Nursing home finance
We arrange commercial finance for operators, buyers and investors acquiring, refinancing or building nursing homes. This is business lending against a trading nursing home, not help with paying nursing home fees.
Funding nursing homes
Nursing homes are registered to provide care from qualified nurses alongside personal care, which lets them support higher-dependency residents and command higher fees. For lenders that means stronger income but a sharper focus on staffing, agency reliance and clinical governance.
Nursing home finance, as we use the term, is the commercial mortgage, development facility or going-concern loan used to buy, build or refinance a nursing home as a trading business. The decision rests on the operator covenant, the CQC rating, occupancy and the balance between private self-funders, local-authority placements and NHS-funded nursing care.
Because nursing fees are higher, a well-occupied home can carry strong absolute earnings, but the EBITDARM margin is finer than personal care once nursing payroll is accounted for. Lenders therefore underwrite the staffing model as closely as the property.
We assemble the clinical and financial story so healthcare lenders can price the covenant with confidence, and we test the whole market rather than a single bank.
What we fund
- Purpose-built nursing homes with full clinical facilities
- Dual-registered nursing and residential homes
- Nursing homes with dedicated dementia nursing units
- Mid-market regional nursing homes of 40 to 80 beds
- Larger corporate nursing homes of 80-plus beds
- Nursing homes carrying NHS continuing healthcare placements
Indicative terms
- Commercial mortgage LTVUp to 70 to 75% of value
- Going-concern basisTo around 70% of going-concern value
- Term15 to 25 years
- Indicative rateFrom around 7 to 9%
- EBITDARM lendingSized on a multiple of maintainable earnings
- Key testsCovenant, CQC rating, occupancy, staffing and agency mix
- RepaymentCapital and interest or part interest only
Indicative only. Terms vary by lender, operator and home and are not an offer of finance.
How we fund nursing homes
We fund nursing homes on maintainable trading earnings, with extra weight on the staffing model. For an acquisition or refinance we build the EBITDARM, stress it for nurse payroll and agency cost, and place the request with healthcare lenders on a commercial mortgage to around 70 to 75% of value over 15 to 25 years. Where a buyer takes on a trading nursing home we lend on a going-concern basis, sizing the facility on an EBITDARM multiple to roughly 70% of going-concern value. For new clinical-grade schemes we arrange development finance to around 60 to 70% of loan-to-cost with a term exit once occupancy stabilises. All figures are indicative and depend on the home's accounts, rating, staffing and location; nothing here is an offer.
Lender appetite for nursing homes
Nursing homes attract committed but selective appetite because the clinical risk is higher. Shawbrook and OakNorth lead with dedicated healthcare teams that understand nursing EBITDARM and staffing risk. Assetz Capital and Allica Bank support owner-operator and mid-market nursing acquisitions, Paragon and Atom Bank lend on well-rated stabilised stock, and Puma Property Finance and Ortus tend to appear on development and repositioning. As a broker without an exclusive tie we match the home's staffing profile and covenant to the lender most comfortable with clinical risk rather than defaulting to one name.
The nursing home market
Nursing trades on higher fees and finer margins. Knight Frank reports FY2024/25 nursing fees at £1,420 a week, with private at £1,638 and local authority at £1,365, and a nursing EBITDARM margin of 31.1% against 29.2% for personal care. Carterwood puts self-funder nursing fees at £1,696 a week as of September 2025, up 8.3%. Knight Frank also notes agency has fallen to 2.9% of nursing staff cost from 6.8%, easing a long-standing margin drag, while sector occupancy sits at 88.7%. With the ONS projecting the over-85 population to nearly double to 2047 and Carterwood flagging a projected shortfall of tens of thousands of market-standard beds, lenders see well-staffed nursing homes as resilient income assets with a clear future exit.
Finance that suits this setting
- Care home purchase and investment financeThe main route for acquiring a trading nursing home or expanding a portfolio.
- Going-concern and operator financeLends on nursing EBITDARM where a buyer takes on a trading clinical business.
- Care home refinanceRe-prices debt or releases equity once a nursing home is stabilised and well rated.
- Care home development financeFunds purpose-built clinical-grade nursing schemes through to a stabilised exit.
Fund a nursing homes home
A view on fundability within one working day.
What drives a nursing home's numbers
Nursing homes earn more but on a finer margin once nurse payroll is counted. Knight Frank reports FY2024/25 nursing fees at £1,420 a week, with private at £1,638 and local authority at £1,365, and a nursing EBITDARM margin of 31.1%. Carterwood puts self-funder nursing at £1,696 a week as of September 2025, up 8.3%. The decisive variable is the staffing model: Knight Frank records agency at 2.9% of nursing staff cost, down sharply from 6.8%, which has eased a long-standing margin drag. A nursing home with stable permanent nursing cover, low agency reliance and solid occupancy, against the 88.7% sector level, converts its higher fees into dependable earnings. We model EBITDARM after nurse staffing, because that is the number lenders size against.
Indicative nursing home leverage and rates
Indicatively we arrange nursing-home commercial mortgages to around 70 to 75% of value, or going-concern lending on an EBITDARM multiple to roughly 70% of going-concern value, over 15 to 25 years, with pricing from around 7 to 9%. A strong covenant, Good or Outstanding CQC rating, high occupancy and low agency use earn the keener end; heavy agency reliance or a weak rating pull leverage and price back. Purpose-built clinical-grade development runs to about 60 to 70% of loan-to-cost. These are market-typical, indicative figures and never an offer; the terms a given nursing home attracts hinge on its accounts, staffing and rating, and we run the market to secure them.
Frequently asked questions
Can I get funding to buy a nursing home?
Yes. We arrange commercial mortgages and going-concern lending to buy trading nursing homes, typically to around 70 to 75% of value or roughly 70% of going-concern value, over 15 to 25 years. The terms depend on the operator covenant, CQC rating, occupancy and the staffing model. We present the leverage as indicative, not an offer.
How do lenders treat nursing staff costs?
Closely. Registered-nurse payroll and agency reliance are the biggest swing factors in a nursing home's margin, so lenders stress the staffing model when sizing a loan. A home with stable permanent nursing cover and low agency use will support keener terms than one leaning heavily on agency staff.
Does NHS continuing healthcare income help or hinder finance?
It is simply part of the fee mix lenders assess. NHS-funded nursing care and continuing healthcare placements add income diversity, though lenders generally favour a healthy private self-funder share for margin resilience. We present the full fee mix so the covenant is understood.
What loan-to-value can I expect on a nursing home?
Indicatively up to 70 to 75% of value on a commercial mortgage, or around 70% of going-concern value where lending is sized on an EBITDARM multiple. A strong covenant, Good or Outstanding CQC rating and high occupancy support the upper end; weaker accounts or ratings pull it down.
Can I refinance a nursing home to release equity?
Yes. Once a nursing home is stabilised with a sound rating and steady occupancy, we can refinance to re-price the debt or release equity for reinvestment or further acquisitions, subject to the trading performance supporting the new facility.
Funding a nursing homes home?
Tell us about the home and the operator and we will come back with a view on fundability and likely terms.