Evaluate payer mix stability, clinician retention risk, HIPAA compliance, and referral source durability before closing on an SLP practice.
Find Speech Therapy Practice Acquisition TargetsAcquiring a speech therapy practice requires scrutiny beyond standard financial review. Buyers must assess owner clinical dependency, Medicaid reimbursement exposure, SLP licensure and retention risk, and the durability of school district and physician referral relationships that drive sustainable revenue.
Verify revenue sustainability by analyzing payer mix, reimbursement rates, and owner-adjusted EBITDA across at least three years of accrual-based financials.
Quantify revenue by private insurance, Medicaid, school contracts, and direct pay. Heavy Medicaid concentration above 50% signals reimbursement rate risk and administrative burden.
Identify all personal expenses run through the practice and document legitimate add-backs to calculate true normalized EBITDA for accurate valuation and SBA underwriting.
Review accounts receivable aging and collections ratios by payer. Persistent AR over 90 days may indicate billing errors, credentialing gaps, or payer contract disputes.
Assess HIPAA compliance posture, EHR documentation quality, billing audit history, and staff licensure records to quantify regulatory and operational risk.
Review business associate agreements, PHI handling procedures, and EHR documentation standards. Any unresolved audit findings or breach history materially increases liability exposure.
Confirm all licensed clinicians hold current state licensure, required CEUs, and applicable specialty certifications. Lapses can disrupt billing and trigger payer contract violations.
Request any prior insurance or Medicaid audit correspondence. Unresolved overpayment demands or pattern billing errors represent significant post-close financial and compliance liability.
Evaluate owner dependency, clinician retention probability, referral source concentration, and appropriate deal structure to protect against revenue erosion post-close.
Determine what percentage of billable hours the owner personally generates. Owners responsible for more than 40% of revenue with no transition plan significantly elevate post-close risk.
Map revenue by referral origin — school districts, pediatricians, ENTs, direct pay. Single-source concentration above 30% warrants earnout provisions or seller retention commitments.
Review employment agreements, non-solicitation clauses, and compensation benchmarks for all SLPs. Clinician departures post-close are the most common source of revenue erosion.
Verify the Speech Therapy Practice acquisition qualifies for SBA financing, the purchase price is supportable by the verified cash flow, and the deal structure protects the buyer's downside.
Confirm the Speech Therapy Practice meets SBA 7(a) eligibility requirements: the business is for-profit, U.S.-based, within SBA size standards, and the buyer meets personal financial requirements. Some industries have specific SBA restrictions — verify before LOI.
Model verified normalized EBITDA against projected SBA loan payments at current rates. A $1M SBA 7(a) loan at 10.5% over 10 years costs approximately $13,000/month. The Speech Therapy Practice must generate at least 1.25x debt service coverage after a market-rate manager salary to pass underwriting.
Confirm the seller note is properly subordinated to the SBA loan and goes on 24-month standby as required by SBA rules. If an earnout is included, define exact measurement metrics, time period, and dispute resolution process before signing the purchase agreement.
Before signing a Letter of Intent, request these documents from the seller. Missing or incomplete items are a red flag — not a reason to proceed without them.
Most speech therapy practices trade at 3.5x–6x EBITDA. Practices with multiple employed SLPs, diversified payer mix, low owner clinical involvement, and recurring school contracts command multiples at the higher end.
Yes. Speech therapy practices are SBA-eligible businesses. SBA 7(a) loans are commonly used with 10–20% buyer equity, a seller note on standby, and loan amounts up to $5M covering purchase price and working capital.
Owner clinical dependency is the top risk. If the selling SLP generates more than 40% of revenue personally, revenue attrition post-close is likely unless a structured transition, earnout, or equity rollover is negotiated.
Request a three-year payer mix report and compare Medicaid reimbursement rates to commercial benchmarks. Also review any state audit history, overpayment notices, and compliance with current billing and documentation requirements.
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