Home Care, Home Health & Senior Living Services
| Low | 2× |
| Median | 3× |
| High | 4.5× |
| Low | 2.5× |
| Median | 4× |
| High | 5.5× |
A non-medical home care agency with $400K SDE, 70%+ private pay revenue, and strong caregiver retention (65%+ annual) typically sells for $800K–$1.8M (median 3.0× SDE). Medicare-certified home health agencies command 3.5–5.0× EBITDA. Private pay, metro-market agencies are the most sought-after asset class in senior care.
The U.S. senior care market is $525 billion annually (NIC 2024), growing at 6–8% annually as the 75+ population expands. Home health and non-medical home care (companionship, ADL assistance) are the fastest-growing segments. Medicaid reimbursement rates vary by state but provide baseline revenue stability. The primary constraint: caregiver recruitment and retention in a tight labor market. Companies with strong caregiver retention programs, training systems, and geographic density command premium valuations.
Contact-based value drivers — buyer due diligence essential.
Senior care businesses are excellent SBA candidates (approval 75–82%). The combination of aging demographics, Medicaid reimbursement stability, and high caregiver turnover creating acquisition opportunities makes this a lender-favorable industry. Lenders look for: (1) payer mix (Medicaid vs private pay vs Medicare), (2) caregiver retention rate (target >60% annual), (3) caregiver wage rates and compliance. Private pay businesses command higher multiples than Medicaid-heavy ones.
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Open Business Valuation Calculator →Three structural reasons: (1) Demographic tailwind — the 85+ population is the fastest-growing demographic, projected to double by 2040. This means revenue is virtually guaranteed to grow without any marketing investment. (2) Medicaid reimbursement is set by states and indexed to cost inflation — revenue is predictable and inflation-protected. (3) Caregiving is a local service with high switching costs — once a caregiver is trusted in a senior's home, families don't switch providers unless forced to. The result: a home care agency in a growing metro market is almost like owning a utility that grows with the population.
Caregiver turnover (annual turnover runs 50–80% industry-wide) is the #1 operational risk. A company with high caregiver turnover has: (1) higher recruiting and training costs, (2) less consistent care quality, (3) client dissatisfaction as they get assigned unfamiliar caregivers. Ask for: (1) caregiver retention rate for the past 3 years, (2) caregiver wage structure vs competitive market rates, (3) caregivers covered by non-compete agreements (prevents competitor poaching). Companies with strong culture, training, and benefits programs (health insurance, PTO, retention bonuses) have lower turnover and command higher multiples.
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