How much is my hospice worth?
Most operating hospices sell for 3 to 7 times earnings. Where yours lands depends on average daily census, aggregate cap headroom, survey history, and how much of the agency runs without you.
Typical ranges by census
These are the ranges we see in current transactions. They are a starting point, not a quote.
- Average daily census under 25: about 3.0x to 4.0x seller's discretionary earnings (SDE). The buyer is mostly paying for the license and the referral base.
- Census of 25 to 75: about 4.0x to 5.5x adjusted EBITDA. This is the heart of the market.
- Census above 75: about 5.5x to 7.0x adjusted EBITDA. Sponsor-backed and regional buyers compete here.
SDE or EBITDA?
Smaller hospices where the owner works in the business are priced on SDE: net profit plus the owner's salary and benefits and any one-time costs. Larger hospices with a management team are priced on adjusted EBITDA, which keeps a market salary for whoever runs the agency.
Using the wrong figure can move the price by a lot, so settle this before you share any number with a buyer.
What pushes the number up or down
- Cap headroom: buyers look at three cap years, not one. A cap liability that has not been demanded yet still gets priced, either as a lower offer or as escrow.
- Length of stay and referral mix: a base weighted to assisted living means longer stays and tighter cap headroom than a hospital discharge base.
- Survey history: standard-level findings are normal. Condition-level findings change the buyer's diligence budget and their view of clinical leadership.
- Owner dependence: if the owner is also the administrator, the marketer, or the main referral relationship, buyers discount for transition risk.
- Census trend over the last 24 months, and staff retention.
Hospices with little or no census
A certified hospice with no patients is not priced on earnings. Buyers pay for time saved: Medicare enrollment, accreditation, and state licensure they would otherwise wait many months for.
That value has gone up since CMS paused new hospice Medicare enrollments in May 2026, because buying an existing certified agency became the main way into the program. Price still depends on state, enrollment age relative to the 36-month rule, accreditation, and how clean the record is.
Get a number for your hospice
A free, confidential valuation from Riverbluff uses your census, three years of financials, cap position, and survey record. It is written by a broker who has run a healthcare agency, it takes about one business day, and you keep it whether or not you sell.