TFSA: 2 Income Stocks That Pay Monthly Cash

The healthcare sector is one of the best places to invest, especially for long-term dividends.

If you’re an income investor, monthly paycheques from your portfolio can make life a lot smoother. Instead of waiting every quarter, you get consistent cash flow that covers bills or can be reinvested to grow your wealth faster. On the TSX, a few names stand out for their steady monthly payouts. Two that have been making headlines this year are Extendicare (TSX: EXE) and NorthWest Healthcare Properties REIT (TSX:NWH.UN). Both cater to essential sectors of senior care and healthcare real estate, but the paths over the past year have been very different.

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EXE

Extendicare is on a strong run. Over the last 12 months, its share price has surged more than 70%, driven by solid earnings growth and aggressive expansion. Its most recent quarter showed adjusted earnings before interest, taxes, depreciation, and amortization (EBITDA) up 15% year over year, fuelled by acquisitions and rising demand in home healthcare.

The purchase of nine long-term care homes from Revera and the acquisition of Closing the Gap have expanded both its footprint and its service capacity. With home health care average daily volume climbing 10.9% and third-party beds under management increasing, the business is scaling efficiently. Revenue rose 11.4% compared to the same quarter last year, and net earnings jumped by $6 million to $31.9 million.

This momentum supports powerful demographic tailwinds. Canada’s aging population is driving higher demand for both home and long-term care services, and the Ontario government’s new capital funding policy for LTC construction adds another layer of growth potential. The stock’s forward yield of around 3.8% may not be the highest in the sector, but the steady monthly dividend and improving adjusted funds from operations suggest room for future increases. The main watchpoint is integration risk; absorbing recent acquisitions smoothly will be key to keeping margins healthy. Rising labour and technology costs could also pressure profitability if not managed carefully.

NWH

NorthWest Healthcare Properties REIT, however, has been more of a recovery story. Over the past year, the unit price has been volatile, still down slightly from where it started despite some major improvements in operations. The real estate investment trust (REIT) spent much of 2024 and 2025 selling non-core assets, with over $260 million so far this year, and is using proceeds to pay down debt. These moves have brought leverage down from over 50% to about 48.6% post-quarter, while also extending debt maturities and reducing average interest costs.

Its first-quarter results showed adjusted funds from operations of $0.10 per unit, matching last quarter and up from $0.09 a year earlier. The AFFO payout ratio has improved to 92% from 105% last year, a sign that the distribution, currently yielding about 7.5%, is on a more stable footing. Operationally, the REIT posted 4.5% same property net operating income growth, with occupancy holding at a strong 96.5% and a long weighted average lease expiry of 13.6 years. Hospitals, clinics, and healthcare facilities across several continents anchor that stability.

Still, there are challenges to watch. A key tenant in Australia, Healthscope, has been granted partial rent deferrals while it works through a potential sale or recapitalization. While the REIT has put safeguards in place, tenant-specific risks like this can create uncertainty in cash flows. Dispositions, while improving the balance sheet, also reduce revenue until capital is redeployed into higher-yielding assets.

Bottom line

For investors, the appeal of these two dividend stocks lies in the essential-service niches and monthly distributions. Right now, those monthly distributions could come to $47 each and every month from investing $5,000 in each stock.

COMPANYRECENT PRICENUMBER OF SHARESDIVIDENDTOTAL PAYOUTFREQUENCYTOTAL INVESTMENT
EXE$13.21378$0.50$189.00Monthly$4,994.38
NWH.UN$4.741,054$0.36$379.44Monthly$4,994.96

Both will require monitoring — Extendicare for acquisition integration and cost management, and NorthWest for tenant stability and effective capital recycling. But in a market where reliable monthly cash is rare, these two stand out as options worth considering for a diversified income portfolio. The trick will be deciding whether you want more yield today or more growth for tomorrow.

Fool contributor Amy Legate-Wolfe has no position in any of the stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.

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