Russia Long Term Care Market Overview, 2031

Key Insights

• Russia's long-term care market is undergoing a fundamental transformation as the country faces accelerating population aging. At the beginning of 2025, people aged 65 and over accounted for nearly 18% of Russia's total population, up from 9.9% in 1990. By mid-century, their share is projected to reach 24%.
• The Russian government is implementing a historic reform of the long-term care system. The Ministry of Labour has introduced a legislative bill that will establish long-term care as a legally enshrined component of the social service system from January 1, 2027, transitioning from a pilot project to a fully operational nationwide system.
• Federal budget allocations for long-term care have increased substantially. In 2025, 22.7 billion rubles were allocated to the long-term care program, with 32 billion rubles planned for 2026–2027. Over 80 billion rubles are planned for 2025–2027 for the development of the long-term care system for the elderly and disabled.
• The long-term care system currently serves approximately 174,000 citizens, with a presidential target of reaching 500,000 people in need of care by 2030. The system has created more than 47,000 additional jobs, with over 16,600 previously unemployed relatives finding work as paid caregivers.
• Russia's nursing home and residential care market is valued at over 20 billion rubles, according to industry estimates. The market is expanding rapidly, driven by the aging population and the ongoing development of the long-term care system infrastructure. However, the country faces a severe shortage of trained care workers, with regions across Russia reporting significant workforce deficits.

Market Outlook

• According to the research report, "Russia Long Term Care Market Overview, 2031," published by Bonafide Research, the Russia Long Term Care Market is anticipated to grow at more than 5.10% CAGR from 2026 to 2031. This growth is supported by accelerating demographic aging, the nationwide rollout of the long-term care system, and significant government investment in care infrastructure.
• Russia's demographic trajectory is a primary driver of long-term care demand. At the beginning of 2025, the population aged 65 and over reached 25.8 million, representing 17.7% of the total population. According to Rosstat projections, Russia's population, which stood at 146.1 million at the start of 2025, will decline to 141.3 million by 2035 and 139 million by 2045. While the total population is shrinking, the proportion of elderly citizens continues to rise, creating sustained demand for long-term care services.
• The long-term care system is transitioning from a pilot project to a fully operational nationwide system. Currently operating as a pilot in all regions, the system will become a legally enshrined part of the social service system from January 1, 2027. The system includes elderly citizens and disabled individuals over 18 years of age who are unable to fully or partially care for themselves. Care is provided through social care packages ranging from 14 to 28 hours per week, including 50 different services.
• The nursing home and residential care market is expanding rapidly. The market for boarding houses for the elderly in Russia is estimated at over 20 billion rubles. Construction of new facilities is underway across the country under the national project "Family," with 31 construction projects currently in progress and 19 expected to be completed in 2025, providing over 2,000 new places.
• The federal project "Older Generation" has allocated 361.6 billion rubles through 2030, of which 307.4 billion rubles will be directed toward providing services within the long-term care system. This substantial investment will support the expansion of care infrastructure and the scaling of long-term care services nationwide.

Market Dynamics

Driver: Accelerated Demographic Aging and Rising Care Dependency Russia is undergoing a profound demographic transformation that is fundamentally reshaping the long-term care landscape. The population aged 65 and over has grown from 14.6 million (9.9% of the population) at the beginning of 1990 to 25.8 million (17.7% of the population) at the beginning of 2025. By mid-century, the share of people aged 65 and over is projected to reach 24%. By the mid-2040s, pensioners are expected to account for 27% of the population, while children and adolescents may account for just 14.2%. The number of pensioners increased by 94,000 in the last year, reflecting the scale of demographic aging. Russia's birth rate has fallen to its lowest level since the late 18th century, intensifying the demographic crisis and accelerating population aging. Life expectancy is increasing, with the gap between men and women remaining significant. However, male life expectancy has shown volatility, declining from 66 years in 2024 to 61 years in mid-2025, while female life expectancy has remained stable at 75 years. This demographic shift creates sustained demand for long-term care services across home healthcare, nursing facilities, and assisted living settings.

Challenge: Severe Workforce Shortages and Caregiver Deficit Russia's long-term care market faces a persistent and intensifying workforce crisis that threatens the expansion and quality of care services. While the long-term care system has created more than 47,000 additional jobs, with 16,600 previously unemployed relatives finding work as paid caregivers and nearly 9,000 people able to maintain employment while providing care, the system continues to face severe workforce shortages. The number of middle and junior medical personnel, who form the backbone of care services, has been shrinking. Regions across Russia report significant staffing deficits, with low wages and the absence of additional payments for medical staff in private institutions failing to incentivize work in nursing homes. The presidential target of covering 500,000 citizens in need of care by 2030 will require substantial workforce expansion and training. The main contingent involved in family caregiving is citizens aged 60 and older, highlighting the challenge of relying on an aging caregiver workforce. Without significant investment in workforce recruitment, training, compensation, and career development, Russia's long-term care system will face increasing difficulty in meeting the growing demand for care.

Trend: Nationwide Rollout of the Long-Term Care System and Shift Toward Home-Based Care A fundamental shift in long-term care delivery is occurring in Russia with the nationwide rollout of the Long-Term Care System (Sistema Dolgovremennogo Ukhoda). The system has been in pilot form since 2018, initially in six regions, expanding to all regions from September 2023. From January 1, 2027, the system will transition from a pilot format to a fully operational part of the social service system. The system provides free at-home assistance to citizens in need of care, including social, medical, and psychological services. Care packages range from 14 to 28 hours per week and include 50 different services. Priority rights for care are given to veterans of the Great Patriotic War and special military operations. The system's development is supported by the federal project "Older Generation" and the new national project "Family". The shift toward home-based care is driven by both the preference of Russian seniors to age in place and the cost-effectiveness of home care compared to institutional care. The system's expansion is being accompanied by the development of home care infrastructure, with free assistance available to citizens in need of care at home.

Policies

• The Ministry of Labour has introduced a legislative bill establishing long-term care as a legally enshrined component of the social service system from January 1, 2027. The bill introduces new federal powers to approve the social package of long-term care, establish the order and conditions for its provision, and determine individual care needs. New concepts are being introduced, including "long-term care," "social care services," and "social package of long-term care".
• The federal project "Older Generation" has allocated 361.6 billion rubles through 2030, of which 307.4 billion rubles will be directed toward providing services within the long-term care system. More than 336 billion rubles will come from the federal budget.
• Federal budget allocations for long-term care have increased substantially. In 2024, 16 billion rubles were allocated. In 2025, 22.7 billion rubles were allocated, including 2.7 billion rubles added through budget amendments. For 2026–2027, 32 billion rubles are planned. Over 80 billion rubles are planned for 2025–2027 for the development of the long-term care system.
• The system is financed predominantly from the federal budget, with regional budget contributions accounting for just over 13%. The federal government provided 16 billion rubles in 2024 and 31.5 billion rubles in 2026.
• The Ministry of Labour has issued Order No. 732 of December 27, 2024, on the implementation of the standard model of the long-term care system for elderly citizens and disabled people in need of care in 2025. The order establishes free social services at home for citizens in need.
• The government is constructing new residential care facilities under the national project "Family." As of 2025, 31 construction projects are in progress, with 19 expected to be completed in 2025, providing over 2,000 new places. More than 38 social inpatient facilities for elderly and disabled citizens have been built across the country.
• Discussions are ongoing regarding the introduction of an insurance-based financing model for long-term care. An analysis published in 2025 suggests that an insurance-based financing model deserves to be revisited as the foundation for Russia's long-term care system. However, the insurance model has not yet received support due to the significant burden on the budget and business.

Segment Analysis

Russia Long-Term Care Market By Service Type • Home Healthcare: Home healthcare represents the largest and fastest-growing service segment in Russia's long-term care market, driven by the nationwide rollout of the Long-Term Care System and the preference for aging in place. The system provides free at-home assistance to citizens in need of care, including social, medical, and psychological services. Care packages range from 14 to 28 hours per week and include 50 different services. The home care segment is supported by the federal project "Older Generation," which has allocated 307.4 billion rubles for long-term care services through 2030. The domiciliary care market is experiencing steady growth driven by an aging population, increased healthcare awareness, and a shift toward home-based care services. More than 8,000 residents in Primorsky Krai receive social services at home from non-profit organizations. Over 32,000 elderly residents of Volgograd Oblast have received social assistance at home.
• Nursing Care / Skilled Nursing Facilities: The nursing facility sector in Russia comprises state and private nursing homes, boarding houses, and residential care facilities for the elderly and disabled. The market for boarding houses for the elderly is estimated at over 20 billion rubles. The sector includes both state social inpatient facilities and private nursing homes. More than 38 social inpatient facilities for elderly and disabled citizens have been built across the country. In 2025, 7 social inpatient facilities were commissioned in 6 regions of the Russian Federation. Construction is ongoing, with 31 projects currently in progress and 19 expected to be completed in 2025, providing over 2,000 new places. The sector faces capacity constraints, with demand for nursing home places significantly outstripping supply.
• Assisted Living Facilities: Assisted living represents an emerging segment in Russia's long-term care market. The Russia Assisted Living Market is experiencing growth driven by the aging population and increasing demand for residential care services. The sector includes independent living, assisted living facilities, and dementia care units. Private assisted living facilities are expanding, with operators offering specialized care for elderly residents. The segment is supported by the development of the long-term care system and the construction of new residential care facilities under the national project "Family".
• Hospice and Palliative Care: Hospice and palliative care services in Russia are delivered across multiple settings, including homes, state hospices, hospitals, and palliative care centers. Approximately 1.5 million adults and 100,000 children need palliative care in Russia every year. Palliative care and stays in state hospices are provided free of charge. In Moscow, the modernization of palliative care infrastructure has been completed, with the Multidisciplinary Palliative Care Center having a total capacity of over 630 beds for adult patients and 30 beds for children. A new hospice opened in Luhansk in 2025, with capacity for 100 people. The Ministry of Health and the Ministry of Labour issued a joint order in April 2025 establishing regulations for the organization of palliative care, including the interaction of medical organizations, social service organizations, and non-profit organizations.
• Other Services: This segment includes adult day care, long-term rehabilitation services, social service centers, and communication centers for seniors. Over 900 communication centers for seniors operate in 87 Russian regions, with over 140,000 events and 1.3 million participants. Territorial comprehensive social service centers provide services under the long-term care program. In Dagestan, a territorial comprehensive center provided over 170,000 services to elderly citizens and people with disabilities under the long-term care program in 2025. The development of community-based services is supported by the federal project "Older Generation" and the national project "Family".

Russia Long-Term Care Market By Payer Type • Public: Public sources are the dominant payer for long-term care services in Russia. The system is financed predominantly from the federal budget, with regional budget contributions accounting for just over 13%. In 2025, 22.7 billion rubles were allocated to the long-term care program. Over 80 billion rubles are planned for 2025–2027 for the development of the long-term care system. The federal project "Older Generation" has allocated 361.6 billion rubles through 2030, of which 307.4 billion rubles will be directed toward providing services within the long-term care system. Long-term care services under the system are provided free of charge.
• Private: Private sources account for a growing but still limited portion of long-term care spending in Russia. The private nursing home market is estimated at over 20 billion rubles. Private sector operators are expanding, with facilities offering paid care services. Private long-term care insurance is emerging as a potential growth segment. Insurance mechanisms could play a special role in providing support and counseling. However, the insurance model has not yet received widespread support due to the significant burden on the budget and business. Private nursing homes and assisted living facilities predominantly serve individuals who can afford out-of-pocket payments.
• Out-of-Pocket: Out-of-pocket payments represent a substantial component of long-term care spending in Russia. Private nursing homes and assisted living facilities charge fees for their services. The market for boarding houses for the elderly is estimated at over 20 billion rubles, with the majority of this revenue coming from out-of-pocket payments. Out-of-pocket costs vary significantly by facility type, location, and level of care provided. Private sector facilities are expanding to meet the demand from families who can afford paid care.

Russia Long-Term Care Market By Gender • Female residents account for the largest share of Russia's long-term care spending, driven by higher life expectancy and higher rates of disability in advanced age. Women's life expectancy in Russia is approximately 75 years, compared to 61 years for men. The gender gap in life expectancy is approximately 10 years. Among older adults, women significantly outnumber men, particularly in the oldest age cohorts. Women are more likely to live alone in old age, increasing their reliance on formal paid care services. The caregiving workforce is predominantly female. The long-term care system provides care for both genders, with the majority of recipients being women due to their longer life expectancy.
• Male residents account for a smaller but growing share of Russia's long-term care spending. Male life expectancy in Russia has shown volatility, declining from 66 years in 2024 to 61 years in mid-2025. Men are more likely to need long-term care at younger ages due to disabilities and chronic conditions. As male life expectancy gradually increases, the representation of men in the older adult cohort is slowly growing. The long-term care system serves both male and female citizens in need of care.

Russia Long-Term Care Market Economics

• The cost of long-term care services varies significantly by service type, geographic location, and facility ownership. The market for boarding houses for the elderly is estimated at over 20 billion rubles. Private nursing home costs vary widely depending on location, services provided, and facility quality. Public long-term care services under the system are provided free of charge. Construction costs for new facilities are substantial, with one 150-bed facility costing over 1 billion rubles.
• Public financing of long-term care is substantial and growing. In 2025, 22.7 billion rubles were allocated to the long-term care program. Over 80 billion rubles are planned for 2025–2027. The federal project "Older Generation" has allocated 361.6 billion rubles through 2030. The system is financed predominantly from the federal budget, with regional budget contributions accounting for just over 13%.
• Staffing costs represent the largest operating expense for all long-term care providers. The sector faces significant workforce shortages, with regions across Russia reporting staffing deficits. Low wages and the absence of additional payments for medical staff in private institutions fail to incentivize work in nursing homes. The long-term care system has created more than 47,000 additional jobs.
• The economic value of home- and community-based services relative to institutional care is a key policy consideration. Home care is generally less expensive than institutional care on a per-patient basis, and the shift toward home care is expected to continue. The long-term care system provides free at-home assistance to citizens in need of care.


Considered in this report
• Historic Year: 2020
• Base year: 2025
• Estimated year: 2026
• Forecast year: 2031

Aspects covered in this report
• Long-term care Market with its value and forecast along with its segments
• Various drivers and challenges
• On-going trends and developments
• Top profiled companies
• Strategic recommendation

By Service Type
• Home Healthcare
• Nursing Care / Skilled Nursing Facilities: 
• Assisted Living Facilities
• Hospice & Palliative Care:
• Other Services

By Payer Type
• Public
• Private
• Out-of-Pocket

By Gender
• Male
• Female