Growing Together
Investor Presentation
May 2026
Cover O
o/s new photo
ption
Extendicare (TSX: EXE)
Canada's largest seniors' care provider focused on long-term care and home health care
58 years
Strong growth opportunities: Organic growth driven by demographic trends augmented by deep acquisition pipeline in a fragmented Canadian market
Industry leading performance: Technology platform in the cloud enables high quality, efficient service delivery and acquisition synergies
Strong balance sheet: Low leverage and free cash flow support acquisitions and shareholder returns
Capital efficient: Joint venture with Axium Infrastructure enables long-term care growth with minimal capital requirements
Revenue stability: Over 90% of revenue is derived from government contracts that insulate results from the economic cycle
~$228Mpro forma available liquidity(1)
~41%payout ratio(2)
of providing seniors' care
~2.8xpro forma debt to adjusted EBITDA (1)
$0.5292annual dividend/share
1968
(1) Pro forma available liquidity reflecting the impact of the April 2026 CBI acquisition and Notes Offering, refer to slides 8, 12 and 16
Direct care for seniors
NOI contribution by segment (before CBI) (1)
Long-term care
59
Long-term care homes owned
TTM Q1 2026 Adjusted NOI(1) $244.5M
$35.8M
services 14.7%
Managed
41.3%
Home health care
$100.9M
44.1%
Long-term care
$107.8M
Home health care
Home health care
14.5M hours(4)
CBI Home
Health adds ~10M hours
Managed services Geographically diversified operations(2)
Management & consulting
40
Homes under contract
Group purchasing
157K
Third-party & JV beds served
Province
ON
AB
MB
BC
QC
Other
Total
LTC homes owned
39
14
6
-
-
-
59
- beds
5,660
1,514
973
-
-
-
8,147
Home health care hours delivered (TTM 000's)
12,884
429
-
-
-
581
13,894
Assist and JV beds under management contract(3)
5,259
-
978
-
-
-
6,237
SGP 3rd party & JV beds served
58,682
19,721
2,140
31,457
35,911
9,161
157,072
Positioned for
GROWTH
High growth business model to expand home health care services and build new LTC homes through capital efficient JV with Axium to generate managed services revenue
TTM Q1 2026 adjusted NOI excludes out-of-period items, refer to slide 15 for details and the impact
Figures as at March 31, 2026
Represents 40 homes, including 28 operational LTC homes owned in the joint ventures with Axium in which the Company has a 15% managed interest 4
Business model enables growth without significant capital requirements
Building new LTC homes to address the rising demand for long-term care |
|
|
|
Enhancing home health services to ease health care system strain |
|
|
3x
3.0
2.5
2.0
(millions)
1.5
1.0
0.5
0.0
2x
2.70
1.61
0.86
2006 2011 2016 2021 2026 2031 2036 2041 2046 2051
Observed Projected
Source: Statistics Canada, Table 17-10-0057-01, Projected population as of July 1, 2025, released January 2026
Source: Ontario Ministry of Long-Term Care Client Profile Database (CPRO), September 2025
The Conference Board of Canada; Sizing Up the Challenge; Meeting the Demand for Long-Term Care, November 2017 5
Compelling growth in long-term care and home health care
From 1996 to 2006, over 23,000 LTC beds were added in Ontario, raising the ratio to a high of 99 beds per 1,000 Ontarians aged 75+
From 2006 to 2024, only 4,200 LTC beds were added, despite a growing seniors' population
The ratio has fallen to 57 beds per 1,000, with over 50,000 people4 on the LTC waitlist
To maintain the current ratio, Ontario must add 4,000 beds annually as the aged 75+ population grows
Ontario LTC beds per 1,000 people over 75
94
99
93
94 92 90
93
57
60
62
64
67
72
94
99 96
90
88
86
84
82
81
79
77
74
94 92 90
88
LTC beds per 1,000 Ontarians aged 75+
100
90
80
70
60
50
40
30
20
10
1996-97
1997-98
1998-99
1999-00
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
2016-17
2017-18
2018-19
2019-20
2020-21
2021-22
2022-23
2023-24
2024-25
0
Licensed beds per 1,000(1)
Beds in operation per 1,000(2)
Closed 3rd and 4th ward beds(3)
Source: Financial Accountability Office of Ontario, April 2025, Nov 2025.
Beds in Operation = Licensed Beds - Closed 3rd and 4th Ward Beds.
Source: OLTCA Home Profile Data, Nov 2025.
Ontario LTC beds per 1,000 people aged 75+Development activity has not kept up with growing demand; home health care bridges the gap
- Robust demand for home health care services driven by aging Canadian population, strained hospital system, limited supply of LTC homes and strong preference to age at home
- Margin growth as technology-enabled back-office drives scalable, efficient service delivery
- Ontario government is making significant investments in home health care; $2.2 billion to be invested over the next 3 years to expand home care capacity; 2026 bill rate increases remain uncertain
99% of ParaMed revenue from provincial government contracts
Volume growth TTM Q1 2026 +40.1%
from 2023
(16.2% CAGR)
$120M
$100M
$80M
$60M
$40M
$20M
0
14M
Adjusted NOI margin(1) TTM Q1 2026 at 13.5%
a multi-year high
12M
10M
8M
6M
4M
Home Health Care Adjusted NOI & NOI Margin(1)
12.8%
13.5%
11.4%
9.4%
2023 2024 2025 TTM Q1-26
Home Health Care Hours of Service
13.0
11.0
9.9
13.9
2023 2024 2025 TTM Q1-26
16%
14%
12%
10%
8%
6%
4%
2%
0%
(1) Adjusted NOI & NOI margins exclude items as outlined on slide 15
Home health careIndustry leading recruiting, training programs and technology platform support strong volume and NOI
growth; highly fragmented market offers M&A opportunities
$504M
Revenue(1)
(FY 2025)
$69.6M
Adjusted EBITDA(1)
(FY2025)
- $570 million acquisition closed April 1, 2026
Advances Extendicare's services focused strategy
Highly complementary to ParaMed, with substantial presence in Western Canada and the potential for significant synergies
~10M hours Annual Volume (2024A)
~8.5k Team Members
- Enhances Extendicare's ability to deliver innovative care models including hospital to home programs and specialized community services
The acquisition creates the largest home health care platform in Canada
Funded with $200 million common share issuance in December 2025, and an upsized credit facility
(1) CBI Home Health results on a standalone basis for the year ended December 31, 2025, adjusted for estimated IFRS 16 lease accounting adjustments of $5.5M, net of Extendicare Quality of Earnings (QoE) EBITDA adjustments of $3.3M and excludes approximately $15.0M in out of period adjustments for retroactive funding and workers compensation rebates related to prior periods. (further details can be found on Extendicare's press release issued on May 12, 2026 and the Business Acquisition Report ("BAR
Closed CBI Home Health acquisitionCreates a national home health care platform
LTC segment has returned to pre-pandemic occupancy and NOI
Extendicare operates 59 fully owned LTC homes
Provincial funding model enables stable operating margins
-
Annual rate increases mitigate the impact of inflation
and support more hours of care
$100M
$80M
$60M
$40M
$20M
0
Adjusted NOI margin(1) TTM Q1 2026 at 11.6%
+70 bps from 2025
100%
95%
90%
85%
LTC Adjusted NOI & NOI Margin(1)
10.4%
10.9%
11.6%
8.4%
2023 2024 2025 TTM Q1-26
LTC Average Occupancy
Average occupancy consistently above the 97% needed to receive full funding
59 fully owned LTC homes with 8,147 beds
97.4% 97.9% 98.1% 98.1%
12%
10%
8%
6%
4%
2%
0%
80%
2023 2024 2025 TTM Q1-26
Adjusted NOI & NOI margins exclude items as outlined on slide 15
Long-term care
Industry-leading scale and improved operating performance driving NOI growth
Upgrading our portfolio quality, driving management fee growth
Six LTC homes (1,408 new beds) under construction in Axium JV to replace 1,072 Class C beds
Opened Beauclaire (320-beds, Ottawa) in May 2026, on track to open Forest Trail (256-beds, Peterborough) later this year
Pipeline of 17 projects representing more than
~3,500 beds to replace ~1,600 Class C beds
Redevelopment funded via capital-efficient JV strategy
Sold the vacated West End Villa Class C home for
$12.1M in February 2026
Sold the Sudbury 320-bed project into the Axium JV in early Q2
Redevelopment projects
# of beds
# Class C beds replaced
Expected opening
Estimated development costs (1)
($ millions)
Forest Trail (Peterborough)
256
172
Q3-26
104.9
Orleans (Ottawa)
256
240
Q1-27
103.3
St. Catharines
256
152
Q1-27
106.4
Port Stanley
128
60
Q1-27
52.7
London
192
170
Q2-27
77.7
Sudbury
320
278
Q1-29
125.9
1,408
1,072
570.9
(1) Development costs are defined on an IFRS basis (which includes the cost of land, hard construction and soft development costs, furniture, fixtures and equipment,
Building for the futureTwo new homes opening in 2026; recycled capital from sale of legacy Class C home in Q1
- Highest margin segment, focused on expanding service offerings and geographic reach
Extendicare's managed services segment has two offerings:
Extendicare Assist: provides management, consulting and other services to third parties and its own joint ventures, enabling clients to provide high-quality, cost-efficient services in a complex regulatory environment
SGP Purchasing Network: Offers access to cost-effective products and services to other seniors' care providers
- Substantially insulated from inflation with minimal capital needs
$45M
$30M
$15M
0
Managed Services NOI and NOI Margin
52.5%
53.5%
55.0%
55.4%
2023 2024 2025 TTM Q1-26
Assist Management Contract Beds
(at period end) (1,2)
6,237
6,237
9,783 9,909
2023 2024 2025 TTM Q1-26
SGP Purchasing Network Beds
(at period end, 3rd party & JV)(2)
136,164
146,292 153,575 157,072
70%
60%
50%
40%
30%
20%
10%
0%
Consistent 50-55% NOI margins(3)
Operate 40 LTC homes, with 6,237 beds(2)
SGP 3rd party & JV clients
~157,100 beds
+12.0% CAGR since
Q1 2023
Assist management contracts declined in Q2 2025 largely due to Revera's sale of 21 Class C homes to a third party on May 1, 2025 and 9 Class C homes to Extendicare on June 1, 2025, resulting in the termination of management agreements with Extendicare Assist
Includes 28 homes (3,886 beds) in the joint venture with Axium in which Extendicare owns a 15% managed interest
2023 2024 2025 TTM Q1-26
Managed services | Extendicare Assist and SGPGrowth in SGP purchasing clients and management clients drive NOI growth
As at March 31, 2026 | |||
Cash | Available Revolving Facility | Long-term debt(1) | |
Reported | $321M | $154M | $366M |
Pro forma(3) | ~$67M | $161M | $714M |
Debt Metrics(1) 10.0x 10.6x
38.6%
7.4x
37.0%
7.9x
31.4%
26.0%
25.5%
4.2x4.0x
2.6x
2.3x
2.1x
1.9x
2022 2023 2024 2025 TTM Q1-26
TTM interest coverage Debt/Adjusted EBITDA Debt/GBVDebt maturities as at March 31, 2026(2)
($ millions)
Subsequent to Q1, capital structure changes improve maturity profile and cost of capital
2026 2027 2028 2029 2030 Thereafter
~$161M(3) available on new $250M senior unsecured revolving credit facility
166.3
Delayed draw term loan fully repaid subsequent to Q1 with proceeds from Senior Unsecured Note offering
Mortgage/loan principal at maturity Mortgage amortization
Lease liabilities
Delayed draw term loan
43.1
44.0
6.5 2.5 6.9
7.2 2.9
6.7 2.2
7.1 1.8 12.1 6.6 1.5
7.9
5.2
Improved maturity profile with unsecured revolving facility maturity extended to April 2029 and 5-year $450M senior unsecured notes (BBB stable) maturing in April 2031
Pro forma Debt to Adjusted EBITDA(4) is estimated to be
~2.8x(4) reflecting the CBI Acquisition and the full-year impact of the 2025 transactions
Pro forma Debt to Adjusted EBITDA based on Extendicare's pro forma Adjusted EBITDA for the trailing twelve months ended March 31, 2026 plus the annualized impact of the Closing the Gap and LTC Transactions and
$61.9 million of pro forma Adjusted EBITDA for CBI Home results on a standalone basis for the twelve months ended July 31, 2025, adjusted for estimated lease accounting adjustments of $5.5M, net of Extendicare Quality of Earnings (QoE) EBITDA adjustments of $3.3M (further details can be found in Extendicare's Q4 2025 MD&A and in the press release issued on November 19, 2025 announcing the acquisition of CBI Home Health, as filed
Debt includes current portion of long-term debt and letters of credit drawn on the revolving credit facility; excludes deferred financing costs
Debt maturities exclude letters of credit drawn on the revolving credit facility
Pro forma cash, pro forma available revolving credit facility and pro forma long-term debt based on Extendicare's as at March 31, 2026 results, including letters of credit drawn on the revolving credit facility and excluding deferred financing costs, reflecting the impact of the CBI acquisition closed April 1, 2026 and the Notes Offering closed April 14, 2026 as outlined on Slide 16. Further details can be found in Extendicare's Q4 2025 MD&A as filed on SEDAR+ at https://www.sedarplus.com
on SEDAR+ at https://www.sedarplus.com and on Extendicare's website at https://www.extendicare.com) and the impact of the CBI acquisition closed April 1, 2026 and the Notes Offering closed April 14, 2026 on the pro forma longterm debt outlined on Slide 16.
12
Strong liquidity and credit metrics~$228M of available liquidity pro forma CBI acquisition and senior unsecured note offering
Appendix
o/s new photos
Q4-25 deck
Identify Project
Pipeline of 17 projects representing more than 3,500 beds replacing
~1,600 C beds
Develop Project
Acquire land, design and tender project, secure permits & MLTC approval to construct
Sell Project to JV
Sell project to JV, with reimbursement to Extendicare of upfront land, project planning and construction costs incurred prior to sale, and opportunity for gains on sale and development
Manage Construction & Commissioning
Extendicare earns development fees during construction
Manage Operations
Recycle Capital
Sell vacated Class C home, recycling capital into redevelopment and 15% interest in the JV for new projects
Extendicare earns management fees for the term of the 30-year government license
+
15% share of JV earnings
Joint Venture
Development Fees
Management Fees
JV acquires project 85% Axium/15% Extendicare
JV assumes construction contract & project financing (backstopped by Axium & Extendicare guarantees)
Development fees paid to Extendicare to manage construction and commissioning of the new home
Distributions on
JV owns the new home and pays recurring management fees to Extendicare
Distributes excess cashflow to JV unitholders
15% JV interest
Joint Venture with Axium InfrastructureFunds LTC redevelopment and expansion, driving revenue growth in Managed Services
2023 results impacted by COVID 19 related funding and costs and other out-of-period items
LTC recognized COVID-19 related funding and costs of $27.7M and $15.6M, respectively, for a net $12.1M impact to NOI
LTC recognized out-of-period funding of $6.6M
Home health care recognized $1.0M of COVID-19 related funding and costs
2024 results impacted by out-of-period funding and costs
LTC recognized out-of-period funding of $15.3M
Home health care recognized $13.6M of retroactive funding and offsetting one-time costs in Q1 2024 in connection with the 6.7% rate increase announced in Q4 2023
2025 results impacted by out-of-period funding and costs, and workers compensation rebates
LTC recognized $2.3M of out-of-period funding offset by $2.3M of retroactive union wage adjustments
Home health care recognized $11.0M of retroactive funding and offsetting one-time costs in Q1 2025 in connection with the 4% rate increase announced in Q4 2024
LTC and home health care recognized workers' compensation rebates of $5.6M and $9.4M, respectively
TTM Q1 2026 results impacted by out-of-period funding and costs and workers compensation rebates
LTC recognized $5.0M of out-of-period funding, offset by
$2.3M of retroactive union wage adjustments
LTC and home health care recognized workers' compensation rebates in Q4-25 of $2.9M and $5.5M, respectively
Impact out-of-period items on Revenue, NOI, Adjusted EBITDA and AFFO/basic share | ||||
Impact on: | FY 2023 | FY 2024 | FY 2025 | TTM Q1 2026 |
Revenue | ||||
Long-term care | $34.3M | $15.3M | $2.3M | $5.0M |
Home health care | $1.0M | $13.6M | $11.0M | - |
NOI and Adjusted EBITDA | ||||
Long-term care | $18.7M | $15.3M | $5.6M | $5.6M |
Home health care | - | - | $9.4M | $5.5M |
AFFO AFFO/basic share(1) | $0.161 | $0.146 | $0.135 | $8.8M $0.092 |
(1) TTM Q1 2026 AFFO/basic share computed using Q1 2026 weighted average shares of 95.371 million 15
Adjustments to revenue, NOI, EBITDA and AFFOYears ended December 31, 2023, 2024, and 2025, and twelve months ended March 31, 2026
Closed CBI Acquisition
(April 1, 2026)
Issued $450M Senior Unsecured Notes (Morningstar DBRS: BBB stable)
(April 14, 2026)
Source and Use (in millions)
Sources
Source and Use (in millions)
Sources
Equity Issuance (net of fees) | $ 191.5 |
Delayed Draw Term Loan | $ 154.5 |
Revolver Draw | $ 153.7 |
Cash & Cash Equivalents | $ 82.5 |
Total Sources of Funds | $ 582.2 |
4.345% April 2031 Senior Unsecured Notes $ 450.0
Total Sources of Funds $ 450.0
Uses
Uses
Repayment of Delayed Draw Term Loan Partial Repayment of Revolving Facility
$ 327.7
$ 100.0
Purchase Price | $ 572.6 | Financing Fees | $ 2.0 | |
Transaction & Financing Fees | $ 9.6 | General Corporate Purposes and financing fees | $ 20.3 | |
Total Uses of Funds | $ 582.2 | Total Uses of Funds | $ 450.0 |
Concurrent with the Senior Unsecured Note offering, amended senior secured credit facility to a $250 million senior unsecured revolving facility, maturing April 2029
Inaugural $450M Senior Unsecured Note OfferingCBI Acquisition provided the catalyst to issue BBB stable senior unsecured notes
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Extendicare Inc. published this content on May 31, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on June 01, 2026 at 00:49 UTC.
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