In a quiet private estate within Taman Johor, a 30-minute drive from the Causeway, there is a large two-storey bungalow with high ceilings and a lush garden.
At first glance, it looks like a typical suburban residence. But it is really a nursing home, and Singaporean Andrew Tan is one of its residents.
The house is part of a cluster of 10 bungalows within the estate, making up the City Heart Care Nursing Home.
"There are computers for me to check my Facebook page, my own TV to watch the news and I can even go to the coffee shop outside for noodles," said Mr Tan, 43, who is paralysed from the chest down after a car accident 20 years ago.
His family, who lives in Singapore, sent him there as his ageing parents no longer have the strength to care for him.
After visiting more than 10 nursing homes in Singapore and Malaysia, the former electrical technician, who is single, chose City Heart Care as "it does not feel or smell like a hospital".
"I also have my own room, which means I have privacy when my diapers need changing," he said.
He is one of a growing number of infirm Singaporeans who have been admitted to nursing homes in Johor Baru, where prices can be as low as half those in Singapore.
Mr Tan's family pays $900 a month for a two-bedded private room. A similar room in Singapore would cost more than double.
The growing influx is convincing major nursing home players to expand in Johor Baru.
Singapore company Econ Healthcare Group, which runs eight nursing homes here, opened a 57,000 sq ft, four-storey home in Taman Perling this month. The 199-bed centre is a 30-minute drive from the Causeway.
Spring Valley Homecare, believed to be Johor Baru's largest nursing home operator, with 210 beds, recently bought an 8,000 sq ft piece of land in Johor Baru.
Its Singaporean-Malaysian owners want to build a three-storey, 84-bed home by the end of the year.
City Heart Care is also looking to buy more bungalows.
Said Econ group executive chairman Ong Chu Poh: "There is potential in Johor Baru because of lower land and labour costs, which mean lower fees."
Three residents from Econ's nursing homes in Singapore have already moved over to its new Taman Perling home.
At Spring Valley, more than 40 per cent of its 150 residents are Singaporeans, compared with a fifth five years ago. At City Heart Care, the number of Singaporeans has doubled in the last two years to make up 20 per cent of its residents.
Affordability is the key pull. Nursing home fees in Singapore range from $1,200 to $3,500 a month. This is before government subsidies of between 10 per cent to 75 per cent. But those with per capita household incomes of above $2,600 do not qualify for these subsidies.
In Johor Baru, nursing home fees start from $600 a month, making them attractive to middle-class Singaporeans.
Mr Frankie Ker, director of Spring Valley, said most of his Singaporean residents come from the "sandwiched middle class".
He said: "If you are poor, the Government will look after you. If you are rich, you can afford three maids to look after you 24 hours. If you're middle-class, it's tough."
Spring Valley offers basic, spacious open wards for $600 a month. Those who prefer more privacy can pay $900 for a two-bedded room in City Heart Care's bungalows.
"Singaporeans are very price-sensitive and will bargain for even $20 off," said City Heart Care's Malaysian owner, Mr Jeremy Yeo.
Econ's homes target those with higher spending power, charging up to $2,500.
Besides offering single rooms with attached toilets, it has barbecue pits and outdoor exercise gardens. Still, its fees are up to a third lower than its Singapore rates.
The space crunch in homes in Singapore is another reason more are heading across the Causeway.
There are 10,000 beds now and the Health Ministry is pushing to increase this to 17,150 by 2020. Work on seven new nursing homes began this year.
Operators said demand for nursing home space here will only grow, given Singapore's ageing population, creating a spill-over effect across the Causeway.
For some though, being in Johor can be a more lonely experience as the hassle of crossing the border deters some families from visiting, said operators.
Retired labourer Seow Teck Beng, who has been living at Spring Valley for three years, sees his children every three months. "I miss them," the 89-year-old said.
Operators said that they try to encourage family visits.
Econ's Mr Ong said: "Singaporeans can combine the visit with weekend shopping. Johor Baru is not that far away - it's like an MRT trip from Jurong to the airport."
For Mr Tan, who said he is now good friends with the Indonesian staff at City Heart Care, Johor Baru has become a long-term choice.
He gets visits from his family several times a year, but he said: "This is my home now."
More S'porean men than women in JB homes
The residents in Singapore nursing homes are evenly split between men and women. But in homes across the Causeway, there are about twice as many men as women.
At Spring Valley Homecare nursing home, 36 of the 62 Singaporean residents are men.
Over at City Heart Care nursing home, the number is 13 out of 20.
Mr Frankie Ker, director of Spring Valley Homecare, said families find it easier to care for their elderly women relatives at home. "It is tougher to take care of men if they cannot walk. Because of their size, maids may not be able to handle them," he said.
"Another reason is that it is easier for the woman to live with her daughter's family, but harder for the man."
Mr Jeremy Yeo, owner of City Heart Care nursing home, offers a more direct explanation.
"It's simple," he said.
"People love their mothers more. That's why they send their fathers to the nursing homes farther away, but not the mothers."
This article was first published on March 15, 2015.
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