Fractional CFO
for Care Homes
Board-level financial leadership for care home operators without the cost of a full-time hire. Led by Bharat Varsani FCCA, who is Group CFO to a 15-entity care and property group.
What does a fractional CFO do for a care home?
A fractional CFO for a care home provides senior finance leadership on a part-time basis. That means timely management accounts and KPIs, cash flow and covenant monitoring, lender reporting, EBITDA and agency cost analysis, and fee-rate and debt recovery work with local authorities and the NHS. Key Ledgers Global is led by Bharat Varsani FCCA, who currently serves as Group CFO of a 15-entity care and property group that includes a 117-bed nursing home.
Key Ledgers Global · Last updated 24 September 2026
Finance led by someone
who runs it.
Key Ledgers Global currently operates at Group CFO level within a 15-entity care and property group: 117-bed nursing home, 140 supported living beds, 500+ properties, £55m+ revenue.
Live operational experience informing every care home finance instruction we take. Not textbook advisory.
Book a Care Home Review →When a care home needs a fractional CFO.
A bookkeeper or accountant reports what has happened. A CFO decides what to do about it, and speaks to lenders on your behalf. These are the moments when operators typically bring one in.
Lenders size debt on normalised EBITDA and expect a credible model and an operator who can explain the numbers. See how care home EBITDA is calculated.
Quarterly packs, covenant headroom and early warning of a breach are a finance leadership job, not a compliance task.
Small movements in occupancy and agency staffing change EBITDA disproportionately, because most care home costs are fixed. See the KPIs to track.
Groups need consolidated reporting and intercompany control. See how a portfolio CFO works.
What a care home fractional CFO covers.
The scope is set at the start and is specific to the home or group. These are the areas care home operators most often need covered.
Monthly management accounts, occupancy and average weekly fee by funding source, agency ratio, EBITDA margin, and a budget that operational managers actually use.
Preparing lender packs, presenting the numbers, managing covenants and supporting refinancing or acquisition finance.
Reviewing NHS and local authority fee rates against the cost of care, and recovering aged debt. We have recovered over £1.4m for a single operator.
Cash flow forecasting, tax planning and group structure, so that decisions to buy, sell or restructure are made with the financial consequences clear.
Fractional CFO, finance director or financial controller?
The titles overlap, so it helps to separate the jobs. Our guide to the three roles explains them in detail.
| Role | What it usually covers | Typical fit for a care home |
|---|---|---|
| Financial controller | Accounts, month-end, compliance and controls | A single home that needs reliable accounts |
| Finance director | Financial management and reporting to the board, often full-time | A larger group with a full-time finance function |
| Fractional CFO | Strategy, lender relationships, funding and financial leadership, part-time | Owners who need senior judgement without a full-time salary |
Active. Not
theoretical.
Bharat Varsani currently serves as Group CFO to a 15-entity care and property group, 117-bed nursing home, 140 supported living beds, 500+ properties. This is live, operational experience at group level, and it informs every care home instruction we take.
Bharat Varsani is Group CFO to a 15-entity care and property group, so the advice comes from running the numbers of a care business, not from outside it.
Experience presenting care home finance to funders and managing the reporting that covenants require.
Structured review and negotiation of fee rates, and recovery of aged debt.
Financial planning aligned to CQC requirements and staffing cost modelling. See how CQC rating affects value and finance.
Healthcare finance demands sector expertise. We don't advise on this sector from the outside, we operate within it at group CFO level.
Bharat Varsani FCCAGroup CFO, 15-Entity Care & Property GroupFractional CFO for care homes
questions answered.
If your question is not covered below, contact us directly and we will respond the same working day.
A fractional CFO provides senior finance leadership part-time. For a care home that means management accounts and KPIs, cash flow and covenant monitoring, lender reporting, EBITDA and agency cost analysis, fee-rate negotiation and debt recovery with local authorities and the NHS, and support with acquisition finance or refinancing.
It depends on the size of the home or group, the number of entities and how much lender and reporting work is involved. Our initial healthcare finance review is fixed fee and delivered within two weeks, and the fee is agreed before we start. Our fractional CFO cost guide explains the ranges and what drives them.
An accountant prepares the accounts, tax returns and statutory filings and reports what has happened. A fractional CFO uses that information to advise on decisions, manage lender relationships, forecast cash and plan funding. Many care homes need both.
Yes. That includes monitoring covenant headroom, preparing the quarterly pack, modelling the effect of occupancy and agency costs, and presenting the case to a new lender. See our guide to the business plan a lender expects.
We work with care home operators, nursing home groups, supported living providers and other healthcare businesses. A single home benefits from CFO-level input at key moments such as an acquisition, a refinancing or a fee negotiation. Groups benefit from ongoing consolidated reporting.
Start with net profit, add back interest, tax, depreciation and amortisation, then normalise for owner costs, one-off items, agency spend above the normal run-rate and fee timing. The result is what lenders and buyers use. See how care home EBITDA is calculated, with a worked example.
Other practice areas you may need.
Care Home Finance
NHS fee negotiation, aged debt recovery and financial health checks for care home operators.
View service →Fractional CFO Advisory
Board-level finance capability without a full-time hire.
View service →Care Home Acquisition Due Diligence
Independent financial due diligence before you buy or fund a care home.
View service →How Is Care Home EBITDA Calculated for Acquisition Finance?
Normalising reported earnings into the EBITDA a lender or buyer will use, with a worked example.
What Financial KPIs Should a Care Home Operator Track?
The six core KPIs, how each is calculated, and what lenders expect to see.
What Is a Portfolio CFO and How Does It Work Across Multiple Businesses?
Group-level finance, consolidated reporting and intercompany control, with a worked example.
Whether it's tax, CFO
or strategic finance.
Whether you are seeking tax optimisation, CFO advisory or strategic finance support, we respond promptly and work with precision. No junior gatekeepers. You speak directly to Bharat Varsani FCCA.
19-21 Westfield Lane
Harrow, London HA3 9ED