Healthcare financing has remained a challenge for many developing countries. With increasing financial constraints and persistent pressure on healthcare systems, prioritization of needs has become an issue of strategic importance in public hospitals. Notwithstanding the role of Facilities Management (FM) services in facilitating core healthcare delivery, resource allocation works to the disadvantage of FM. Given the relevance of FM services to support the core business of rendering clinical care, this paper aimed to investigate the mediating effects of finance on the performance of hospital FM services, using Ghana as a case study. In line with the exploratory sequential mixed method approach adopted by the study, experts’ interviews and thematic analysis were conducted at the exploratory stage, followed by a questionnaire survey to generate quantitative performance data which was analysed with Partial Least Squares Structural Equation Modelling (PLS-SEM). A total of 17 Key Performance Indicators (KPIs) and four performance outcomes were utilized in the study. Following the theoretical conceptions of the Balanced Scorecard, we analyzed the indirect effects of finance on the relationship between service quality, learning & growth, internal business and FM performance. The study theoretically confirmed the dominant role of finance to FM performance, given that we found significant indirect effects for all the three performance dimensions. The study should motivate hospital management to prioritize FM in hospitals as part of sustainable resource management to improve healthcare outcomes. This, however, requires healthcare managers to acknowledge the role of FM in healthcare delivery rather than seeing FM as cost centres. It is thus recommended that performance-based financing should be encouraged.