Tool · state data from Medicare cost reports

SNF valuation and coverage calculator

Start from census and per-day revenue and cost, the way an operator reads the building. The calculator builds EBITDAR, NOI and value at your cap rate, then tests the debt against coverage and HUD's 232 limits.

Census Compare against Licensed beds Occupancy, %

Per patient day Net revenue per patient day, $ All payers, after contractual allowances. Operating expense per patient day, $ Before rent, interest, depreciation and the management fee. Management fee, % of revenue Underwriting usually charges a market fee even if you self-manage. Replacement reserve, $ per bed per year

Building cost and value Annual rent, $ If the operator leases the building. Leave 0 if owned. Cap rate, % Your assumption or your broker's. No public source sets it.

Debt Loan amount, $ Leave 0 to see what the building supports. Interest rate, % Amortization, years

Every input starts as an example. Replace them with your T-12 (trailing 12 months).

Value at your cap rate

Turn on JavaScript to run the numbers

How the numbers stack

Patient days are beds × 365 × occupancy; multiply by revenue and expense per day for annual dollars. Revenue less operating expense, before the management fee and any building cost, is EBITDARM. Subtract a management fee for EBITDAR; lenders and buyers use a market fee even when the owner manages the building. EBITDAR divided by annual rent is rent coverage, the first number a landlord or REIT checks.

Subtract a replacement reserve from EBITDAR for NOI, and divide NOI by the cap rate for value. DSCR is NOI divided by annual principal and interest; on a HUD 232 loan the annual mortgage insurance premium is added to debt service.

The HUD line sizes a 232/223(f) refinance at the lower of 80% of the value shown and the loan NOI can carry at 1.45 coverage with the 0.65% annual MIP (HUD Handbook 4232.1, section 3.8; MIP per the Federal Register notice of June 26, 2025). It ignores the cost-to-refinance test, which caps a refinance at your payoff plus costs.

Why not just use the cost report's margin?

The state medians on this site put the reported operating margin near zero. That figure subtracts every operating cost on the cost report, including the building and related-party charges an underwriter replaces with its own assumptions. NOI built from your own statement, starting with EBITDAR, is what values the building. More on the difference.

Send these numbers to the desk

If the coverage works, the desk tells you which lenders, HUD or bridge, fit the building and what they will ask for. Your calculator inputs are attached to the inquiry.

Name

Work email

Phone (optional)

You are the

Facility name or CCN

What do you need?

Approximate loan amount (optional)

Timing

Anything the desk should know (beds, current lender, occupancy, payer mix)

This goes to Janover Capital LLC only, and a person there will reply. It is not a loan application, and nothing here is an offer to lend. Please leave out resident names and any health information.

An estimate, not an appraisal, a loan offer or a commitment. Per Patient Day is operated by Janover Capital LLC and is not affiliated with CMS, HUD or FHA. Benchmarks: CMS cost reports for fiscal years ending August 2024 to August 2025.

Questions

What is EBITDAR for a skilled nursing facility?

Earnings before interest, taxes, depreciation, amortization and rent: patient revenue less operating expenses, with the building cost (rent, or interest and depreciation for an owner) left out. It lets a lender or buyer compare a leased building with an owned one, and dividing it by rent gives rent coverage.

What debt service coverage does HUD require for a nursing home refinance?

HUD Handbook 4232.1 sets a minimum of 1.45 for Section 232 loans, including 223(f) refinances, with the mortgage insurance premium counted as debt service. A 223(a)(7) refinance of an existing FHA loan needs 1.11.

Where do the state numbers come from?

CMS Skilled Nursing Facility Cost Report data, full-year reports for fiscal years ending August 2024 to August 2025. The calculator shows where your occupancy and revenue per day fall against that state's middle half of facilities, and lists the state's median cost-report expense per day for reference.