Structured finance for healthcare at portfolio scale.
Large-ticket facilities for hospital groups and healthcare platforms: multi-city rollouts, acquisition of existing units, brownfield expansion across a portfolio, and consolidation of legacy debt into a single structured facility.
Portfolio lending, not single-asset lending
Once a group operates more than one facility, the appraisal changes character. Lenders assess consolidated cash flow across units, cross-collateralise the security, and lend against the portfolio rather than against any single hospital. Mature units subsidise the ramp-up of new ones, which is precisely what makes a chain a better credit than a standalone greenfield project.
These facilities are covenant-driven. Expect a minimum DSCR, a debt-to-EBITDA ceiling, restrictions on further indebtedness and on distributions, and financial reporting obligations on a quarterly basis. Negotiating headroom into those covenants at sanction is far more valuable than shaving a few basis points off the rate, because a breach can trigger consequences a rate never will.
Structure often matters more than pricing at this size. A single facility with staged availability across a rollout, a holding-company structure with unit-level security, sale-and-leaseback of stabilised property assets to release capital, or a combination of term debt with lease rental discounting on leased units — the right architecture can be worth considerably more than the coupon.
Indicative pricing in 2026
At this size, pricing is negotiated rather than quoted. The bands below reflect what established groups with audited consolidated financials have been achieving.
Public Sector Banks
Tier-1 Private Banks
NBFCs & structured lenders
Negotiating a large healthcare facility
Covenant headroom over headline rate
On a ₹50 Cr facility, twenty-five basis points is real money but a DSCR covenant set with no cushion is an existential issue. Occupancy dips, a delayed scheme settlement or one slow quarter can breach a tight covenant and hand the lender remedies you never intended to give. Negotiate the cushion first.
Staged availability instead of full drawdown
A rollout does not need all the money on day one, and undrawn debt costs a commitment fee rather than full interest. Structuring availability against unit milestones reduces carry cost materially over a two to three year programme.
Release capital from stabilised assets
A group with mature, unencumbered hospital property is sitting on locked capital. Sale-and-leaseback, or a mortgage against stabilised units to fund new ones, is frequently cheaper than raising fresh project debt against unproven assets.
Documents required
Incomplete files cause most multi-week delays. We assemble the full set upfront, in the order credit teams read it.
KYC & constitution
- PAN & Aadhaar of all promoters / partners / directors
- Certificate of incorporation, MOA-AOA or partnership deed
- Board resolution or partners' authority letter
- GST registration & trade licence
Group & portfolio
- Consolidated audited financials for 3 years, all entities
- Unit-wise operating data — beds, occupancy, ARPOB, payer mix
- Group structure chart and shareholding pattern
- Existing debt schedule across all entities with security details
- Board-approved business plan and rollout programme
Assets & compliance
- Title documents for all owned property; lease deeds for leased units
- Clinical establishment registrations and licences for each unit
- AERB, biomedical waste and fire clearances per unit
- Insurer and scheme empanelment across the portfolio
- Valuation reports for property and major equipment
How a structured healthcare facility comes together
Consolidated financial model
Unit-level and consolidated projections, DSCR under base and stress cases, and the debt capacity the portfolio genuinely supports.
Structure design
Term debt, staged availability, working capital, LRD on leased units and any sale-and-leaseback element designed as one architecture.
Lender syndicate and term sheets
Approached in parallel; term sheets compared on covenants, security and flexibility, not only on rate.
Documentation and drawdown
Security creation across entities, covenant definitions negotiated, and disbursal against agreed milestones.
Related facilities & deep-dive guides
Every facility below is placed through the same 80+ lender panel. The long-form guides carry the working numbers, worked examples and lender-by-lender detail.
Frequently Asked Questions
The questions our advisory desk is asked most often about Healthcare Infrastructure Loan.
Broadly beyond ₹10–15 Cr, or once a group runs multiple units. Below that, facilities are largely standardised; above it, appraisal moves to consolidated cash flow, cross-collateralised security and negotiated covenants.
The practical difference is that terms become negotiable across structure, security and covenants rather than being taken off a product sheet.
Lenders typically ask for a minimum DSCR of 1.30 to 1.75x on consolidated debt, tested quarterly or annually.
What matters more than the number is the cushion between it and your base-case projection. A covenant set right at your projected DSCR leaves no room for a slow quarter, and breach consequences are far more damaging than a slightly higher rate.
Yes, and it is often the main reason groups approach this market. Multiple facilities across entities at legacy rates, with fragmented security and mismatched tenures, can be refinanced into a single structured facility.
The gains are usually a lower blended rate, a longer tenure, released security and simpler covenant management. The costs are fresh stamp duty and any exit charges, which we model before recommending it.
It can release substantial capital from stabilised assets without diluting equity, and for groups whose property is unencumbered and mature it is worth evaluating seriously.
The trade-off is a long-term rent obligation replacing an owned asset, and the loss of future appreciation. Whether it beats a straightforward mortgage depends on the rent, the term and your view on the property.
Realistically two to four months from a complete information pack, longer where a syndicate is involved or where security spans multiple entities and states.
The pace is usually set by documentation quality. Groups arriving with clean consolidated financials, a clear structure chart and an accurate existing-debt schedule close materially faster.
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