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."