kos is positioned as a leader with its Anni Azzurri brand, managing not only residences for the elderly but also health and rehabilitation facilities, with 6,200 beds concentrated mainly in the northern regions. In strong expansion is the Friulian group Sereni Orizzonti, which boasts 91 facilities and 6,000 beds in Italy, with a presence also in Spain, offering services ranging from residences for the elderly to psychiatric communities and minors. They are followed by the French Korian, the Lombardy group Gheron and the Tuscan group La Villa, linked to the French Maisons de Famille, which manage 3,400 and 2,200 beds respectively.
"There is a shortage of beds and significant investments are needed," says Massimo Blasoni, founder of Sereni Orizzonti, "and it is the private sector that is filling this gap given the scarcity of public funds. Our group is building 20 new RSAs over the next five years, with an investment of 200 million. Home care has objective limitations for the severely non-self-sufficient elderly, as it cannot guarantee a continuous presence, while carers, although essential, rarely have adequate health training. This is why RSAs are indispensable, but it is necessary to overcome regional regulatory fragmentation and ensure high quality, comfortable and welcoming facilities'.
Many existing facilities, both public and private, are obsolete and do not always guarantee high standards. This is why the sector is moving towards more innovative and sustainable solutions. ESG (Environmental, Social, Governance) principles are becoming a priority for those wishing to develop new facilities. According to Istat data updated on 1 January 2023, in Italy there are 12,363 residential facilities with about 408,000 beds, equivalent to 7 per thousand inhabitants. However, a strong territorial disparity emerges: 10 beds per thousand inhabitants in the North against 3 in the South.
However, the issue of costs remains in the foreground. Daily fees fluctuate between EUR 80 and 120, and the public contribution, provided through ASLs and municipalities with criteria differentiated by region, rarely exceeds 50% of the amount. This has led to the growth of a private market paid for entirely by families. "In Germany," Blasoni points out, "there is a system of protection for non-self-sufficiency, which can be private voluntary or public compulsory: a mechanism that, although based on provisions during working life, protects the elderly and prevents families from having to bear the often prohibitive costs entirely.
A further critical issue concerns the shortage of qualified personnel: social workers and nurses are increasingly difficult to find, with few graduates available and a lack of attractiveness of the sector. Proposals to address this shortage range from salary increases, with the risk of repercussions on fees, to the use of foreign staff, a solution complicated by the difficulty in recognising qualifications and sometimes opposed by professional associations.
Perhaps better planning of university courses is lacking: meanwhile the number of elderly people continues to grow. We must avoid an Italian paradox: a country that excels in longevity but runs the risk of not having a fully adequate model for taking care of the elderly and the costs of care.
Full article available at the following link 👇