106 Beds, 15% of Malaysia

What the numbers tell us about eldercare—and what families need to know before the next hospital discharge

By Denis Lim

I’ve handled every admission at our nursing home since we opened in July 2024. Over 180 families. Almost every conversation starts the same way: a parent just got discharged from hospital, the family is overwhelmed, and someone told them to “find a nursing home.”

So they search online. They call places. And here’s where it gets complicated: most of what comes up aren’t nursing homes at all. They’re care centres. Different licensing, different capabilities, different limitations. But the names sound similar, and in a crisis, who has time to parse regulatory frameworks?

I’ve sat with families who only discovered after placement that the facility they chose wasn’t equipped to handle their parent’s care needs. It’s not a reflection on the facility—care centres serve a different purpose and serve it well. But when families make urgent decisions without understanding the regulatory distinctions, these mismatches happen. With the right information upfront, they’re entirely avoidable.

Two Acts, Two Different Systems

Elderly care centres are registered under the Care Centres Act 1993 (Akta 506), overseen by JKM—the Department of Social Welfare. The Act defines “jagaan” as perlindungan, pengawasan, pemulihan dan latihan—protection, supervision, rehabilitation, and training. Notice what’s absent: any mention of clinical or medical care.

Section 7(g) of Act 506 requires care centres to make “adequate arrangements” for medical treatment “within reasonable time”—meaning referral pathways to healthcare, not in-house clinical services. There are approximately 490 such registered facilities nationwide, doing important work for relatively independent seniors who need meals, companionship, and supervision.

Nursing homes operate under the Private Healthcare Facilities and Services Act 1998 (Act 586)—the same law governing private hospitals. We’re licensed by the Ministry of Health, not JKM. The requirements are healthcare-grade: staffing ratios, medication protocols, infection control, continuous compliance audits. Section 3 of Act 506 explicitly excludes healthcare facilities. The two systems don’t overlap by design.

The Numbers

As of October 2025, there are exactly 18 MOH-licensed private nursing homes in Malaysia. Total capacity: 747 beds.

Our facility recently received Phase 2 approval, bringing us to 106 beds. That single expansion made us the third-largest MOH-licensed nursing home nationwide—approximately 15% of total national capacity. One facility. In Melaka.

Malaysia has nearly 4 million citizens aged 60 and above—approximately 11.6% of our population as of 2024, up from just 5.4% in 1970. We’re on track to become an “aged nation” by 2030, when seniors will constitute 15% of the population. And we have 747 licensed nursing home beds nationally.

The gap between supply and demand isn’t just significant. It’s structural.

Why So Few?

The barriers are real. MOH licensing is rigorous—facility design, staffing ratios, equipment standards, clinical protocols. It takes years and significant capital to meet requirements. Malaysia faces a projected 60% nursing shortage by 2030. And the economics are challenging: skilled nursing care is expensive to deliver, but families expect costs comparable to basic elderly care.

The government recognises this. Budget 2024 introduced a 10% Industrial Building Allowance for MOH-approved private nursing homes—covering building and renovation costs through December 2026. Budget 2026 allocates RM40 billion for healthcare under the 13th Malaysia Plan. These are meaningful signals. But tax incentives alone don’t solve the workforce crisis, and they don’t shorten the years required to navigate MOH approval. The gap between policy intent and operational reality remains wide.

The Missing Middle

After 180-plus family conversations, I’ve come to believe our eldercare system has a structural gap. Care centres for relatively healthy seniors. Nursing homes for clinical needs. But not much in between—and no culture of planning for transitions.

Most families only search when they’re in crisis. A stroke. A fall. A hospital discharge with requirements no family member can handle. By then, choices are limited and decisions get made under pressure.

A better model recognises that care needs exist on a continuum. Planning ahead isn’t pessimism—it’s pragmatism. The families who’ve navigated this best visited facilities and understood options while their parents could still participate in the decision.

This is partly why we’re developing BIGTREE Residences (BTR)—a 538-unit integrated senior living community on the same campus as our nursing home, completing in 2028-2029. The concept is straightforward: families can live together or nearby across generations, with seamless access to nursing care when it becomes necessary. When a resident eventually needs clinical support, the transition happens within the same ecosystem—no relocation trauma, no scrambling during crisis, familiar faces throughout.

This integrated model was selected to represent Malaysian innovation at Osaka Kansai World Expo 2025. Not because we’ve solved eldercare—we haven’t. But because the approach addresses something our current system doesn’t: the continuum between independent living and clinical care that most families will eventually need to navigate.

What Families Can Do Now

First: Understand the categories. If your parent has clinical needs—wound care, tube feeding, catheter management, medication that requires nursing supervision—you need an MOH-licensed nursing home, not a JKM-registered care centre. Ask about licensing explicitly. Request to see the licence. Don’t assume based on the name.

Second: Ask the right questions. What is your nurse-to-resident ratio? Is there an in-house doctor, and what are their visiting hours? What happens if my parent’s condition deteriorates at 2am? How do you handle medication management? What rehabilitation services do you offer on-site versus through referral? These questions reveal capability gaps that facility tours alone won’t surface.

Third: Start conversations before crisis. I know it’s uncomfortable. Malaysian families don’t like discussing decline and dependency. But the families who’ve done best visited facilities and understood options while their parents could still participate in the decision. When your parent has a voice in the choice, the transition carries less grief and more dignity.

Fourth: Be realistic about capacity. Eighteen nursing homes nationwide. 747 beds for nearly 4 million seniors. If you wait until hospital discharge to start searching, you may not find immediate availability.

747 beds for 4 million elderly Malaysians. The question isn’t whether your family will navigate this landscape. It’s whether you’ll do so with preparation or under pressure.

The choice is still yours to make.

Denis Lim is Managing Director of BIGTREE Medicare & Nursing Home in Melaka, one of only 18 Ministry of Health-licensed nursing homes in Malaysia. He also serves as VP of AgeCope Melaka, an association of professional eldercare providers advocating for higher standards in Malaysian eldercare.

If you’re beginning to think about care options for your family, we welcome conversations—no pressure, just information. Contact us at +6012 685 5103 or visit www.bigtree.care to schedule a facility tour.