Assisted living and nursing home businesses sold on BizBuySell average 4.3x SDE; senior living providers with $1M–$3M of EBITDA average 4.7x EBITDA. Occupancy, payer mix, and licensing history are the primary valuation drivers.
Assisted living facilities in the $1M–$5M revenue range are valued primarily on a multiple of EBITDA or Seller's Discretionary Earnings. Buyers adjust multiples based on occupancy rates, Medicaid versus private-pay revenue mix, staffing stability, and state licensing history. Real estate ownership can add significant value above the business multiple.
| Segment | Size / Basis | Multiple Range | Notes |
|---|---|---|---|
| Main Street sale (owner-operated) | SDE basis · median sale price $610,000 | 4.30x avgSDE | Average sale price ÷ seller's discretionary earnings for assisted living and nursing home businesses sold on BizBuySell, Q3 2021–Q2 2026. Average revenue multiple 1.35x. |
| Senior living, $1M–$3M EBITDA | $1M–$3M EBITDA | 4.7xEBITDA | FOCUS Investment Banking healthcare EBITDA multiples by subsector: senior living. |
| Senior living, $3M–$5M EBITDA | $3M–$5M EBITDA | 6.2xEBITDA | FOCUS Investment Banking: senior living. |
| Senior living, $5M–$10M EBITDA | $5M–$10M EBITDA | 7.4xEBITDA | FOCUS Investment Banking: senior living; lower volatility, tied to demographics and facility ownership. |
Ranges reflect figures published by BizBuySell and FOCUS Investment Banking; see sources below. SDE = seller’s discretionary earnings (owner pay added back); EBITDA multiples apply to larger, manager-run businesses. Sources ↓
The spread within these ranges is not random. These factors determine where a business lands.
Occupancy Rate & Trend
HighFacilities sustaining 90%+ occupancy over 24 months command top multiples. Declining occupancy signals revenue risk and compresses buyer confidence and price.
Payer Mix: Private Pay vs. Medicaid
HighPrivate-pay residents generate 20–40% higher revenue per bed than Medicaid. High Medicaid dependency reduces margins and lowers achievable multiples significantly.
Licensing & Citation History
HighA clean state license with no substantiated deficiency citations is essential. Open enforcement actions or probation status can kill deals or force deep price reductions.
Staffing Stability & Turnover
Medium-HighLow caregiver turnover and documented training programs reduce operational risk. Buyer concern over post-close staffing gaps or owner-as-caregiver dependency lowers value.
Real Estate Ownership
MediumOwned real estate adds a separate asset layer, often valued at $500K–$2M independently. PropCo/OpCo structures allow sellers to retain real estate while monetizing the operations.
Sustained demand from aging Baby Boomers is keeping valuations resilient. Rising caregiver labor costs are compressing EBITDA, pushing buyers to scrutinize staffing expense closely. SBA 7(a) financing remains active for qualified buyers, supporting deal volume in the $1M–$3M purchase price range.
Individual Operator / Search Fund
Entrepreneurship through acquisition (ETA), first-time buyers, industry-adjacent operators
What they want: Stable, transferable cash flow in a Assisted Living Facility. SBA-eligible business, strong revenue quality, and a seller available for a 12–18 month transition.
Pros for seller
Cons for seller
PE-Backed Roll-Up Platform
Private equity consolidators building a Assisted Living Facility portfolio, regional or national platforms
What they want: Scale, operational quality, and geographic coverage. Strong revenue quality with minimal owner dependency. Clean financials, documented systems, and staff who can operate without the selling owner.
Pros for seller
Cons for seller
Strategic Acquirer
Larger Assisted Living Facility operators, adjacent-industry buyers adding capacity or geography
What they want: Client relationships, staff, and market position that complement their existing operations. revenue quality is especially valuable when it fills a gap the buyer can't easily build organically.
Pros for seller
Cons for seller
EBITDA Valuation Estimator
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Industry: Assisted Living Facility · Multiples based on 6.2x (Senior living, $3M–$5M EBITDA)
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For Sellers: 4-Step Valuation Walkthrough
Compile three years of P&L statements and tax returns that reconcile line by line — SBA lenders and institutional buyers both require this, and any unexplained gap triggers diligence delays or price renegotiation.
Build a normalized EBITDA schedule with every add-back documented: owner W-2 above a market-rate manager salary, personal expenses, one-time items, and non-recurring costs. Undocumented add-backs get cut.
Address your owner dependency before going to market — this is the most common reason Assisted Living Facility businesses receive offers at the low end of the range. Buyers identify it in diligence and reprice accordingly.
Quantify and document your revenue quality with supporting records: contracts, renewal histories, client revenue breakdowns. This is the primary evidence for commanding a premium multiple, and you need it before the first buyer call.
For Buyers: Validate the Asking Multiple
Request trailing 12-month and 3-year P&L with bank statement backup before making an offer. If a Assisted Living Facility seller can't produce reconciled financials, that's a signal about what the full diligence process will look like.
Verify the revenue quality claims independently — pull contract copies, renewal documentation, and client-level revenue data. This is the primary driver of whether this Assisted Living Facility lands at the top or the bottom of the range.
Assess owner dependency directly: ask which revenue or client relationships are personal to the current owner, and what the transition plan is. An exit-ready seller has already thought through this.
Model your SBA debt service against verified EBITDA before signing the LOI. At current rates, a $1M SBA 7(a) loan runs approximately $13,000/month over 10 years — the business needs at least 1.25x debt service coverage after a market-rate manager salary.
Senior living providers with $1M–$3M of EBITDA average 4.7x EBITDA, rising to 6.2x at $3M–$5M (FOCUS Investment Banking); smaller facilities sold on BizBuySell average 4.3x SDE. Strong occupancy, private-pay mix, and clean licensing push multiples toward the high end of that range.
Real estate is typically valued separately from operations. Owned property is either included in the sale price or structured as a PropCo/OpCo lease, adding significant value above the business multiple.
High Medicaid dependency compresses margins and reduces buyer appetite. Facilities with 70%+ private-pay revenue consistently achieve higher multiples than Medicaid-heavy counterparts.
Yes. SBA 7(a) loans are commonly used for assisted living acquisitions, covering goodwill, working capital, and sometimes real estate. Buyers typically need relevant healthcare or management experience to qualify.
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