In response to Proposal No. 1328 from the 16th Shanghai Municipal People's Congress, which focused on enhancing the operational efficiency and resource allocation mechanisms of elderly care institutions, the Shanghai Civil Affairs Bureau has recently issued an official reply detailing its plans.
According to the reply, the bureau will establish a coordinated adjustment mechanism linking population dynamics with elderly care facility supply, ensuring that infrastructure development keeps pace with actual demand. District authorities will be guided to conduct annual reviews based on local changes in the elderly population, such as migration patterns, aging growth rates, and shifts in family structures, allowing for the timely initiation of mid-to-long-term regional facility layout plans.
The reply also addresses the need to optimize the allocation of government-guaranteed beds by strengthening a tiered waiting list system at both the municipal and district levels. This strategy aims to dismantle barriers between sub-districts and regions, enabling elderly residents in central urban areas to opt for beds in suburban districts through a coordinated pool. Suburban institutions will be encouraged to offer incentives such as discounted admission fees and commuter shuttle services to balance demand distribution and alleviate the uneven utilization of resources across the city.
The proposal, as acknowledged in the reply, highlighted five major challenges facing Shanghai: spatial misallocation of elderly care resources, insufficient alignment between supply and demand, an overemphasis on construction over operation, difficulties in transforming existing facilities, and information asymmetry. It offered five practical strategies, including reforming performance evaluations, establishing periodic assessments, revitalizing inefficient facilities, integrating population planning, and upgrading the information service platform. These measures are recognized for their significant practical value in optimizing resource coordination, enhancing institutional efficiency, and addressing structural supply-demand imbalances.
Regarding performance evaluation, the bureau plans to overhaul the assessment system for elderly care institutions, guided by operational outcomes, and introduce a mandatory linkage mechanism. Starting in January 2026, the new “Implementation Measures for Subsidies and Rewards for Elderly Care Service Institutions” will align financial support directly with core performance indicators. These metrics include average annual bed utilization rates, occupancy stability, resident satisfaction, the proportion of disabled elderly care, and effectiveness in rectifying vacancies, creating two primary subsidy categories: service operations and quality improvement. This approach establishes a clear principle of rewarding high-performing institutions with more support while limiting subsidies for underperformers.
Additionally, the bureau will refine the core indicators used for routine monitoring and quality grading, increasing the weight of operational efficiency in existing standards. Safety protocols, care levels, and resident satisfaction will be integrated into daily monitoring, while spatial supply-demand matching, community outreach services, and short-term trial stays will be included as grading criteria. Moving forward, the bureau will increase support for institutions that demonstrate strong service quality, offering enhanced managerial and operational assistance.
To address resource utilization, a closed-loop management system featuring “annual monitoring and dynamic adjustments” will be implemented. Publicly-run institutions will have their bed utilization rates included in annual performance reviews, with detailed assessment criteria and scoring rubrics. Institutions with low occupancy rates will be required to develop plans to optimize admission processes and activate idle beds. Overcapacity situations will be monitored dynamically, with red, yellow, and blue warnings issued and mandatory rectification deadlines set. The bureau is also exploring the development of a large-scale model for bed supply-demand forecasting to identify mismatches, such as saturated city-center beds versus underutilized beds in outer suburban new towns.
For revitalizing inefficient facilities, the bureau will focus on functional restructuring and reuse, creating pathways for transforming existing resources. Institutions with persistently high vacancy rates, particularly those poorly located relative to the elderly population, will be supported in converting to community-based services like small-scale care homes or adult day care centers. Providers will also be encouraged to extend services beyond their walls, leveraging nursing staff, rehabilitation equipment, and dietary resources to deliver home-based care, including in-home assistance, rehabilitation guidance, and respite services. Future plans include categorizing institutions into types—such as basic security, inclusive support, and fully market-oriented—and drafting exit mechanisms for those under the inclusive support category.
With respect to population-linked planning, the bureau will implement the “Shanghai Elderly Care Service Facility Layout Plan (2022-2035)” as the overarching framework. District authorities will conduct pre-construction demand assessments for new projects to minimize supply-demand mismatches from the outset. The tiered bed allocation system will be strengthened through the management of district- and municipal-level coordination pools, enabling cross-district bed selection for seniors on waiting lists in central areas and promoting attractive offers from suburban institutions to ensure a more balanced inflow of residents.
Finally, the information platform will undergo continuous upgrades, encompassing the Shanghai Elderly Care Service Platform and the “Shenqing Yiyang” mini-program. These tools will provide transparent, comprehensive listings of all elderly care facilities, including institutions, community care homes, and community-based service organizations, presented through a “one-map” interface to help citizens locate suitable care options. The bureau will keep updating data and features to deliver convenient, authoritative services for information queries, administrative procedures, and comprehensive supervision, thereby empowering the broader development of the elderly care sector.