Commercial Financing
Medical Practice Acquisition Financing
Buying a medical practice is rarely a single loan. You inherit the seller's timeline, insurance re-credentialing lag, and lenders who know clean single-site files — not multi-location stacks, bankruptcy assets, or a building that has to close the same day as the practice.
Medical practice acquisition financing is the capital that funds the purchase of an established practice (and often the working capital you need until reimbursements catch up). On complex deals, it also means structuring practice cash flow and real estate on the tracks that actually fit — then taking a clean package to the lenders most likely to say yes.
I close deals from both sides: financing and real estate. When the building is in the deal, nothing gets lost between the lender and the purchase. This page is for buyers who already have a target or an LOI — not for rate shopping with no deal.
What medical practice acquisition financing actually covers
One product rarely funds the whole takeover. A typical stack has separate pieces:
- Purchase / acquisition facility — practice goodwill and assets
- Working capital — payroll and reimbursement lag after close
- Equipment — its own collateral path when you need it
- Real estate — MOB or owner-occupied building on a separate track when the building is part of the deal
Banks and single-product paths often miss the messy parts: multi-location platforms, distressed or bankruptcy assets, practice plus real estate on one close calendar, and working capital on day one. Specialty desks and stacked structures exist for a reason. The job is matching the structure to the deal — not forcing the deal into whatever is easiest to sell.
Who this is for (and not for)
For you if:
- You're a physician, group, or operator buying an established practice or multi-site platform
- You already have a target, LOI, or live negotiation
- A bank already stalled — or the file is more complicated than a clean single-site credit memo
Not for you if:
- You're asking a personal consumer mortgage question
- You're shopping “today's rate” with no deal in hand
If you have a real target and a real timeline, keep reading.
How we underwrite before we go to market
Before we approach a single lender, we do our own underwriting. We build the story — your numbers, patient and panel risk, location concentration, bankruptcy or distressed history, seller-note expectations, and how each risk gets addressed — until the package is bulletproof.
Then we go to market with a clean, documented package to the two or three lenders most likely to say yes. Not spray-and-pray.
Process on this site is the same shape you see elsewhere on benrecord.com:
- 1. Underwriting — story, risks, mitigants, structure
- 2. Term sheets — options you can actually compare
- 3. Close support — appraisals, document requests, title, lender questions; you're not the bottleneck
Structures buyers should know
This is education, not a rate table. I won't invent APRs, LTVs, or “typical” close days.
SBA-backed practice acquisition paths
Common for many practice purchases. Often slower. Useful when the file fits the program and the timeline can take it. Not automatically “best.”
Specialty healthcare / practice finance desks
Built for practice cash flow, provider concentration, and healthcare collateral. Often the right lane when a generalist bank stalls on clinical or multi-site complexity.
Stacked structures
Acquisition plus working capital plus equipment when needed — with real estate on its own track when the building is in play. One close calendar can still mean more than one facility.
Seller notes and standby equity pieces
Sometimes they fill a gap the senior lender won't. They change risk and economics for both sides. We name that in the package; we don't pretend it's free money.
How we choose: by the deal — timeline, collateral, locations, distress, and what has to close together — not by a product brochure.
Complex deals: multi-site, bankruptcy assets, high leverage
Banks know clean single-site files. They get quieter when:
- Locations span states
- One site sits in bankruptcy
- You need acquisition capital and working capital at close
- Cash at close is thin and the structure has to carry the gap
- Practice cash flow and real estate must land on the same closing day
Case from the Deal Room: four oncology locations, $13M, 100% financed
Published on benrecord.com: the buyer needed four clinic locations across two states, one in active bankruptcy. A $13M deal that required 100% acquisition financing plus $2M in working capital, structured as a single close with no cash out of pocket.
What made it hard:
- Four locations, two states
- One location in bankruptcy proceedings
- 100% acquisition financing goal
- Working capital required at close
- One closing — not a staggered patchwork
What the structure had to solve: underwrite the whole platform (including the distressed piece), place acquisition and working capital together, and get to a single close. Fee on that deal, as published on the site: $113,750.
More breakdowns live under Advice from the Deal Room on the site.
Process and timeline (honest)
To start underwriting, I need:
- Target practice(s) and where you are in the deal (LOI, PSA, early diligence)
- Timeline the seller is running
- What you already have from a bank or broker (if anything)
- What's stuck — structure, WC, RE, distress, multi-site, or something else
“Go to market” means: we take the underwritten package to a short list of lenders matched to the structure, then bring back term sheets you can compare in plain English. (A deeper term-sheet comparison page is planned; until then, we do that work in the deal room.)
I won't promise “funded in 48 hours.” Complex practice acquisitions move on diligence, insurance, appraisals, and lender credit — not slogans.
FAQ
Can I finance 100% of a practice acquisition?
Sometimes. It depends on the practice, the structure, and the lender. The oncology Deal Room case above was structured at 100% acquisition financing plus working capital with no cash out of pocket — that was that deal, not a guarantee for every buyer.
What if one location is in bankruptcy?
It's underwritable when the story, risks, and mitigants are built into the package. Distressed assets are why underwriting comes before lender outreach.
Do I finance the building with the practice?
Often on a separate track. Practice cash flow and real estate collateral are different. When both are in the deal, they still need to land on one close calendar — that's a structuring problem, not a reason to mash them into one product that doesn't fit.
SBA or specialty — how do you choose?
By fit: timeline, program rules, collateral, and complexity. SBA is common and often slower. Specialty desks handle healthcare complexity banks bounce. We pick the lane that can say yes to this file.
What belongs in an underwriting package?
Numbers, deal structure, patient/panel and concentration risk, location map, any distress or bankruptcy history, seller-note expectations, and how each risk is addressed. Clean enough that two or three right lenders can underwrite without guessing.
When should I call an advisor vs only my bank?
Call when the bank stalled, the file is multi-site or distressed, practice and real estate have to close together, or you need working capital through insurance lag — not only a purchase line. A single bank product is fine when the deal is clean and fits. Most acquisitions that find this page aren't that clean.
Have a practice deal?
Send where you are — target, timeline, and what's stuck. I'll tell you what I see.
Talk through your deal →For more deal breakdowns, see Advice from the Deal Room on the site.