Why We Think In-Home Senior Care Businesses Are a Great Acquisition Target

October 19, 2026 · Ben Sampson · 15 min read

TL;DR:

The Federal Reserve's 2025 Survey of Consumer Finances, released October 9, 2026, shows families headed by someone 75 or older saw median net worth jump 37% since 2022 to $504,900. They are now the wealthiest age group in the survey.
Baby Boomers hold roughly $97 trillion, about 52% of all U.S. household wealth, per the Fed's Distributional Financial Accounts for Q2 2026.
75% of adults 50 and older want to stay in their current home as they age (AARP). That makes in-home care the default choice, not the fallback.
Non-medical in-home care is the cleanest way to own this trend: no real estate, no Medicare certification, and small-agency asking prices that median around 1.3x SDE on current listings.
Demand is not the problem. Staffing is. Caregiver turnover runs 75% to 80% a year. Buy an agency that has solved recruiting, or buy one you are confident you can fix, and growth largely takes care of itself.

Why is in-home senior care a strong acquisition target right now?

Because the largest, wealthiest cohort of retirees in history is entering the age where it needs help at home, and it would very much prefer to stay there.

The demographic math is not a forecast so much as a calendar. Per the Census Bureau's national projections, every Baby Boomer will be 65 or older by 2030, and roughly 1 in 5 Americans will be at retirement age. By the mid-2030s, Americans 65 and older are projected to outnumber children for the first time in U.S. history. The 85-and-older population, the group most likely to need daily help, is projected to roughly triple by 2060.

The oldest Boomers turn 80 this year. That is the age when "Mom is fine" quietly becomes "Mom needs someone there a few hours a day." Most families make that call in a kitchen, not a sales funnel, which is why a well-run local agency grows by referral.

An elderly walrus in a bathrobe clings to his cottage doorframe while his grown children try to coax him away, and a hedgehog caregiver arrives with a casserole — Three in four adults over 50 want to stay put. The product is help arriving at the front door, not a move.

Three things make this different from the usual "aging population" pitch deck:

The customers have money. Not all of them, but more than any elderly cohort before them (next section).
The customers want the product. 75% of adults 50 and older want to stay in their current home as they age, and 73% want to stay in their community, per AARP's 2024 Home and Community Preferences Survey.
The product is cheaper than the alternative. A home health aide runs a national median of about $34 an hour. A private nursing home room runs a median $129,575 a year, per the 2025 CareScout (formerly Genworth) Cost of Care Survey. For families who need part-time help, in-home care is the obvious first purchase.

How much money do older Americans actually have?

More than any other age group. The Fed's 2025 Survey of Consumer Finances, released October 9, 2026, made it official: families headed by someone 75 or older now have the highest median net worth of any age bracket.

Metric (Fed SCF 2025, inflation-adjusted)	Families 75+	Families under 35
Median net worth, 2025	$504,900	$33,000
Change in median net worth, 2022 to 2025	+37%	-23%
Mean net worth, 2025	$1.96M	$135,400
Change in median income, 2022 to 2025	+24% (to $66,800)	+2%

For context, median net worth across all U.S. families rose just 2% over the same period, to $215,900.

Zoom out to the whole generation and it gets bigger. The Fed's Distributional Financial Accounts put Baby Boomers at about $97.4 trillion in net worth as of Q2 2026, roughly 52% of the $185.7 trillion U.S. total, despite making up about 30% of households.

Why this matters to a buyer: non-medical home care is mostly private pay. Medicare does not cover custodial help like bathing, dressing, meals, and companionship. That bill goes to the family, long-term care insurance, or in some states a Medicaid waiver. An agency whose clients pay out of a half-million-dollar median balance sheet, with income that grew 24% in three years, has a customer base that is unusually insensitive to a $2 rate increase.

One honest caveat: averages flatter. The median 75+ household is comfortable, not rich, and much of that wealth sits in home equity. Underwrite your specific market's demographics, not the national headline.

Why buy in-home care instead of assisted living or senior housing?

Because you get the same demographic tailwind without buying a building. Assisted living is a real estate business with a care business stapled on. Non-medical in-home care is a people business with a laptop.

Senior care model	Real estate required	Regulatory burden	Who pays	Capital intensity	Primary risk
Non-medical in-home care	None (small office, often optional)	State license in many states; no Medicare certification	Mostly private pay, long-term care insurance, some Medicaid waiver	Low: working capital for payroll	Caregiver recruiting and retention
Medicare-certified home health	None	Medicare certification, CMS surveys, clinical leadership (RN/DON)	Medicare, Medicare Advantage	Low to moderate	Reimbursement cuts, compliance
Assisted living	Yes: own or lease the facility	State facility licensing, life safety inspections	Mostly private pay	High: property, capex, occupancy ramp	Occupancy, cap rates, debt
Adult day care	Yes: dedicated facility	State licensing	Private pay, Medicaid, VA	Moderate	Utilization, transportation

What this means in practice:

Smaller checks. A single-location non-medical agency often trades in the low-to-mid six figures. That is SBA 7(a) territory with a manageable equity injection, not a real estate syndication.
No occupancy risk. An empty assisted living bed still carries a mortgage. An unfilled home care shift costs you nothing but the revenue.
Variable cost structure. Caregiver wages are the biggest expense, and they are only paid when a shift is billed. Gross margin moves with volume rather than collapsing when it drops.
Simpler compliance. No Medicare certification means no CMS survey cycle, no star ratings, and no clinical director requirement on the org chart. Your state's licensing rules still apply, and they vary a lot. Check them before the LOI.

What does a home care business cost to buy?

Small non-medical agencies are cheap on paper, and the multiple expands sharply with scale. That gap is the opportunity.

Segment and size	Typical multiple	Source
Non-medical, small agencies (asking prices)	Median 1.26x SDE; middle half 1.06x to 2.70x	Main Street Index, Oct 2026, n=246 listings
Non-medical, owner-run (under ~$2M enterprise value)	~2x to 3.5x SDE	Ad Astra Equity, 2026
Non-medical, under $5M revenue	3x to 5x adjusted EBITDA	Ad Astra Equity; Focus Bankers
Medicare home health, small (asking prices)	Median 4.00x SDE	Main Street Index, n=45 listings
Non-medical, $5M to $15M EBITDA	7x to 9x EBITDA	CT Acquisitions, 2026
Non-medical, $50M+ EBITDA	9x to 11x EBITDA	CT Acquisitions, 2026

Two reads on this table.

First, the median small listing asks about $252,500 for $213,000 of annual owner earnings. Treat that with suspicion, not excitement. Many of those listings are owner-operator jobs where the seller is also the scheduler, the recruiter, and the 2 a.m. fill-in caregiver. Asking prices are not closed prices, and SDE is only real if it survives the owner leaving.

Second, the spread between 1x to 3x at the bottom and 7x to 11x at the top is the whole thesis for a roll-up. Private equity is paying platform multiples for scaled agencies (CT Acquisitions cites TEAM Services Group's April 2026 sale to General Atlantic at roughly 10x). Buy small, professionalize recruiting, add locations, and you are manufacturing the asset those buyers want.

For a realistic single-location example: a franchise resale recently listed in Sarasota, Florida showed about $1.36M in revenue and $191K in SDE, asking $521K, or roughly 2.7x SDE. Stable revenue across 2023 to 2025, no medical background required.

What is the biggest risk in buying a home care agency?

Staffing. Not demand, not competition, not reimbursement. A home care agency is a recruiting business that happens to deliver care.

A beaver agency owner warmly shakes hands with new otter caregivers at the front door while others climb out the window behind him — Most home care agencies hire all year and still shrink. The turnover happens behind the owner's back, mostly in the first 90 days.

The numbers are blunt:

Caregiver turnover ran about 77% in 2024 and 75% in 2025, per industry data compiled by EngineHire.
Most of the churn is early: roughly 80% of turnover happens in the first 90 days.
59% of agencies report operating with insufficient staff, and about one in four clients who need care are being turned away, per ShiftCare.
Replacing a caregiver costs roughly $2,600 to $5,000 per hire once you count recruiting, onboarding, and lost shifts.
The Bureau of Labor Statistics projects more than 6.1 million job openings for home health and personal care aides from 2024 to 2034, second among all U.S. occupations.
Immigrants make up roughly a third of the home health workforce (KFF), which makes immigration policy a real supply variable.

Here is the upside hiding in that list: when one in four clients gets turned away, the agency that can actually staff shifts does not need a marketing budget. Hospital discharge planners, elder law attorneys, and adult children all call whoever answers and says yes. That is why a properly staffed agency tends to grow organically.

How do the best operators solve home care staffing?

Pay matters until you are at market. After that, stability matters more. Agencies with the lowest turnover tend to share the same habits:

Pay at or above local market, then stop competing on wage alone. Being $1 below market loses caregivers. Being $1 above it rarely keeps them by itself.
Offer consistent clients and predictable hours. Caregivers leave over chaotic schedules and part-time hours as often as over pay. Matching a caregiver to the same client builds loyalty on both sides.
Run recruiting like a sales funnel. Always-on job ads, a mobile application that takes minutes, same-day interviews, and a tracked time-to-fill. If the owner "recruits when someone quits," the agency is already behind.
Obsess over the first 90 days. Shadow shifts, scheduled check-ins at week one and month one, and a named point person. This is where most of the turnover lives.
Pay fast and transparently. Scheduling and payroll that show caregivers their logged hours immediately remove a common source of distrust.
Track turnover by tenure cohort. Under 90 days, 90 days to a year, over a year. A blended turnover number hides whether you have an onboarding problem or a culture problem.
Build a referral engine. Your best caregivers know other good caregivers. A meaningful referral bonus, paid after the new hire's 90th day, is usually the cheapest recruiting channel available.

If you are evaluating a target, these are also your diligence questions. An agency with mediocre financials and a strong recruiting machine is often a better buy than the reverse.

What should you check in home care business due diligence?

Start with the caregivers, then the clients, then the license. The financials only mean something once those three hold up.

Area	What to request	Green flag	Red flag
Caregiver retention	24 months of hires and terminations by tenure cohort	90-day survival improving; a core of tenured caregivers	Blended turnover only; no records by cohort
Recruiting engine	Applicant volume, time-to-fill, hire sources	Repeatable channels; referral program with payouts	Owner personally recruits on demand
Client concentration	Revenue by client and by referral source	No client over ~5% of revenue; several referral sources	One facility or one case manager drives most starts
Payer mix	Revenue by private pay, LTC insurance, Medicaid, VA	Mostly private pay and LTC insurance	Heavy single-state Medicaid waiver exposure
Hours and margin	Billed hours by month, bill rate vs. caregiver wage	Stable or rising hours; gross margin holding as wages rise	Hours falling while revenue is propped up by rate increases
Owner dependence	Org chart, who schedules, who handles intake	Office manager and scheduler in place	Owner is the scheduler, recruiter, and backup caregiver
Licensing and transfer	State license, franchise agreement if any	License transfers cleanly; franchisor approval path is clear	Change of ownership triggers a new license application with a long timeline
Employment compliance	W-2 vs. 1099 status, overtime and travel-time pay practices	W-2 caregivers; overtime handled correctly	1099 caregivers or unpaid travel time (wage claim exposure)

Two structural points worth negotiating into the deal: a seller note or earnout that rewards caregiver and client retention after close, and a transition period long enough for referral sources to meet the new owner. Our LOI guide covers how to frame both.

How do you find a home care business for sale?

Search every marketplace at once for the on-market deals, then go direct to owners for the ones that never get listed.

On-market: home care listings are scattered across BizBuySell, broker sites, franchise resale boards, and a dozen smaller marketplaces, often duplicated with slightly different numbers. Accredited Pro pulls listings from 12 marketplaces and deduplicates them into one searchable database (70,000+ unique businesses), with comps and benchmarks so you can see whether a 1.3x ask is a bargain or a warning sign. Set a saved search for home care in your target metros and get alerted when something new hits.

Off-market: the best agencies are often run by a 68-year-old founder who has never thought about selling until a letter shows up. Accredited Pro's off-market sourcing finds home care agencies by geography, enriches owner contact details, and lets you send personalized letters by First Class mail at scale. Read our off-market outreach guide for templates and response-rate expectations.

There is a nice irony here. Many home care founders are Boomers themselves, which means the same demographic wave driving demand is also driving the supply of agencies for sale. More on that in our Silver Tsunami analysis.

Start a 7-day Accredited Pro trial and run your first home care search today.

Frequently Asked Questions

Is a home care business a good investment in 2026?

For a buyer who can solve staffing, yes. Demand is backed by an aging population, a strong preference for aging in place (75% of adults 50+ per AARP), and the wealthiest elderly cohort on record, with families 75+ now holding a $504,900 median net worth per the Fed. The binding constraint is caregiver supply, not client demand.

What is a non-medical home care agency worth?

Small non-medical agencies list at a median of about 1.26x SDE, with most between roughly 1x and 2.7x. Owner-run agencies that sell typically land around 2x to 3.5x SDE. Agencies with $5M to $15M of EBITDA trade around 7x to 9x EBITDA, and the largest platforms around 9x to 11x.

What is the difference between home care and home health?

Non-medical home care provides personal help such as bathing, dressing, meals, and companionship, and is mostly paid privately. Home health is skilled medical care ordered by a physician, delivered by a Medicare-certified agency, and paid mainly by Medicare. Home health carries higher multiples and much heavier regulation.

What is the biggest challenge in running a home care agency?

Caregiver recruiting and retention. Industry turnover runs about 75% to 80% a year, most of it in the first 90 days. Agencies that pay at market and offer consistent clients and predictable hours retain far better.

Do you need medical experience to buy a home care business?

Not for non-medical home care. Owners need operating skill in recruiting, scheduling, and local referral relationships. Licensing requirements vary by state, so confirm what your state requires for a change of ownership before signing an LOI.

Can you use an SBA loan to buy a home care agency?

Generally yes. Non-medical home care agencies are common SBA 7(a) acquisitions because they produce documented cash flow and require little fixed collateral. Lender appetite, equity injection, and seller note terms depend on the deal and current SBA rules. Our SBA SOP 50 10 8.1 breakdown covers what changed on October 1, 2026.

Sources

Disclaimer

This article is for informational purposes only and is not investment, legal, tax, or lending advice. Valuation ranges are drawn from third-party listing data and advisor reports, reflect asking prices or broad market ranges, and will differ from any specific transaction. Home care licensing, employment, and Medicaid rules vary by state. Consult qualified advisors before acquiring a business. Accredited does not broker transactions.